Climate change and health: gender and social inequalities in contexts of urban vulnerability among women

BACKGROUND: Climate change represents a global challenge with unequal impacts on vulnerable populations, particularly women living in vulnerable urban contexts. This study examines, from the perspective of women residing in an urban occupation within the metropolitan region of São Paulo, how climate change exacerbates social and gender inequalities, affecting living conditions and health. METHODS: This qualitative study was guided by Emancipatory Action Research and conducted in the Lélia Gonzalez occupation, linked to the Homeless Workers' Movement (MTST), in Santo André (São Paulo, Brazil), between March and August 2025. Thirteen women participated, including both cisgender and transgender individuals. Data were generated through six emancipatory workshops and a complementary questionnaire, supported by audio recordings, full transcription, and field notes. Data were analyzed using open coding and the development of emergent categories, interpreted through the Social Determination of Health framework and the 4 S principles: sustainability, security, solidarity, and sovereignty. RESULTS: Participants associated climate change with everyday experiences such as extreme heat, flooding, respiratory diseases, food insecurity, and precarious housing conditions. These phenomena were perceived as intensifying gender inequalities, increasing work and care burdens, exacerbating situations of violence, and reinforcing processes of social exclusion. CONCLUSIONS: Climate change deepens social and gender inequalities, directly affecting the health and daily lives of women in vulnerable urban settings. Emancipatory Action Research was a useful approach for articulating experiences, fostering critical reflection, and supporting collective action. The findings highlight the relevance of gender-sensitive, intersectoral public policies guided by the principles of sustainability, sovereignty, solidarity, and security, particularly in such contexts. DESCRITORES: Mudanças Climáticas; Equidade de Gênero; Vulnerabilidade em Saúde; Saúde; Mulheres; Desigualdades de Saúde. DESCRIPTORS: Climate Change; Gender Equity; Health Vulnerability; Health; Women; Health Inequalities. DESCRIPTORES: Cambio climático; Equidad de Género; Vulnerabilidad in Salud; Salud; Mujeres; Inequidades in Salud.