Systematic review of methods used to study the intersecting impact of sex and social locations on health outcomes

Phillips, Susan P.; Vafaei, Afshin; Yu, Shuang; Rodrigues, Ricardo; Ilinca, Stefania; Zolyomi, Eszter; Fors, Stefan

doi:10.1016/j.ssmph.2020.100705

Cited by 11 publications

(12 citation statements)

References 46 publications

(78 reference statements)

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“…Consistent with recent reviews, we found that meaningful theoretical elements of intersectionality, such as the conceptualization of social power, are lost in the translation to quantitative approaches ( Bauer et al, 2021 ; Phillips et al, 2020 ). This oversight is partially manifested in the exposure definition across studies – specifically, most of the studies in this review focused on social identity factors, rather than intersecting social structures and power relations, which can lead to attention being shifted away from structural factors in favor of individual-level interventions ( Lofters & O'Campo, 2012 ).…”

Section: Discussionsupporting

confidence: 87%

“…To better understand the different analytic methods that have been used, we conducted a systematic review of analytic approaches that were applied to study intersectionality within quantitative studies. This systematic review is distinct from, and builds upon, recent reviews of quantitative intersectionality ( Bauer et al, 2021 ; Phillips et al, 2020 ) by expanding upon specific statistical methods that have been applied to study intersectionality. Bauer et al established an important foundation with their review by describing the landscape of research and critiquing the incorporation of theory into supposed quantitative intersectionality studies ( Bauer et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An investigation of quantitative methods for assessing intersectionality in health research: A systematic review

Guan

Thomas

Vittinghoff

et al. 2021

SSM - Population Health

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

An investigation of quantitative methods for assessing intersectionality in health research: A systematic review

Guan

Thomas

Vittinghoff

et al. 2021

SSM - Population Health

View full text Add to dashboard Cite

“…The main limitation of the research arises, however, from uncertainty about best methods for evaluating intersectionality. Several methods are suggested for such work [ 53 ] however whether any of these is ‘best’ is still debated [ 57 ]. We selected MLA because quantification of cluster effects of social strata provides information beyond that obtainable from regular regression analyses and clearly addresses both within and across category (or cluster) variability.…”

Section: Discussionmentioning

confidence: 99%

The intersectional impact of sex and social factors on subjective health: analysis of the Canadian longitudinal study on aging (CLSA)

Vafaei

Phillips

2021

BMC Geriatr

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Background Self-rated health (SRH) is a widely validated measure of the general health of older adults. Our aim was to understand what factors shape individual perceptions of health and, in particular, whether those perceptions vary for men and women and across social locations. Methods We used data from the Canadian Longitudinal Study on Aging (CLSA) of community-dwelling adults aged 45 to 85. SRH was measured via a standard single question. Multiple Poisson regression identified individual, behavioural, and social factors related to SRH. Intersections between sex, education, wealth, and rural/urban status, and individual and joint cluster effects on SRH were quantified using multilevel models. Results After adjustment for relevant confounders, women were 43% less likely to report poor SRH. The strongest cluster effect was for groupings by wealth (21%). When wealth clusters were subdivided by sex or education the overall effect on SRH reduced to 15%. The largest variation in SRH (13.6%) was observed for intersections of sex, wealth, and rural/urban status. In contrast, interactions between sex and social factors were not significant, demonstrating that the complex interplay of sex and social location was only revealed when intersectional methods were employed. Conclusions Sex and social factors affected older adults’ perceptions of health in complex ways that only became apparent when multilevel analyses were carried out. Utilizing intersectionality analysis is a novel and nuanced approach for disentangling explanations for subjective health outcomes.

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“…The main limitation of the research arises, however, from uncertainty about best methods for evaluating intersectionality. Several methods are suggested for such work (56) however whether any of these is 'best' is still debated (59). We selected MLA because quanti cation of cluster effects of social strata provides information beyond that obtainable from regular regression analyses and clearly addresses both within and across category (or cluster) variability.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The intersectional impact of sex and social factors on subjective health: analysis of the Canadian Longitudinal Study on Aging (CLSA)

Vafaei

Phillips

2021

Preprint

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BACKGROUND Self-rated health (SRH) is a widely validated measure of the general health of older adults. Our aim was to understand what factors shape individual perceptions of health and how those perceptions vary for men and women and across social locations.METHODS We used data from the Canadian Longitudinal Study on Aging (CLSA) of community-dwelling adults aged 45 to 85. SRH was measured via subjective questions. Multiple Poisson regression identified individual, behavioural, and social factors related to SRH. Intersections between sex, education, wealth, and rural/urban status, and individual and joint cluster effects on SRH were quantified using multilevel models.RESULTS After adjustment for relevant confounders, women were 43% less likely to report poor SRH. The strongest cluster effect was for groupings by wealth (21%). When wealth clusters were subdivided by sex or education the overall effect on SRH reduced to 15 percent. The largest variation in SRH (13.6%) was observed for intersections of sex, wealth, and rural/urban status. In contrast, interactions between sex and social factors were not significant, demonstrating that the complex interplay of sex and social location was only revealed when intersectional methods were employed.CONCLUSIONS Sex and social factors affected older adults' perceptions of health in complex ways that only became apparent when multilevel analyses were carried out. Utilizing intersectionality analysis is a novel and nuanced approach for disentangling explanations for subjective health outcomes.

show abstract

Systematic review of methods used to study the intersecting impact of sex and social locations on health outcomes

Cited by 11 publications

References 46 publications

An investigation of quantitative methods for assessing intersectionality in health research: A systematic review

An investigation of quantitative methods for assessing intersectionality in health research: A systematic review

The intersectional impact of sex and social factors on subjective health: analysis of the Canadian longitudinal study on aging (CLSA)

The intersectional impact of sex and social factors on subjective health: analysis of the Canadian Longitudinal Study on Aging (CLSA)

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