The feminist perspective of intersectionality in the field of public health: a narrative review of the theoretical-methodological literature

Marcia Thereza Couto; Elda de Oliveira; Marco Antônio Alves Separavich; Olinda do Carmo Luiz

doi:10.18294/sc.2019.1994

The feminist perspective of intersectionality in the field of public health: a narrative review of the theoretical-methodological literature

Marcia Thereza Couto PhD in Sociology. Post Doctorate in Collective Health. Professor, Department of Preventive Medicine, School of Medicine, University of São Paulo, Brazil. , Elda de Oliveira PhD in Sociology. Researcher in Preventive Medicine, School of Medicine, University of São Paulo, Brazil. , Marco Antônio Alves Separavich PhD in Collective Health. Researcher, Department of Preventive Medicine, School of Medicine, University of São Paulo, Brazil. , Olinda do Carmo Luiz PhD in Preventive Medicine. Researcher, Department of Preventive Medicine, School of Medicine, University of São Paulo, Brazil.

Received: 9 August 2018, Accepted: 20 December 2018, Published: 9 March 2019

https://doi.org/10.18294/sc.2019.1994 | PMID: 37697497

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Abstract

The intersectionality approach emerged in the late 1990s in the field of black feminist activism in the USA, as a critique of one-dimensional analyses of social inequalities. This descriptive-analytical narrative review presents the current state of theoretical-methodological inclusion of intersectionality in public health. Seven scientific literature databases were consulted: Web of Science, Embase, Cinahl, Scopus, Sociological Abstracts, Lilacs, and Medline, resulting in 1763 papers. After duplicates were eliminated and the titles and abstracts screened, 30 papers produced in five countries between 2006 and 2017 were selected. The analysis, structured into three central themes (theoretical-methodological debates, social markers – gender, race, ethnicity and sexual orientation – and health policies and practices), shows intersectionality to be a promising analytical resource for understanding and facing the global challenge of inequalities in health.

Keywords: Public Health, Review, Health Disparities, Gender Identity, Race and Health

References

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.