Unequal burdens: a scoping review of key social determinants of health affecting wellbeing of international vs. domestic students

This scoping review synthesizes evidence on the social determinants of health (SDoH) affecting university students, with a specific focus on comparing the experiences of international versus domestic students. Researchers examined four key pillars of student health: food insecurity, housing issues, social isolation, and psychological distress. By analyzing 23 peer-reviewed studies published between 2014 and 2024, the review maps how these factors create unique, interconnected vulnerabilities for international students.

The analysis reveals that international students face disproportionately higher burdens across all studied SDoH compared to their domestic counterparts. This inequality is driven by a complex interplay of challenges. For example, international students often lack the established family or local support networks that buffer domestic students against crises. This social isolation is further aggravated by unfamiliarity with local housing markets and restricted access to government-funded safety nets, which worsens food insecurity.

The study highlights that these factors are not merely independent risks but operate as triggers that amplify each other. Specifically, the stress of navigating a new cultural environment, combined with financial instability and limited social support, significantly increases the risk of depression and anxiety. While domestic students also face academic pressure, they typically have more robust mechanisms to mitigate these stressors.

Understanding these disparities is essential for higher education institutions that aim to support their entire student body. The findings suggest that current support systems are often insufficient or inaccessible for international students, who may be hindered by cultural stigma, language barriers, or a lack of awareness regarding available resources. By identifying the specific intersectional challenges faced by international students—particularly the link between housing, social connection, and food security—this review provides a foundation for universities to develop more effective, targeted, and culturally sensitive interventions to improve student equity and health outcomes.