Toward feminist principles for epidemiology and public health.

Background: Epidemiology has traditionally examined the distribution and determinants of health in populations. While early work focused on social determinants and collective conditions, recent decades have seen a shift toward individualized, molecular, and risk-based models emphasizing behavior, biology, and lifestyle. This shift has often obscured structural determinants and reinforced a biomedical paradigm. Feminist scholarship critiques these trends by centering lived experiences, power dynamics, and inequities in health research. Main body: This commentary explores how feminist principles can inform epidemiology, and Public Health, bridging the divide between positivist health sciences and feminist epistemologies. It outlines key feminist contributions including epistemology, theory, methodology, and reflexivity, and demonstrates how they can be operationalized in epidemiological practice. Feminist epidemiology emphasizes problem definition grounded in marginalized experiences, co-production of knowledge, intersectional analysis of sex, gender, and other social determinants, and critical attention to power relations. It advocates for the integration of qualitative, quantitative, and mixed methods, including non-traditional data sources and inclusive language, while maintaining scientific rigor through reflexivity and contextual sensitivity. Conclusion: Incorporating feminist principles transforms epidemiology and Public Health into a socially accountable, reflexive, and justice-oriented discipline. Health is both biological and political, and evidence production must account for structural inequalities, marginalized voices, and experiential knowledge. Feminist epidemiology does not sacrifice methodological rigor. It expands its scope to include ethical, social, and participatory dimensions, promoting more inclusive, accurate, and equitable science.