Black-White health inequalities in Canada at the intersection of gender and immigration

Abstract

OBJECTIVES: Intersectionality theory proposes that each combination of social categories derived from gender, race and nationality, such as immigrant White man or native-born Black woman, is associated with unique social experiences. We tested the potential of intersectionality theory for explicating racial inequalities in Canada by investigating whether Black-White health inequalities are conditioned by gender and immigrant status in a synergistic way. METHODS:Our dataset comprised 10 cycles (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) of the Canadian Community Health Survey. We used binary logistic regression to model BlackWhite inequalities in hypertension, diabetes, self-rated health, self-rated mental health and asthma separately for native-born women, native-born men, immigrant women and immigrant men. RESULTS:After controlling for potentially confounding factors we found that immigrant Black women had significantly higher odds of hypertension, diabetes and fair/poor self-rated health than immigrant White women. Native-born Black women and immigrant Black men had higher odds of hypertension and diabetes than native-born White women and immigrant White men respectively, and native-born White women were more likely than native-born Black women to report asthma. There were no statistically significant health differences between native-born Black and White men. Socio-economic status, smoking, physical activity and body mass index were implicated in some but not all of these racial health inequalities. None of the three-way interactions between racial identity, gender and immigration status was statistically significant. CONCLUSION:We found relatively high risks of ill health for Black Canadians in three of the four samples. Overall, however, we found little support for the intersectional hypothesis that Black-White health inequalities in Canada are conditioned by gender and immigrant status in a synergistic way.KEY WORDS: Canada; Black; White; intersectionality; racial health inequalities; gender; immigration; socioeconomic status; health behaviours; body mass index La traduction du résumé se trouve à la fin de l'article.

Black, White, Black and White: mixed race and health in Canada

“…However, racial identities both singular and hybrid are imbued with social significance in Canadian society which means that they can be causally implicated in the production of health inequalities for social reasons. Consistent with previous research (Veenstra 2009;Chiu et al 2010;Liu et al 2013;Veenstra and Patterson 2015;Ramraj et al 2016;Patterson and Veenstra 2016;Veenstra and Patterson 2016), I find that, compared to White Canadians, Black Canadians are relatively likely to report hypertension after controlling for age and immigrant status. A small portion of this risk is attributable to differences in income.…”

“…For example, researchers have documented that, after controlling for age and immigrant status, Black Canadians are more likely than White Canadians to report hypertension and diabetes (Veenstra 2009;Chiu et al 2010;Liu et al 2010;Veenstra and Patterson 2015;Ramraj et al 2016;Patterson and Veenstra 2016;Veenstra and Patterson 2016) and native-born Black Canadians are more likely than native-born White Canadians to report poor self-rated health (Veenstra and Patterson 2015). Conversely, Black women are less likely than White women to report poor selfrated mental health and Black Canadians have lower agestandardized mortality rates than White Canadians (Wilkins et al 2008;Pinault et al 2016).…”

Racial Differences in Home Dialysis Utilization and Outcomes in Canada

“…In fact, compared with the United States, blacks in Canada had relatively higher education, income, and employment (42). Nonetheless, recent studies have shown that black-white disparities still persist in Canada in regards to income and education (43,44).…”

An Intersectional Analysis Providing More Precise Information on Inequities in Self-Rated General Health

“…For example, the impacts of class, gender, race, migration and sexual orientation in Canada have been investigated (43,44), as has those of gender, sexual orientation and race in the United States (45,46), and of class, gender and regional context in Spain (47). Common to these studies, however, is that they adopt a categorical approach focused on between-group differences in average risk, without assessing individual heterogeneity and thus potentially allowing for a complementary anti-categorical stance.…”