La perspectiva feminista de la interseccionalidad en el campo de la salud pública: revisión narrativa de las producciones teórico-metodológicas

Marcia Thereza Couto Doctora en Sociología. Posdoctora en Salud Colectiva. Profesora, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, Brasil. image/svg+xml , Elda de Oliveira Doctora en Ciencias. Investigadora en Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, Brasil. image/svg+xml , Marco Antônio Alves Separavich Doctor en Salud Colectiva. Investigador, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, Brasil. image/svg+xml , Olinda do Carmo Luiz Doctora en Medicina Preventiva. Investigadora, Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, Brasil. image/svg+xml
Recibido: 9 agosto 2018, Aceptado: 20 diciembre 2018, Publicado: 9 marzo 2019 Open Access
Vistas de resumen
4698
Cargando métricas ...

Resumen


El abordaje de la interseccionalidad emergió a fines de la década de 1980, en el campo del activismo feminista negro en EEUU, como crítica a los análisis unidimensionales de las desigualdades sociales. Esta revisión narrativa descriptivo-analítica presenta el estado actual de la inclusión teórico-metodológica de la interseccionalidad en la salud pública. Se consultaron siete bases de bibliografía científica: Web of Science, Embase, Cinahl, Scopus, Sociological Abstracts, Lilacs y Medline, y se obtuvieron 1.763 artículos. Eliminados los duplicados y leídos los títulos y resúmenes, se seleccionaron 30 artículos producidos en cinco países entre 2006 y 2017. El análisis, estructurado en tres temas (debates teórico-metodológicos; marcadores sociales –género, raza, etnicidad, orientación sexual–; y políticas y prácticas de salud), muestra que la interseccionalidad es un recurso analítico prometedor para la comprensión y el enfrentamiento del desafío global de las desigualdades en salud.


Referencias bibliográficas


1. Barata RB. Como e por que as desigualdades sociais fazem mal à saúde [Internet]. 21a ed. Rio de Janeiro: Editora Fiocruz; 2009 [citado 05 jun 2017]. Disponible en: https://tinyurl.com/ychv5ae8.

2. Couto MT, Schraiber LB, Ayres JR. Aspectos sociais e culturais da saúde e da doença. En: Martin MA, Carrilho FJ, Castilho EA, Alves VAF, Cerro GG, (eds.). Tratado de Clínica Médica. V. 1. São Paulo: Manole; 2009. p. 350-356.

3. Prado EAJ, Sousa MF. Políticas Públicas e a saúde da população LGBT: uma revisão integrativa. Tempus Actas de Saúde Coletiva. 2017;11(1):69-80. doi: 10.18569/tempus.v11i1.1895.

4. Costa Jr FMD, Couto MT. Geração e categorias geracionais nas pesquisas sobre saúde e gênero no Brasil. Saúde e Sociedade. 2015;24(4):1299-1315. doi: 10.1590/S0104-12902015140408.

5. Dhamoon RK. Considerations on mainstreaming intersectionality. Political Research Quarterly. 2011;64(1):230-243. doi: 10.1177/ 1065912910379227.

6. Carbado DW, Crenshaw KW, Mays VM, Tomlinson B. Intersectionality: Mapping the movements of a theory. Du Bois Review. 2013;10(2):303-312. doi: 10.1017/S1742058X13000349.

7. Bilge S. Recent feminist outlooks on intersectionality. Diogenes. 2010;57(1):58-72. doi: 10.1177/0392192110374245.

8. Vigoya MV. La interseccionalidade: una aproximación situada a la dominación. Debate Feminista. 2016;52:1-17. doi: 10.1016/j.df.2016.09.005.

9. Carneiro S. Mulheres em movimento. Estudos Avançados. 2003;17(49):117-132. doi: 10.1590/S0103-40142003000300008.

10. Lugones M. Colonialidad y género. Tabula Rasa. 2008;9:73-101.

11. Espinosa Miñoso Y. Escritos de una lesbiana oscura: reflexiones críticas sobre feminismo y política de identidad en América Latina. Buenos Aires: En la Frontera; 2007.

12. Cho S, Crenshaw KW, McCall L. Toward a field of Intersectionality Studies: theory, applications and praxis. Signs: Journal of Women in Culture and Society. 2013;38(4):785-810.

13. Hancock AM. Intersectionality as a normative and empirical paradigm. Politics and Gender. 2007;3(2):248-254. doi: 10.1017/S1743923X07000062.

14. Shields SA. Gender: an intersectionality perspective. Sex Roles. 2008;59:301-311. doi: 10.1007/s11199-008-9501-8.

15. Clarke AY, McCall L. Intersectionality and social explanation in social science research. Du Bois Review. 2013;10(2):349-363. doi: 10.1017/S1742058X13000325.

16. Nygren KG, Olofsson A. Intersectional approaches in health-risk research: a critical review. Sociology Compass. 2014;8(9):1112-1126. doi: 10.1111/soc4.12176.

17. Bowleg L. The problem with the phrase women and minorities: intersectionality-an important theoretical framework for Public Health. American Journal of Public Health. 2012;102(7):1267-1273. doi: 10.2105/AJPH.2012.300750.

18. Collins PH. Intersectionality’s definitional dilemmas. Annual Review of Sociology. 2015;41:1-20. doi: 10.1146/annurev-soc-073014-112142.

19. Hankivsky O. Women’s health, men’s health, and gender and health: implications of intersectionality. Social Science & Medicine. 2012;74(11):1712-1720. doi: 10.1016/j.socscimed.2011.11.029.

20. Hankivsky O, Christoffersen A. Intersectionality and the determinants of health: A Canadian perspective. Critical Public Health. 2008;18(3):271-283.doi: 10.1080/09581590802294296.

21. Choby AA, Clark AM. Improving health: structure and agency in health interventions. Nursing Philosophy. 2014;15(2):89-101. doi: 10.1111/nup.12018.

22. Bauer GR. Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity. Social Science & Medicine. 2014;110:10-17. doi: 10.1016/j.socscimed.2014.03.022.

23. Olofsson A, Zinn JO, Griffin G, Nygren KG, Cebulla A, Hannah-Moffat K. The mutual constitution of risk and inequalities: intersectional risk theory. Health, Risk & Society. 2014;16(5):417-430. doi: 10.1080/13698575.2014.942258.

24. Kapilashrami A, Hill S, Meer N. What can health inequalities researchers learn from an intersectionality perspective? Understanding social dynamics with an inter-categorical approach? Social Theory and Health. 2015;13(3-4):288-307.

25. Larson E, George A, Morgan R, Poteat T. 10 Best resources on... intersectionality with an emphasis on low- and middle-income countries. Health Policy and Planning. 2016;31(8):964-969. doi: 10.1093/heapol/czw020.

26. Hankivsky O, Doyal L, Einstein G, Kelly U, Shim J, Weber L, Repta R. The odd couple: using biomedical and intersectional approaches to address health inequities. Global Health Action. 2017; 10(Suppl 2):1326686. doi: 10.1080/16549716.2017.1326686.

27. Guthrie BJ, Low LK. Moving beyond the trickle-down approach: addressing the unique disparate health experiences of adolescents of color. Journal for Specialists in Pediatric Nursing. 2006;11(1):3-13. doi: 10.1111/j.1744-6155.2006.00038.x.

28. Bredström A. Intersectionality: A challenge for feminist HIV/AIDS research? European Journal of Women’s Studies. 2006;13(3):229-243. doi: 10.1177/1350506806065754.

29. Fish J. Navigating queer street: Researching the intersections of lesbian, gay, bisexual and trans (LGBT) identities in health research. Sociological Research Online. 2008;13(1):1-12. doi: 10.5153/sro.1652.

30. Benoit C, Shumka L, Vallance K, Hallgrímsdóttir H, Phillips R, Kobayashi K, Hankivsky O, Reid C, Brief E. Explaining the health gap experienced by girls and women in Canada: A social determinants of health perspective. Sociological Research Online. 2009;14(5). doi: 10.5153/sro.2024.

31. Lekan D. Sojourner syndrome and health disparities in African American women. Advances in Nursing Science. 2009;32(4):307-321. doi: 10.1097/ANS.0b013e3181bd994c.

32. Hankivsky O, Reid C, Cormier R, Varcoe C, Clark N, Benoit C, Brotman S. Exploring the promises of intersectionality for advancing women’s health research. International Journal for Equity in Health. 2010;9(5):1-15. doi: 10.1186/1475-9276-9-5.

33. McGibbon E, McPherson C. Applying intersectionality and complexity theory to address the social determinants of women’s health. Womens Health Urban Life. 2011;10(1):59-89.

34. Viruell-Fuentes EA, Miranda PY, Abdulrahim S. More than culture: structural racism, intersectionality theory, and immigrant health. Social Science & Medicine. 2012;75(12):2099-2106. doi: 10.1016/j.socscimed.2011.12.037.

35. Koehn S, Neysmith S, Kobayashi K, Khamisa H. Revealing the shape of knowledge using an intersectionality lens: Results of a scoping review on the health and health care of ethnocultural minority older adults. Ageing & Society. 2013;33(3):437-464. doi: 10.1017/S0144686X12000013.

36. Robinson M, Ross LE. Gender and sexual minorities: Intersecting inequalities and health. Ethnicity and Inequalities in Health and Social Care. 2013;6(4):91-96. doi: 10.1108/EIHSC-01-2014-0003.

37. Caiola C, Docherty SL, Relf M, Barroso J. Using an intersectional approach to study the impact of social determinants of health for African American mothers living with HIV. ANS: Advances in nursing science. 2014;37(4):287-298. doi: 10.1097/ANS.0000000000000046.

38. Watkins-Hayes C. Intersectionality and the sociology of HIV/AIDS: Past, present, and future research directions. Annual Review of Sociology. 2014;40:431-457. doi: 10.1146/annurev-soc-071312-145621.

39. O’Brien M, Tolosa MX. The effect of the 2014 West Africa Ebola virus disease epidemic on multi-level violence against women. International Journal of Human Rights in Healthcare. 2016;9(3):151-160. doi: 10.1108/IJHRH-09-2015-0027.

40. Gilbert KL, Ray R, Siddiqi A, Shetty S, Baker EA, Elder K, Griffith DM. Visible and Invisible Trends in Black Men’s Health: Pitfalls and Promises for Addressing Racial, Ethnic, and Gender Inequities in Health. Annual Review of Public Health. 2016;37:295-311. doi: 10.1146/annurev-publhealth-032315-021556.

41. Fields E, Morgan A, Sanders RA. The intersection of sociocultural factors and health-related behavior in lesbian, gay, bisexual, and transgender youth experiences among young black gay males as an example. Pediatric Clinics of North America. 2016;63(6):1091-1106. doi: 10.1016/j.pcl.2016.07.009.

42. Sutherland ME. An intersectional approach for understanding the vulnerabilities of English-speaking heterosexual Caribbean youth to HIV/AIDS and sexually transmitted infections: Prevention and intervention strategies. Health Psychology Open. 2016;3(2):2055102916679349. doi: 10.1177/2055102916679349.

43. Sifris R. The involuntary sterilisation of marginalised women: power, discrimination, and intersectionality. Griffith Law Review. 2016;25(1):45-70.

44. Williams DR, Kontos EZ, Viswanath K, Haas JS, Lathan CS, Macconaill LE, Chen J, Ayanian JZ. Integrating multiple social statuses in health disparities research: the case of lung cancer. Health Services Research. 2012;47(3):1255-1277. doi: 10.1111/j.1475-6773.2012.01404.x.

45. Hankivsky O, Grace D, Hunting G, Giesbrecht M, Fridkin A, Rudrum S, et al. An intersectionality-based policy analysis framework: Critical reflections on a methodology for advancing equity. International Journal for Equity in Health. 2014;13:119. doi: 10.1186/s12939-014-0119-x.

46. Corus C, Saatcioglu B. An intersectionality framework for transformative services research. The Service Industries Journal. 2015;35(7-8):415-429. doi: 10.1080/02642069.2015.1015522.

47. Choo HY, Ferree MM. Practicing intersectionality in sociological research: A critical analysis of inclusions, interactions, and institutions in the study of inequalities. Sociological Theory. 2010;28(2):129-149. doi: 10.1111/j.1467-9558.2010.01370.x.

48. McCall L. The complexity of intersectionality. Signs: Journal of Women in Culture and Society. 2005;30(3):1771-1800. doi: 10.1086/426800.

49. Crenshaw K. Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory, and antiracist politics. University of Chicago Legal Forum. 1989:139-167.

50. Dworkin SL. Who is epidemiologically fathomable in the HIV/AIDS epidemic?: Gender, sexuality, and intersectionality in public health. Culture, Health & Sexuality. 2005;7(6):615-623. doi: 10.1080/13691050500100385.

51. Krieger N. Epidemiology and social sciences: towards a critical reengagement in the 21st century. Epidemiologic Reviews. 2000;22(1):155-163.

52. Santos BS. Um discurso sobre as ciências. São Paulo: Cortez; 2006.