Researching intersectionality in women's health informs that there are still health inequalities and health disparities. It also fails to inform that there is a lack of research beyond race, gander and class. There is more needed research on the intersections of sexual orientation, able-ism, illiteracy, and immigration (just to name a few). Researchers should inform that in women's health when collecting samples not to prejudge your data using stereotypes and when analyzing data, not to be bias. I learned that there is absolutely nothing wrong with the participants or subjects and that, to have further knowledge to better understand how social inequalities affects intersectionality, we need more researchers willing to want to understand other categories.  

Intersectionality and Women's Health

Both Hankivsky and Bowleg state intersectionality originated from African American Feminist scholars, Collins 1990, Crenshaw 1989, and Hooks 1990. Intersectionality was rooted from Black Feminist, Kimbrele Crenshaw. She coined the term to describe the exclusion of Black women from White feminist and antiracist in the 1990’s. When Sojourner Truth was freed, she interrogated the intersections of race and gender in her famous “Ain’t I a Woman?” speech at the 1851 Women’s Convention in Akron, Ohio. In her speech she challenged the notion that being a women and Black are mutually exclusive.  Intersectionality “moves beyond single or typically favored categories of analysis (sex, gender, race, and class) to different aspects of social identity. Including the impact of systems and processes of oppression and domination.

The glossary definition of intersectionality is “a theory used to analyze how social and cultural categories connect”. Intersectionality focuses on examining how social locations and structural forces interact to shape and influence human experiences. This requires people to recognize the hierarchies and the systems of oppression that are dominating society that’s controlling people. Intersectionality is now recognized as a research paradigm that is based on number of key assumptions concerned with the simultaneous nature of multiple categories at multiple levels (Hankivsky, O., Reid, C, 2). She also states that “different dimensions of social life cannot be separated into discrete or pure hands.” I believe when she says that when you continue to read what she said is that it doesn’t matter what comes first. Her example was gender then ethnicity and that there isn’t a pattern that’s going to predetermined your future or faith. When scholars are categorizing intersectionality they are treated all members of a group the same because they are assuming that they somewhat share the same experiences. Not one category is better than the other, this is to better understand what’s been created when to categories intersect and the experiences they may face. This is mainly about recognition of multidimensional categories.

Sometimes scholars refer to intersectionality as a theory but it has more elements and or variables that could be tested. Bowleg says that she avoids the term theory and uses instead, theoretical framework or perspective. It gives intersectionality a more analytical framework or paradigm than a testable theory.  She contrast that intersectionality is different from the typical bio-medical, bio-behavioral and psycho social paradigms that shaped medicine, public health and other social sciences. She used the term “elucidate” the differences between traditional paradigms and intersectionality. Reason being is because when relating to social identities, it’s multidimensional that all connects. People from oppressed and marginalized groups have multiple social identities such as race and gender and structural factors for example poverty, racism, and sexism. These groups are also the ones facing more health disparities.

The topic of intersectionality is discussed among women’s studies and feminist when referring to psychology and interdisciplinary gender studies, but it’s not discussed in terms of public health. Bowleg states that “On November 10, 2011 PubMed search of the keyword intersectionality yielded just 49 results; not a single one was in a mainstream public health journal’ (1268). Intersectionality is critical and is also needed for greater awareness within public health. Public Health scholars have advocated for a greater focus on how social-structural factors beyond the level of the individual influence health. An example from Bowleg, is from an intersectionality perspective, a middle class Latina lesbian’s negative experiences at her physician’s office. This woman is facing sexism because of her gender, hetero-sexism because of her being lesbian, and racism because she’s Latina. "Her experiences at the intersection of her race, ethnicity, sexual orientation, and gender all correspond with evidence of hetero-sexism that lesbian and bisexual women counter so often when they seek health care services and same for racial and ethnic for minority women and health care experiences" (1269). She also states that from a 1988 study Black lesbian and bisexual women disclosed their sexual identity to physicians but most of the research was from White middle-class lesbian and bisexual women. This is one of the many examples that there isn’t much research on racial/ethnic minority women experiences in health care settings and that it also doesn’t include or report their sexual orientation in data, and it’s presumed that they are heterosexual, which is limiting an understanding of women’s experience beyond the intersections of gender and race.

According to Hankivsky in research and policy practice, gender and gender and health are often conflated with women and women’s health (1713). She argues that intersectionality has come to be recognized as a “valuable normative and research paradigm for further understanding of the complexity of health inequalities”. With gender in the title too often, it became a synonym for women. This took the focus off what the actual problem is and not made differences among the genders, and as a result men’s needs receive less when compared to women. There is emphasis on gender or sex that is often motivated by the concerns over the lack of attention to these factors and or lack of clarity about sex when compared to gender and the relationship between both gender and sex in health research. Using an intersectionality framework, researchers noticed a limitation when sex and gender is centered. The focus on gender is problematic because researchers often assume others based on their social statuses.

One example from Hankvisky,  is in the field of violence against women is not only a matter of gendered power relationship but it’s co-constructed with racial and class stratification, heterosexism, ageism, and other systems of oppression. Research on cardiovascular disease (CVD) shows that focusing on sex and gender often ignores the fact that CVD is experienced by racial ethnic and low-income groups. Another example is HIV/AIDS research demonstrates that gender and sexuality cannot be separated from what shapes them. She discussed a recent study of positive HIV migrants in the UK that was carried out by Lesley Doyal, who is a pioneer in feminist political economy of health. Her 1995 book, What makes women sick? Was a class-based analysis of health inequalities that include structures of gender. Her study also highlights the similarities and differences between the experiences of HIV-positive heterosexual women, heterosexual men and gay/bisexual men within the community of Black African migrants living in East London (Keane, 183). Being a gay black man was difficult to maintain their status because they are viewed as weak. That their sexual orientation is a “weakness”. Those that “didn’t come out” to their family, were constantly juggling.

The new public health is characterized by an increased emphasis on individual responsibility for risk reduction through the adoption of a healthy lifestyle. This healthy life campaign is encouraging self-management and self-control. Feminist researchers have been attentive to the negative meanings of fat, in contemporary culture and the misogynist aspects of weight management. Other feminist researchers have criticized what they regard as the lack of feminist engagement with the serious health-damaging consequences of obesity (Keane, 185). Overweight and obesity in the United States is an urgent issue of social justice which is being generally ignored by feminists in favor of a preoccupation with the cultural promotion of female thinness which they argue produces health consequences only for a small minority of women. They also emphasize the higher risks of overweight and obesity among women, especially poor women and women of color, and the burden of chronic disease suffered by the disadvantaged. Balancing these different demands in the face of proliferating discourses of risk, responsibility and healthy living will continue to be one of the characteristic challenges of feminist health research.

The development of intersectionality methodology holds the promise of opening new intellectual spaces for knowledge and research production and has the potential to lead to both theoretical and methodological innovation in women’s health research and in policy and policy analysis innovation. Methodological challenges are the absence of guide lines for quantitative research who wish to conduct intersectionality research and the fact that the task of investigating multiple social groups within and across analytical categories and not on complexities within single groups. More quantitative methodologies are critically needed “to fully engage with the set of issues and topics falling broadly under the rubric of intersectionality” (Bowleg 1270).

 “For a number of reasons, translating intersectionality theory into methodological practice is not easy. First, there is an disconnect between intersectionality scholarship and the conceptualization of research questions and designs. Second, there is a lack of certainty as to how, when, and where intersectionality frameworks should and can be applied. Third, the difficulty of applying intersectionality to empirical designs, especially in areas dominated by quantitative research, has also been highlighted. Fourth, little work has been done to determine whether all possible intersections might be relevant at all times, or when some of them might be most salient. Fifth, intersectionality requires access to pertinent health information that often does not exist - - for example, data that represent multiple groups and which reflect significant variations within those groups across genders, socioeconomic statuses, social classes, and sexual orientations”. (Hankivsky, 3).

How researchers interpret their data is as important as the methodological choices they make about sampling, sample sizes, or using qualitative or quantitative methods. The goal is to have researchers understand social categories, their relationships, and interactions and then to have this different understanding transform how researchers interrogate processes and mechanism of power that shape health inequalities. Intersectionality rejects hierarchical ordering of oppression. Researchers applying this perspective would refrain from presuming before they start any project. This will allow more flexibility and accuracy in the research question, choice of sample, analysis and interpretation of data.

References

1. Bowleg, L. (2012). The Problem with the Phrase Women and Minorities: Intersectionality- an Important Theoretical Framework for Public Health. American Journal Of Public Health, 102(7), 1267-1273.
1. http://rcgd.isr.umich.edu/seminars/Winter2014/Winter14_articles/Lisa_Bowleg_Article_1.pdf
2. Hankivsky, O. (2012). Women’s health, men’s health, and gender and health: Implications of intersectionality. Social Science & Medicine, 74 (11), 1712-1720. 
1. http://ac.els-cdn.com/S0277953612000408/1-s2.0-S0277953612000408-main.pdf?_tid=13c6d5ea-212a-11e6-bfe9-00000aacb362&acdnat=1464037708_68631a56014794cf1ad80b0b7f7f957e  
3. Hankivsky, O., Reid, C., Cormier, R., Varcoe, C., Clark, N., Benoit, C., & Brotman, S. (2010). Exploring the promises of intersectionality for advancing women's health research. International Journal For Equity In Health, 915p-15p 1p.
1. http://equityhealthj.biomedcentral.com/articles/10.1186/1475-9276-9-5
4. Keane, H. (2014). Feminism and the Complexities of Gender and Health. Australian Feminist Studies, 29(80), 180-188.
1. http://www.tandfonline.com/doi/pdf/10.1080/08164649.2014.928192  
5. McGibbon, E., & McPherson, C. (2001). Applying Intersectionality & Complexity Theory to Address the Social Determinants of Women's Health. Women's Health and Urban Life, 10(1), 59-86 
1. https://tspace.library.utoronto.ca/bitstream/1807/27217/1/10.1_mcgibbon_mcpherson.pdf  

Annotated Bibliography: Selected Sources on Intersectionality and Women's Health 

Bengiamin, Marlene I., John A. Capitman, and Mathilda B. Ruwe. (2010). "Disparities in Initiation and Adherence to Prenatal Care: Impact of Insurance, Race-Ethnicity and Nativity." Maternal and child health journal 14.4: 618-24. ProQuest.Web. 2 May 2016.      

     Discusses the impact of racial/ethnic immigration and insurance differences at the beginning of a pregnancy and even after birth for prenatal care (PNC). This article also experience with women in California, comparing how women immigrants to Americans. In this California area there are more non-American than American. This approach will help researchers expand their knowledge of health disparities and identify new ways of eliminating social inequalities.     

Bowleg, L. (2012). "The Problem With the Phrase Women and Minorities: Intersectionality- an Important Theoretical Framework for Public Health." American Journal Of Public Health, 102(7), 1267-1273.       

     Looking back historically oppressed populations there are still in fairness with social justice in Public Health. There’s been many research focusing on certain populations that when relating to intersectionality are minimal. This article addresses theoretical and methodological challenges and also with that you see the benefits of intersectionality for public health theory, research, and policy.

Brankovic, Ivan, Petra Verdonk, and Ineke Klinge. (2013) "Applying a Gender Lens on Human Papillomavirus Infection: Cervical Cancer Screening, HPV DNA Testing, and HPV Vaccination." International Journal for Equity in Health 12: 14

     For educational purpose this article states that they want to address that disparities exist. This research applied to cervical cancer, HPV. any sexually transmitted disease. An example is that uneducated women, older women, uninsured women, homeless women, and even women facing language barriers didn't participate in Pap smears. There needs to be different strategies for these subgroups in prevention and making it available for women who are oppressed. 

Bredstrom, Anna.(2006). "Intersectionality: A Challenge for Feminist HIV/AIDS Research? “ The European Journal of Women's Studies 13.3: 229-43. ProQuest. Web. 2 May 2016.
     One example of research is a challenge for Feminist HIV/AIDS research. When examining how race, ethnicity, and class are theorized, the collection of data when analyzed shows the differences among the groups. This causes problems with the focus on gender and sexuality. This article concludes by arguing that an intersectional perspective poses a challenge to feminist HIV/AIDS research that needs to be addressed in order to produce an effective sexual health policy. 

Calabrese, S. K., Meyer, I. H., Overstreet, N. M., Haile, R., & Hansen, N. B. (2015). “Exploring Discrimination and Mental Health Disparities Faced By Black Sexual Minority Women Using a Minority Stress Framework”. Psychology Of Women Quarterly, 39(3), 287-304

     Black women are marginalized because of their race, gender, and possibly sexual orientation. This article discuss three dimensions of discrimination which are frequency (occurrences, scope (number of acts experiences), and number of bases (number of social statues to which discrimination was attributed). These author uses “black sexual minority” to express their race, gender, and sexual orientation. They also tested the discrimination with the association between race and mental health.

Dillaway, Heather, and Sarah Jane Brubaker. "Intersectionality And Childbirth: How Women From Different Social Locations Discuss Epidural Use." Race, Gender & Class 13.3 (2006): 16-41. ProQuest. Web. 2 May 2016.     

     This article explores the experiences of “different” women that are giving birth. These differences are how women think and possibly decide about the using of a epidural. This article argues that feminist critiques of medication usage of childbirth should be expanded to address race, class, and age as structures of oppression and privilege that shape the women reproductive experiences. Understanding women’s thoughts and decisions about epidurals will help us better understand with commonalties and their differences.

Etherington, N. (2015). "Race, Gender, and the Resources That Matter: An Investigation of Intersectionality and Health." Women & Health, 55(7), 754-777.     

     In this article this is examining racial disparities in health among women, with relationship between social status and both the development of psychosocial resources and good health. By using a sample of women from 2007 of the U.S panel Study of Income Dynamics and Child Development Supplement. Black women didn’t experience the same health benefits when compared to white women. With the help of resources, this may help improve health within the oppressed group, but with that it’s not bringing them to the same level of health experienced by others.

Hankivsky, O. (2012). "Women’s health, men’s health, and gender and health: Implications of intersectionality." Social Science & Medicine, 74 (11), 1712-1720.     

     Health researchers, policy makers, and practitioners concerned with sex and gender are acknowledging the importance of race/ethnicity, class, income, education, ability, age, sexual orientation, immigration status, and geography. It’s best to see how to respond to these issues of differences and how they also shave lives and health. With the recognition of intersectionality being a valued normative. Research paradigm is to help us further understand health inequities. This article is looking at these issues from an intersectionality perspective to see the common struggle within these categories to see the factors that shape health inequalities.

Hankivsky, O., Reid, C., Cormier, R., Varcoe, C., Clark, N., Benoit, C., & Brotman, S. (2010). "Exploring the promises of intersectionality for advancing women's health research." International Journal For Equity In Health, 915p-15p 1p.      

     Women’s health research strives to make change. To produce more knowledge there’s needs to be some type of action on the factors that affect women’s lives and their health. There’s have been movements and awareness of the health effects of sex and gender. Most importantly there is more needed attention to the inequalities among the women that causes racism, colonialism, ethnocentrism, heterosexism and able-bodism. Researchers are looking at different frameworks that can help transform how research is produce and the knowledge that investigations how the systems of discrimination intersect.

Keane, H. (2014). "Feminism and the Complexities of Gender and Health." Australian Feminist Studies, 29(80), 180-188.     

     Feminist activism and research significantly made an impact on public health policy. This article focuses on two ways in which feminist social science has complicated the understandings of gender and health. The first is intersectionality, which emphasizes the interactions because of the differences in social identity and limitations on gender in analyzing experiences of health. Second is critical analysis of health as the ideal, because of the rise of new public health and individual responsibility for risk reduction

McGibbon, E., & McPherson, C. (2001). "Applying Intersectionality & Complexity Theory to Address the Social Determinants of Women's Health." Women's Health and Urban Life, 10(1), 59-86.Retrieved May 1, 2016

     With the lack of access to education this affects income and having the services and goods that are needed in today’s society. The social determinants of health correlates with health deprivation. This article explores the ways to improve inequalities in the social determinants of women’s health to better understand the social and economic marginalization of women.

Perry, Brea L., Kathi L. H. Harp, and Carrie B. Oser. (2013). "Racial and Gender Discrimination in the Stress Process: Implications for African American Women's Health and Well-being." Sociological Perspectives 56.1: 25.

     Sociologist adopted an intersectionality framework to not only explore but also to explain the inequalities in race, class, and gender. The article theorize the role of racial and gender discrimination. They concluded that individuals who were racially and gender discriminated against had an increased risk of poor health and low well-being. This demonstrates that there is an influence on health with the disadvantage group, in particularity this research were African American women.

Price, K. (2011). "It's not just about abortion: incorporating intersectionality in research about women of color and reproduction". Women’s Health Issues: Official Publication of the Jacobs Institute of Women's Health, 21(3 Suppl), S55-S57.      

     Women are the only one that experience the effects of gender in their lives, but they are also affected by their race, ethnicity, class, sexual orientation, and ability. This article express that those identities don’t operate separately from one another, but they work together to shape the social, cultural, economic and political social groups which affects our lives.
 
Rountree, Michele A., Teresa Granillo, and Meredith Bagwell-Gray. (2016). "Promotion of Latina Health: Intersectionality of IPV and Risk for HIV/AIDS." Violence Against Women 22.5: 545. ProQuest. Web. 2 May 2016.     

     The Latina women in the U.S are vulnerable to two public health concerns. Which are intimate partner violence and the risk for HIV/AIDS infection. This article is examining the cultural life factors of the “understudied” population in HIV prevention. With having focus groups of Latina women with some that speak one language and some that speak many. This experience is to see who is more prone to contracting from their partners and infidelity. Data shows that the monolingual had lower levels of the knowledge of HIV and discussed the myths of infection. The bilingual women spent more time discussing specific prevention techniques, including challenges related to the violence in their relationship.

Weerasinghe, Swarna. (2012). "Inequities in Visible Minority Immigrant Women's Healthcare Accessibility." Ethnicity and Inequalities in Health and Social Care 5.1: 18-28.  

     In this article she explores Immigrant women’s encounters and perceptions of healthcare accessibility in Canada. The focus of this paper is on visible minority immigrant women, who were living in Canada at the time of the study and have migrated to Canada within the five-year period prior to the study onset. These women are invisible. The author found that skin color, your accent, and excess body weight lead to lack of approval/support in interpersonal dynamics (person's body language, facial expression, and nonverbal communication).

This page was created by Sharkyla Truth. Please send additions or corrections to Sharkylatruth@eagles.ewu.edu.