Mapping the evidence on the intersection of gender and social determinants of health in health inequality: a scoping review

BACKGROUND: For decades, researchers have acknowledged the persistence of gendered health inequalities across the world. Consequently, an intersectional approach has emerged in public health research as an important methodological advancement for studying health inequalities. However, it remains unclear how the intersection of gender with social determinants of health (SDH) shapes health inequalities across different health domains and regions. This review aims to summarise published studies comparing health outcomes between men and women across health domains and regions, framed within the context of SDH and the emerging intersectionality approach.

METHODOLOGY: This review followed Arksey and O’Malley’s framework and Levac’s recommendations. We searched electronic databases, including EMBASE, PubMed, PsycINFO, and CINAHL, using predefined inclusion criteria, resulting in 83 research papers selected for data extraction published up to March 15, 2024. Data collection, charting, and review were done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guidelines.

RESULTS: This review highlighted that the intersection of gender with SDH influenced health outcomes and contributed to unequal health care use for both men and women. Findings indicated that the intersection of gender and SDH could lead to a widened gender gap in specific health outcomes (e.g., multimorbidity or mortality risk) within a particular health domain (e.g., physical health). However, this pattern was not consistently observed across other health outcomes within the same domain. The review also found that the factors intersecting with gender to produce health inequality varied by region. In America, race and ethnicity were key factors influencing health inequality between men and women. In Europe, the intersection of economic factors and gender played a major role. In Asia and Africa, gendered health inequality was shaped by the intersection of gender with social position-identity. There were also regional differences in the focus on health domains and outcomes. Across the Americas, Asia, and Europe, physical health was the main health domain of study. Commonly explored outcomes included obesity/BMI in the Americas, cardiovascular health in Asia, and poor self-perceived health in Europe. In Africa, studies mostly looked at the health care domain, especially health-seeking behaviour.

CONCLUSIONS: Unequal social positions, identities, economic conditions, and sociodemographic factors contribute to gendered health inequality. Regional patterns reveal the need for more critical and context-sensitive research on health inequalities across genders to inform more nuanced and locally relevant public health strategies.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-25525-8.