An Intersectional Approach to Understanding Barriers to Healthcare for Women

Abstract

Access to health care depends on multiple sociodemographic factors such as race/ethnicity, marital status, education, income, and insurance status. However, a paucity of research has examined access to healthcare disparities as they uniquely affect women, specifically women of color. National data were analyzed from the Medical Expenditure Panel Survey (MEPS) utilizing an 11-year sample (2005–2015) of women ages 18–74 (N = 128,355). More recent data were not included due to changes in how sampling was conducted after 2015. Predictor variables included race/ethnicity cross-classified with marital status, education, income, or insurance status, controlling for age. A dichotomous outcome variable called “any barriers to healthcare” was created based on usual source of care, delayed medical care, delayed dental care and delayed prescription care. Multivariate logistic regression models were used to identify associations with barriers to care. The foundation of this methodology is intersectionality and how it impacts access to care for women across social identities. Hispanic women (OR 1.08, 95% CI 1.02–1.14) had higher odds of having a barrier to care compared to White women. However, Black women (OR 0.92, 95% CI 0.87–0.97) had lower odds of having a barrier to care compared to White women. Race/ethnicity also significantly moderated the relationship between socioeconomic variables (marital status, income, education and insurance status) and having a barrier to care. To achieve a healthy community, addressing these racial/ethnic and socioeconomic inequalities helps to support the people who live and work within these communities. Supplementary Information The online version contains supplementary material available at 10.1007/s10900-022-01147-8.

Examining Educational Debts in Student Preparation for General Chemistry

“…For instance, Black women encounter a distinct set of challenges that arise from the intersection of their racial and gender identities, along with other identities that they may hold. Some of the distinct challenges that Black women face are economic disadvantage due to racial and gender gaps, higher rates of health disparities, and sexual violence. , It is worthwhile to point out that intersectionality and p -values can be in tension with each other. The former encourages the disaggregation of social identity groups to understand the unique experiences of people who belong to multiple historically marginalized groups, while the latter highlights that disaggregating data leads to smaller sample sizes that could increase the difficulty of achieving statistical significance.…”

Eliminating health care inequities through strengthening access to care

“…Intersectionality, increasingly recognized as an important tool for health equity research, considers individuals with multiple marginalized identities who are subject to interactive mechanisms of oppression. 3,4,58,[62][63][64][65] There is limited consensus on best practices in education and training for providers to gain competency in structural racism, racial biases, intersectionality, and how these biases contribute to downstream health inequities. Research demonstrates that health systems and the providers within the systems espouse egalitarian views but concurrently manifest racial biases, which are associated with differential treatment, lower patient satisfaction, and ultimately delays in seeking care.…”

“…While all populations are relevant to the discussion of access to care, widespread inequities in access to care disproportionately exist for racially/ethnically minoritized populations and economically, geographically, and socially disadvantaged groups. These inequities are exacerbated when considering an individual's or population's intersectionality (i.e., the overlapping experiences of discrimination for people who identify with multiple social dimensions such as race/ethnicity, sex, disabilities, and sexual and gender minorities, which include lesbian, gay, bisexual, transgender, and gender‐nonbinary or gender‐nonconforming individuals) 3,4 . This highlights the importance of examining root causes of such inequities, including marginalization, systemic oppression, and racism, and necessitates the examination of health care access through the lens of health equity 5–21 …”

“…These inequities are exacerbated when considering an individual's or population's intersectionality (i.e., the overlapping experiences of discrimination for people who identify with multiple social dimensions such as race/ethnicity, sex, disabilities, and sexual and gender minorities, which include lesbian, gay, bisexual, transgender, and gender-nonbinary or gender-nonconforming individuals). 3,4 This highlights the importance of examining root causes of such inequities, including marginalization, systemic oppression, and racism, and necessitates the examination of health care access through the lens of health equity. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Health equity is the state in which there is "a fair and just opportunity for everyone to attain their highest level of health."…”

Worldwide association of the gender inequality with the incidence and mortality of cervical, ovarian, endometrial, and breast cancers

“…Furthermore, Intersectionality theory in health recognizes that health is shaped by multi-dimensional overlapping factors such as race, poverty status, education, age, ability, gender, sexual orientation, religion, indigeneity, and geography ( Women UNEfGEatEoWU and Kabir, 2021 ). It is a framework to investigate the deep roots of social inequalities and describe how systems of power and oppression interlock to shape people's lived experiences, health, and well-being, based on their multiple identities ( Vohra-Gupta et al, 2023 ; Women UNEfGEatEoWU and Kabir, 2021 ). Therefore, gender inequality, one of the nuisances of such disparities, can lead to substantial health inequalities ( Okojie, 1994 ; Veas et al, 2021 ; Vohra-Gupta et al, 2023 ).…”