The Impact of the Social Determinants of Health on Women with Heart Failure in Europe: a Scoping Review

Abstract Objective This review maps the existing evidence regarding the Social Determinants of Health (SDH) on women with heart failure (HF) in Europe, focusing on healthcare access, diagnostic pathways, clinical management and outcomes. Methods This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. A systematic search of six electronic databases in September 2025 yielded 3728 articles. Articles were eligible for inclusion if they featured women (aged ≥18 years) with a diagnosis of HF, were conducted in countries within the WHO-defined European Region, and specifically examined the impacts of SDH on this population. Following a two-stage screening process, 30 papers met the inclusion criteria. Data synthesis and reporting were guided by the PAGER framework (Patterns, Advances, Gaps, Evidence, and Recommendations). Results Nine dominant patterns were identified, centred largely on socioeconomic status, gender disparities in clinical care, and the impact of gendered labour expectations on health-seeking behaviour. These determinants significantly delay HF diagnosis and affect treatment optimisation among European women. However, a critical gap remains in sex- and age-disaggregated data with European HF datasets and research. Evidence for practice highlights the need for equity-focused care that incorporates social context into clinical management, while research recommendations prioritise investigating the underlying mechanisms behind the SDH-HF relationship to develop targeted interventions. Conclusions Social determinants are fundamental drivers of heart failure outcomes for women in Europe. Addressing the intersection of structural socioeconomic barriers and clinical management is essential to mitigating health disparities and achieving care equity and outcomes for women living with HF.