Intersectionality of the Gender Wage Gap Among Healthcare Professionals: A Scoping Review

A growing body of research has documented persistent wage gaps between women and men in the healthcare workforce, a pattern widely observed across cadres and countries. Less well known is whether various intersecting characteristics often associated with social discrimination may exacerbate or attenuate gendered disparities. This review scopes contemporary research from diverse settings focusing on how race, ethnicity, and sexual and gender minority status may intersect in shaping earnings differentials among healthcare practitioners to help inform policy and management decisions. Studies quantifying the intersecting axes of gender and other postulated social drivers of differed practitioner earnings were identified by systematically searching five bibliographic databases (Embase, CINAHL, EconLit, SocIndex, and PsychInfo) and scanning the reference lists of review articles and other forms of the global health literature. A total of 2123 reports were retrieved; after screening, 21 articles were retained for narrative synthesis. The studies covered data from four countries (Brazil, Norway, the United Kingdom, and the United States). Physicians were researched most often (43% of the synthesized articles) followed by nurses (38%). No uniform patterns were found in gendered earnings variations stratified by race, ethnicity, and/or ancestry; however, wide variations were seen in the way the relationships were operationalized across studies and contexts. One investigation included sexual orientation as a factor in earnings gaps, but presented results combined with other personal characteristics. None of the studies examined wage data by gender minority status. This review highlighted notable limitations in the available research in relation to disaggregated measures of ethnocultural heterogeneity, robust methodologies and transparent reporting, and the underlying health workforce information systems for incorporating more diversity elements and enhancing cross-national comparability in assessments of structural wage gaps among healthcare practitioners.