This paper presents a broad overview and synthesis of the recent research literature on the major psycho social influences on womens health. In the first section, the variability of health among women is reviewed, with a particular emphasis on diversities in health according to womens major social roles of partner, parent and worker. The context within which social roles are carried out, particularly the socio-economic context, is identified as a critical factor. While research examining womens health within the context of both social roles and material circumstances have produced quite complex findings, the research reviewed in this paper clearly suggests that to appropriately document and understand the variability of health among women, attention to the particular circumstances of womens lives is required. This point is further highlighted in sections describing the health issues of older women, Aboriginal women and immigrant and refugee women.

The second half of the paper begins with a review of the research on differences between men and women on various indicators of health and ill-health. Frequently mentioned throughout the literature is the apparent paradox in womens and mens health: mens higher rate of mortality and womens higher rate of morbidity. Recent evidence demonstrating the complexity and variability of gender differences in health is briefly reviewed, suggesting that broad generalizations about health-related gender differences are inappropriate. As a means of clarifying more fully the significance of gender as a determinant of health, gender is examined as it interacts with other social characteristics associated with health and disease, such as socio-economic status, paid and unpaid work, exposure to stressors, and social support. The research that attempts to explain gender related differences in health is also examined, among which social role explanations dominate. Possible reasons for the diminishing longevity advantage of women over men in recent years is also discussed.

While the number of studies concerning womens health has multiplied in recent years, this review of the literature identified a number of general gaps in knowledge, particularly with respect to the Canadian context:

• More investigations are needed of the relationships among and between social roles, including the influence of particular social role characteristics on health as well as the qualitative experience of these roles.
• Social roles beyond that of parent, partner, and paid worker need to be incorporated into the broader social roles research literature. One example would be the caregiver role.
• More research is required on the relationship between womens social roles, socio-economic circumstances and health throughout the life course.
• There is a need for more research attention regarding the determinants of healthy aging among women.
• Studies that address the health needs and determinants of rural women.
• Research examining the variability of health among Canadian women of Aboriginal origin, including factors associated with positive physical and mental well-being.
• Research examining the variability of health among immigrant and refugee women. In particular, research needs to explore how social, economic, behavioural and psychological factors are associated with changes in the health status of immigrant and refugee women over time.
• The investigation of the mental and physical health effects of discrimination as a function of ones gender, race, sexual orientation and /or disability. Further, an examination of how these various statuses interact.
• The development of measures of health determinants which more accurately reflect the realities of womens lives (e.g. paid/unpaid work, social support, exposure to stress, socio-economic context).
• Continued gender-comparative research to understand the influence of gender on health and to identify important differences and similarities between men and women regarding the major determinants of health.