Intersectionality and why it matters to global health

Kapilashrami, Anuj; Hankivsky, Olena

doi:10.1016/s0140-6736(18)31431-4

Cited by 207 publications

(178 citation statements)

References 14 publications

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“…However, it has been pointed that those steps are necessary but not enough to address the multilevel factors shaping healthcare provision [4]. As Thurston and Eisener [40] noted, gender, organizational healthcare culture and structure, and other contextual related variables may play an important role in maintaining barriers and should be studied in depth, avoiding a focus on individual (healthcare provider) level variables.…”

Section: Discussionmentioning

confidence: 99%

“…When all of the transcripts from each phase were coded and analyzed, the investigators met to reorganize them all into meaningful themes focusing on intersectionality and taking into account sociodemographic information. As Anuj Kapilashrami and Olena Hankivsky [4] mentioned, there is no single way to approach intersectionality and no preferred method. However, the authors recognized the importance of interpreting the commonalities and differences within and across population groups without being reductionists and linking individual levels of experience to social structures of power.…”

Section: Universal Health Coveragementioning

confidence: 99%

“…For example, it sheds light to an understanding that a white poor woman might be discriminated for her gender and class status when accessing healthcare but has the relative advantage of ethnicity or race over an indigenous or migrant woman. Second, it highlights the fact that health outcomes resulted from power structures of social domination and historical discriminations [4].…”

Section: Introductionmentioning

confidence: 99%

“…Migration is, therefore, recognized as a key determinant of health [4]. For example, compared to their native counterparts, migrant women experience a higher number of unwanted pregnancies and report lower use of contraceptives and a lower propensity to attend reproductive health services in Latin America [25].…”

Section: Introductionmentioning

confidence: 99%

“…Despite these factors, studies have overemphasized cultural differences between migrant populations and the health system as relationships based on distrust among professionals and users due to cultural gaps [28]. This is why intersectional lens are crucial to understand multilevel factors shaping healthcare provision, practices, and use among migrant groups [4].…”

Section: Introductionmentioning

confidence: 99%

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An Intersectional Innovative Analysis of How Providers’ Discourses Interact with Universal Healthcare Access

Saletti‐Cuesta¹,

Aizenberg²

2019

Universal Healthcare [Working Title]

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Intersectionality is an analytical tool for understanding the ways gender intersects with and is constituted by other social factors such as social class, age, and ethnicity, among others. The chapter discusses the theoretical and analytical intersectionality perspective, focusing on its application to an analysis of empirical data obtained from qualitative research. Semi-structured interviews took place with healthcare providers in Cordoba, Argentina. Thematic analysis was conducted. The findings show the existence of multiple domination systems incorporated in providers' discourses. All of them interact and contribute to gender inequalities in health, specifically on women's access to universal healthcare for violence against women and/or health of migrant women increasing their vulnerability. Training and sensitization among providers regarding gender and health from an intersectional approach are highly recommended as the first step toward a better healthcare system response.

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Section: Discussionmentioning

confidence: 99%

Section: Universal Health Coveragementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

An Intersectional Innovative Analysis of How Providers’ Discourses Interact with Universal Healthcare Access

Saletti‐Cuesta¹,

Aizenberg²

2019

Universal Healthcare [Working Title]

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Representation of Race and Ethnicity in the Contemporary US Health Cohort All of Us Research Program

et al. 2023

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ImportanceTo address systemic disparities in biomedical research, the All of Us (AoU) Research Program was created to identify the root causes and consequences of health outcomes in the US. However, the extent of AoU’s racial and ethnic diversity is unknown.ObjectiveTo quantify representation of key racial and ethnic groups in the accruing AoU nationwide health cohort and compare with their actual representation in the US.Design, Setting, and ParticipantsThis cohort study compared the AoU program from May 2017 to June 2022 for individuals 18 years and older with the Decennial Survey 2020 (DEC) collected by the US Census Bureau.ExposuresRepresentation of non-Hispanic Asian, non-Hispanic Black or African American, Hispanic or Latino, non-Hispanic White, and uncategorized or multiple races in AoU.Main Outcomes and MeasuresThe extent of underrepresentation or overrepresentation of each racial group in the AoU program at both nationwide and state-level relative to DEC.ResultsOf the 358 705 US adults in the AoU to date, individuals identified with the following race and ethnicity categories: 12 710 non-Hispanic Asian (3.5%), 73 348 non-Hispanic Black or African American (20.5%), 58 488 Hispanic or Latino (16.3%), 205 457 non-Hispanic White (57.3%), and 8702 uncategorized or reporting multiple categories (2.4%). Of 355 413 participants with available sex at birth and age data, 218 981 (61.6%) were female and had a mean (SD) age of 53.1 (17.0) years, 136 037 (38.28%) were male and had a mean (SD) age of 56.7 (17.0) years, and 395 reported nonbinary sex (0.1%), with a mean (SD) age of 55.4 (15.8) years. Compared with the referent US, non-Hispanic Black or African American individuals were overrepresented in the AoU by 8.73% (AoU, 20.5% [73 348 of 358 705] vs DEC, 11.7% [30 266 080 of 258 343 281]) and by relative scale, 1.94-fold. Non-Hispanic White individuals accounted for the greatest participation in the AoU with generally consistent dominance across all regions yet numerically underrepresented by absolute difference of −3.54% (95% CI, −3.70 to −3.38). Uncategorized or multiracial group in the AoU (2.4% [8702 of 358 705]) was 0.43-fold likely to be represented relative to the DEC (4.6% [11 922 096 of 258 343 281]) with an absolute difference of −2.19% (95% CI, −2.24 to −2.14). Moreover, non-Hispanic Asian individuals were underrepresented by −2.54% (95% CI, −2.60 to −2.48) prominently in most states. Individuals identifying as Hispanic or Latino were nominally underrepresented by −0.46% (95% CI, −0.58 to −0.34) (AoU, 16.3% [58 488 of 358 705] vs DEC, 16.8% [43 322 792 of 258 343 281]).Conclusions and RelevanceRecruitment trends for the ongoing AoU show relatively improved representation of some major race groups with geographic trends. These findings underscore the need to further tailor and augment recruitment and participation initiatives for diverse populations.

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The structural and social determinants of Alzheimer's disease related dementias

Adkins‐Jackson

George

Besser

et al. 2023

Alzheimer's & Dementia

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Introduction The projected growth of Alzheimer's disease (AD) and AD‐related dementia (ADRD) cases by midcentury has expanded the research field and impelled new lines of inquiry into structural and social determinants of health (S/SDOH) as fundamental drivers of disparities in AD/ADRD. Methods In this review, we employ Bronfenbrenner's ecological systems theory as a framework to posit how S/SDOH impact AD/ADRD risk and outcomes. Results Bronfenbrenner defined the “macrosystem” as the realm of power (structural) systems that drive S/SDOH and that are the root cause of health disparities. These root causes have been discussed little to date in relation to AD/ADRD, and thus, macrosystem influences, such as racism, classism, sexism, and homophobia, are the emphasis in this paper. Discussion Under Bronfenbrenner's macrosystem framework, we highlight key quantitative and qualitative studies linking S/SDOH with AD/ADRD, identify scientific gaps in the literature, and propose guidance for future research. Highlights Ecological systems theory links structural/social determinants to AD/ADRD. Structural/social determinants accrue and interact over the life course to impact AD/ADRD. Macrosystem is made up of societal norms, beliefs, values, and practices (e.g., laws). Most macro‐level determinants have been understudied in the AD/ADRD literature.

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Intersectionality and why it matters to global health

Cited by 207 publications

References 14 publications

An Intersectional Innovative Analysis of How Providers’ Discourses Interact with Universal Healthcare Access

An Intersectional Innovative Analysis of How Providers’ Discourses Interact with Universal Healthcare Access

Representation of Race and Ethnicity in the Contemporary US Health Cohort All of Us Research Program

The structural and social determinants of Alzheimer's disease related dementias

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