Applying intersectionality theory to health outcomes and healthcare utilisation of ethnic minority populations: a systematic review protocol

INTRODUCTION: Intersectionality, as applied to health, provides a framework for understanding how overlapping social identities, such as ethnicity, gender and socioeconomic status, shape differential health outcomes and healthcare experiences. Individuals who occupy multiple marginalised identities often experience compounded disadvantages. Ethnic minority (EM) populations, defined here as social groups who are numerically smaller and/or socially marginalised within a given national or regional context based on ethnicity, race, culture, language, ancestry, or related heritage (often overlapping with racialised identities), frequently experience systemic exclusion, racism and structural barriers that also contribute to persistent disparities in morbidity, mortality and healthcare access. However, much health research relies on single-axis analyses, which can obscure within-group variation and may inadvertently reinforce inequities. Despite growing recognition of intersectionality, its empirical application to EM health remains limited. This systematic review aims to synthesise evidence on how intersectionality theory has been conceptualised and applied to understand health outcomes and healthcare utilisation among EM populations globally. METHODS AND ANALYSIS: This systematic review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the PRISMA-Equity Extension. Comprehensive searches of peer-reviewed databases and grey literature, including MEDLINE, EMBASE, CINAHL Plus, Scopus, Web of Science and ProQuest will identify quantitative, qualitative and mixed-method empirical studies published from 2000 to 2026. Eligible studies must implement intersectionality theory to EM health or healthcare utilisation outcomes. Two independent reviewers will screen titles, abstracts and full-text articles. Data extraction will also be conducted independently and discrepancies will be discussed with input from a third reviewer. Guided by the PROGRESS-Plus equity framework, findings will be synthesised thematically, implementing a mixed-method convergent integrated synthesis design. ETHICS AND DISSEMINATION: This review only analyses previously published data, thus it does not require ethical approval. Findings will be presented at relevant academic or professional conferences and submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD420251248887.

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Journal
BMJ Open
Published
2026-05-01
DOI
https://doi.org/10.1136/bmjopen-2026-117588
Primary Topic
Cultural Competency in Health Care
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article
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article

Applying intersectionality theory to health outcomes and healthcare utilisation of ethnic minority populations: a systematic review protocol

Peter Tanuseputro, William Chi Wai Wong, Junjie Ma, Jane E. Parry et al.
BMJ Open
Cultural Competency in Health Care
article

Applying intersectionality theory to health outcomes and healthcare utilisation of ethnic minority populations: a systematic review protocol

Peter Tanuseputro, William Chi Wai Wong, Junjie Ma, Jane E. Parry, L. Pulido, Emma Victoria Marianne Bilney, Linda Chan, Mazariegos Melanie Laam Chan, David Ka Ki Wong, Qiman Shi, Emily Tsui Yee Tse
article en

Abstract

INTRODUCTION: Intersectionality, as applied to health, provides a framework for understanding how overlapping social identities, such as ethnicity, gender and socioeconomic status, shape differential health outcomes and healthcare experiences. Individuals who occupy multiple marginalised identities often experience compounded disadvantages. Ethnic minority (EM) populations, defined here as social groups who are numerically smaller and/or socially marginalised within a given national or regional context based on ethnicity, race, culture, language, ancestry, or related heritage (often overlapping with racialised identities), frequently experience systemic exclusion, racism and structural barriers that also contribute to persistent disparities in morbidity, mortality and healthcare access. However, much health research relies on single-axis analyses, which can obscure within-group variation and may inadvertently reinforce inequities. Despite growing recognition of intersectionality, its empirical application to EM health remains limited. This systematic review aims to synthesise evidence on how intersectionality theory has been conceptualised and applied to understand health outcomes and healthcare utilisation among EM populations globally. METHODS AND ANALYSIS: This systematic review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the PRISMA-Equity Extension. Comprehensive searches of peer-reviewed databases and grey literature, including MEDLINE, EMBASE, CINAHL Plus, Scopus, Web of Science and ProQuest will identify quantitative, qualitative and mixed-method empirical studies published from 2000 to 2026. Eligible studies must implement intersectionality theory to EM health or healthcare utilisation outcomes. Two independent reviewers will screen titles, abstracts and full-text articles. Data extraction will also be conducted independently and discrepancies will be discussed with input from a third reviewer. Guided by the PROGRESS-Plus equity framework, findings will be synthesised thematically, implementing a mixed-method convergent integrated synthesis design. ETHICS AND DISSEMINATION: This review only analyses previously published data, thus it does not require ethical approval. Findings will be presented at relevant academic or professional conferences and submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD420251248887.

BMJ OpenVol. 16(5)
Chinese University of Hong Kong (HK), Hong Kong Jockey Club (HK), University of Hong Kong - Shenzhen Hospital (CN), University of Hong Kong (HK)
Reduced inequalities
Openalex Percentile: Top 4%
Cultural Competency in Health Care
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