Background and objective:
Gender is critical for assessing the economic and social costs associated with climate change. Health impacts of climate change on women differ from impacts on men owing to complex social contexts and adaptive capacities. The objective of this study is to identify interactions within and across four subsystems—food security, communicable and non-communicable diseases, ecological services, and extreme weather—and their influence on gender-specific health impacts.

Methods:
A systematic literature review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework was conducted to generate the database. From 62 included articles, information was extracted on health-related variables, climate induced change in the variable (positive or negative), exposure pathways and their resulting health impacts. An Influence Diagram was then developed to visualize the cause-and-effect relationships within variables and help explain the change in variables over time. A bibliometric analysis was conducted to understand the status of gender-focussed research in climate-change and health.

Results:
53 gender-specific variables were identified, with socio-economic variables playing a more dominant role than environmental. Gender was discussed most in relation to food security and least in relation to communicable and non-communicable diseases. The bibliometric analysis showed an upward trend in studies focussed on gender and climate change since 2015, and 53% of the articles were a collaboration between male and female authors.

Conclusion:
Overall, women and girls are more susceptible to climate change. In certain situations, men have shown higher vulnerability to climate change than women. Hence, generalization of women to be the highest at-risk category in all climate change related situations should be consciously avoided. Understanding the complexity arising from multiple interacting variables requires holistic and context-specific research approaches.