An Intersectionality-Based Policy Analysis Framework: Critical Reflections on a Methodology for Advancing Equity

Abstract

Introduction: In the field of health, numerous frameworks have emerged that advance understandings of the differential impacts of health policies to produce inclusive and socially just health outcomes. In this paper, we present the development of an important contribution to these effortsan Intersectionality-Based Policy Analysis (IBPA) Framework. Methods: Developed over the course of two years in consultation with key stakeholders and drawing on best and promising practices of other equity-informed approaches, this participatory and iterative IBPA Framework provides guidance and direction for researchers, civil society, public health professionals and policy actors seeking to address the challenges of health inequities across diverse populations. Importantly, we present the application of the IBPA Framework in seven priority health-related policy case studies. Results: The analysis of each case study is focused on explaining how IBPA: 1) provides an innovative structure for critical policy analysis; 2) captures the different dimensions of policy contexts including history, politics, everyday lived experiences, diverse knowledges and intersecting social locations; and 3) generates transformative insights, knowledge, policy solutions and actions that cannot be gleaned from other equity-focused policy frameworks. Conclusion: The aim of this paper is to inspire a range of policy actors to recognize the potential of IBPA to foreground the complex contexts of health and social problems, and ultimately to transform how policy analysis is undertaken.

Moving towards a more inclusive patient and public involvement in health research paradigm: the incorporation of a trauma-informed intersectional analysis

“…Dhamoon [69] looks at the representation of different dimensions of socio-political life as a four-pronged endeavour, examining: 1) identities of individuals or social groups; 2) categories of difference; 3) systems of domination; and 4) processes of subject formation. Adapting from Olena Hankivsky’s Intersectionality-Based Policy Framework [65] as well as SAMSHA’s Guidance for a Trauma-Informed Approach [47] the following types of questions should be considered before deciding on a public involvement approach in the context of health research (Tables 2, 3 and 4). …”

“…Adapting from Olena Hankivsky’s Intersectionality-Based Policy Framework [65] as well as SAMSHA’s Guidance for a Trauma-Informed Approach [47] the following types of questions should be considered when evaluating public involvement in health research (Table 5). …”

‘One size does not fit all’: Perspectives on diversity in community aged care

“…Cultural competency training has absolute merit within health care, critical to understanding the impact of culture on health and illness beliefs . However, viewing an older person through a single lens, such as cultural background, is narrow and does not allow for the intersection of characteristics that makes up the full breadth of human experience .…”

“…Human experience is coloured by a person's social and cultural context , absorbed into consciousness as potential bias and prejudice, with possible health inequity outcomes. Implicit bias, described as unintentional, possibly unconscious, bias , has been noted among health professionals to contribute to health inequities .…”

“…This type of training has merit, but the concept of intersectionality has challenged the traditional uniformity of health service delivery and the homogeneous categories to which people were assigned . Intersectionality is premised on human experience being more than single characteristics, with people prioritising characteristics in their own unique way . Health‐care service delivery must respond through equity in access, policy and practice, with health professionals trained to understand that people are inherently different, with different needs and preferences .…”