Intersectionality, health equity, and EDI: What’s the difference for health researchers?

Abstract

Many countries adopted comprehensive national initiatives to promote equity in higher education with the goal of transforming the culture of research. Major health research funders are supporting this work through calls for projects that focus on equity, resulting in a proliferation of theoretical frameworks including “intersectionality,” “health equity,” and variations of equity, diversity and inclusion, or EDI. This commentary is geared at individual principal investigators and health research teams who are developing research proposals and want to consider equity issues in their research, perhaps for the first time. We present histories and definitions of three commonly used frameworks: intersectionality, health equity, and EDI. In the context of health research, intersectionality is a methodology (a combination of epistemology and techniques) that can identify the relationships among individual identities and systems of oppression; however, it should also be used internally by research teams to reflect on the production of knowledge. Health equity is a societal goal that operationalizes the social determinants of health to document and address health disparities at the population level. EDI initiatives measure and track progress within organizations or teams and are best suited to inform the infrastructure and human resourcing “behind the scenes” of a project. We encourage researchers to consider these definitions and strive to tangibly move health research towards equity both in the topics we study and in the ways we do research.

Inequities in access to directly-funded home care in Canada: a privilege only afforded to some

“…Intersectionality demonstrates how lived-experiences are shaped by the complex and shifting interactions of gender, race, class, dis/ ability, and other key identity factors and is well-suited to qualitative research [24,25]. Population and public health research is increasingly drawing on intersectionality to explain effects of social location on health and well-being [26,27].…”

The Intersection of Social Determinants of Health and Post-stroke Aphasia Outcomes: A Need for Intersectional Analysis

“…Researchers are also urged to consider analytical strategies such as intersectional inquiry that recognizes how SDOH such as race, gender, class, sexual orientation, disability, and other various sources result in intersecting contributions to differences in outcomes (Lopez & Gadsden, 2016). The concept of intersectionality was originally coined by legal scholar Kimberle Crenshaw (1989) who explained the combination of epistemology and specific research techniques that can be utilized to identify the relationships among individual identities and systems of oppression that impact health outcomes (Kelly et al, 2022). Intersectionality considers how the differing experiences across the aforementioned dimensions translate into very different lived experiences and consequently different clinical outcomes (Lopez & Gadsden, 2016).…”

“…Intersectional approaches also consider geographic inequalities and how they influence outcomes (Bambra, 2022). More specifically, the overlap of multiple and everchanging identities and in different locations equates to different experiences that are oftentimes overlooked during traditional analyses that emphasize one unique identify and experience (Kelly et al, 2022). Furthermore, these different experiences result in developmental pathways in childhood and adulthood with some trajectories leading to positive outcomes and other negative outcomes (Lopez & Gadsden, 2016).…”

“…Specifically, these issues have implications for disparities in brain health that potentially translate to stroke disparities as well as disparities in post-stroke conditions (Hilal & Brayne, 2022;Labovitz, 2020). The end result is that some experience health equity, while many others do not (Kelly et al, 2022).…”

“…This type of self-exploration will be required to understand and respond to complex intersection of factors that influence outcomes. Thus, one of the key challenges for researchers and clinicians is their comfort level with a commitment to social justice issues that must be considered in intersectional approaches to research (Kelly et al, 2022). It is also important to acknowledge that it can be challenging for researchers and clinicians to determine the most important intersections (i.e., SDOH) that must actually be explored (Kelly et al, 2022).…”