The Problem With the Phrase Women and Minorities: Intersectionality—an Important Theoretical Framework for Public Health

Abstract

Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). Public health's commitment to social justice makes it a natural fit with intersectionality's focus on multiple historically oppressed populations. Yet despite a plethora of research focused on these populations, public health studies that reflect intersectionality in their theoretical frameworks, designs, analyses, or interpretations are rare. Accordingly, I describe the history and central tenets of intersectionality, address some theoretical and methodological challenges, and highlight the benefits of intersectionality for public health theory, research, and policy.

Development of a Conceptual Framework for Understanding Shared Decision making Among African-American LGBT Patients and their Clinicians

“…14,45,[72][73][74][75][76][77] We also confirmed our conceptual model's core constructs using the studies described in our systematic review.…”

“…In this paper, we also describe a conceptual model, informed by previous work, 14,19,45,[69][70][71][72][73][74][75][76][77] that demonstrates how social identity, perceptions of social identity, and structural inequities all inform shared decision making between patients and physicians. Expectations for, and the interpretation of, clinical encounters are often influenced by past experiences and normative beliefs about physicians and healthcare deliv- ery.…”

“…[40][41][42] 'Intersectionality' is the study of how multiple systems of social stratification (e.g., race, ethnicity, gender, sexual orientation) influence an individuals' identity and lived experience, recognizing that every person holds a position (privilege or disadvantage) in different systems simultaneously, and that such positions can vary in magnitude and direction depending on time, place, and circumstance. [43][44][45][46] For example, an African-American bisexual man may inhabit a different social position as a part of a community coalition to address HIV than while at work in the police department. Intersectionality also explores how different levels of a social framework influence individuals experiences, including the intrapersonal level (e.g., internalized racism), 47 the interpersonal level (e.g., bias, discrimination), 48 the contextual level (e.g., societal victimization such as hate crimes), 49 and the macro-level, where structural inequalities (e.g., education, income distribution) exist.…”

Towards an understanding of the multilevel factors associated with maternal health care utilization in Uttar Pradesh, India

“…An important area of research on inequities coming out of the feminist research literature engages the concept of intersectionality [42–44]. Intersectionality is defined by Bowleg [44] as ‘a theoretical framework for understanding how multiple social identities such as race, gender, sexual orientation, SES [socioeconomic status], and disability intersect at the micro level of individual experiences to reflect interlocking systems of privilege and oppression’ (p. 1267). Based on this concept, an example of a guiding question for implementing interventions might be: What specific processes will interventions develop to reach the women and families who are located at the intersection of multiple categories of disadvantage?…”

Heterogeneities in utilization of antenatal care in Uttar Pradesh, India: the need to contextualize interventions to individual contexts

“…Our interest in such interactions is related to the growing discourse on intersectionality. Intersectionality is defined by Bowleg [13] as ‘a theoretical framework for understanding how multiple social identities such as race, gender, sexual orientation, socio-economic status, and disability intersect at the micro level of individual experiences to reflect interlocking systems of privilege and oppression.’ From an intersectionality perspective, critical guiding questions include: By what mechanisms does the programme intend to disrupt existing patterns of ‘synergies of oppression’? What specific resources does the programme bring to change the behaviours of individuals experiencing ‘intersections’ of disadvantage?…”