Can intersectionality help with understanding and tackling health inequalities? Perspectives of professional stakeholders

Abstract

Background The concept of “intersectionality” is increasingly employed within public health arenas, particularly in North America, and is often heralded as offering great potential to advance health inequalities research and action. Given persistently poor progress towards tackling health inequalities, and recent calls to reframe this agenda in the United Kingdom and Europe, the possible contribution of intersectionality deserves attention. Yet, no existing research has examined professional stakeholder understandings and perspectives on applying intersectionality to this field. Methods In this paper we seek to address that gap, drawing upon a consultation survey and face-to-face workshop (n = 23) undertaken in the United Kingdom. The survey included both researchers (n = 53) and policy and practice professionals (n = 20) with varied roles and levels of engagement in research and evaluation. Topics included familiarity with the term and concept “intersectionality”, relevance to health inequalities work, and issues shaping its uptake. Respondents were also asked to comment on two specific policy suggestions: intersectionally targeting and tailoring interventions, and evaluating the intersectional effects of policies. The workshop aims were to share examples of applying intersectionality within health inequalities research and practice; understand the views of research and practice colleagues on potential contributions and challenges; and identify potential ways to promote intersectional approaches. Results Findings indicated a generally positive response to the concept and a cautiously optimistic assessment that intersectional approaches could be valuable. However, opinions were mixed and various challenges were raised, especially around whether intersectionality research is necessarily critical and transformative and, accordingly, how it should be operationalized methodologically. Nonetheless, there was general agreement that intersectionality is concerned with diverse inequalities and the systems of power that shape them. Conclusions We position intersectionality within the wider context of health inequalities policy and practice, suggesting potential ways forward for the approach in the context of the United Kingdom. The views of policy and practice professionals suggest that intersectionality has far to travel to help counter individualistic narratives and to encourage an approach that is sensitive to subgroup inequalities and the processes that generate them. Examples of promising practice, albeit mostly in North America, suggest that it is possible for intersectionality to gain traction.

Conceptualizing inequities and oppression in oral health research

“…Action on systemic racism, for instance, should be an integral component of any dental school's mandate and, potentially, a metric of social accountability that can be incorporated into accreditation criteria and an indicator of a school's performance in fulfilling its mission towards its community and society at large. Oral health inequities will remain a global issue unless intersecting systems of oppression are taken seriously by oral health researchers, dental educators, dental professionals and other key social actors 56 …”

“…Oral health inequities will remain a global issue unless intersecting systems of oppression are taken seriously by oral health researchers, dental educators, dental professionals and other key social actors. 56…”

Applying an equity lens to liver health and research in Europe

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Contending with Health Outcomes of Sanctioned Rituals: The Case of Puberty Rites

“…The need for holistic and intersectionality approaches to health is highlighted in growing evidence in reports that suggest the need to promote health by reducing health disparities by addressing social determinants of health (WHO 2006;Hankivsky and Christoffersen 2008). The heightened attention to understanding how social determinants of health are defined by a reciprocal and complex web of social reality was acknowledged in the commission on the social determinants of health to promote attention to the overlapping effects and simultaneity of intersecting inequities and implications (Kapilashrami and Hankivsky 2018;Holman et al 2021). The reality of health and healing as social variables with multiple identities that are constructed and defined by social norms is fundamental in addressing health outcomes.…”