PAPERThe Problem with the Phrase women and minorities: Intersectionality-an important theoretical framework for Public Health

Title:

The Problem with the Phrase women and minorities:Intersectionality-an important theoretical framework for Public Health

Writer:

Lisa Bowleg, PhD

Year:

2012

Reference:

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.

My summary

I know about the social determinants of health that notify that a health disparity is not only influenced by individual dimensions, but also social, cultural, health systems and health policy and other layer dimensions in one country. The introduction of intersectionality emphasized that every layer of these social determinants of health cannot be extracted from other layers and embedded in one individual.

For instance, a low educated woman with in a monogamous marriage with HIV with negative-HIV husband, not only deal with a gender inequality because of her gender, but also she was embedded with the marital values as a wife, HIV negative-label on woman as a sex worker and her financial dependence on her husband. This condition will differ with a well-educated woman with HIV status on her first deceased husband and negative-HIV status on her second husband. Both of them may deal with privileges and challenges in accessing a health service.

Therefore, applying intersectionality in data analysis or framework may help to understand health inequity and health inequality within micro level of individual that cannot be extracted or can be interlocked with the macro level of social structural level categories-beyond individual level (ex. racism, sexism, heterosexual hegemony and morality), therefore, a public health has to learn to appreciate every unique experience, especially for marginalized groups.

Important quotation:

Intersectionality is the critical, unifying, and long overdue theoretical framework for which public health has been waiting (Bowleg, 2012, pp 1272)

Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). (Bowleg, 2012, pp 1267)

a low-income Latina lesbian with a physical disability

key omission from most policy and research is first and foremost the recognition of multiple intersecting social identities and next an acknowledgment of how the intersection of multiple interlocking identities
at the micro level reflects multiple and interlocking structural-level inequality at the macro levels of society. (Bowleg, 2012, pp 1267)

most public health research typically examines each system independently, “thus impairing efforts to understand the health of people whose lives cut across these diverse realisms of experiences.”9(p99) (Bowleg, 2012, pp 1267)

(9. Krieger N, Rowley DL, Herman AA, Avery B, Phillips MT. Racism, sexism, and social class: implications for studies of health, disease , and well-being. Am J Prev Med. 1993;9(6):82-122. )

I consider the core tenets of intersectionality most relevant to public health to be as follows: (1) social identities are not independent and unidimensional but multiple and intersecting, (2) people from multiple historically oppressed and marginalized groups are the focal or starting point, and (3) multiple social identities at the micro level (i.e., intersections of race, gender, and SES) intersect with macrolevel structural factors (i.e., poverty, racism, and sexism) to illustrate or produce disparate health outcomes. (Bowleg, 2012, pp 1269)

Yet despite its emphasis on multiple socially disadvantaged statuses as a focal point, intersectionality does not presume that all interlocking identities are equally disadvantaged. Rather, intersectionality considers how low (e.g., racial minority, LGBT persons) and high (e.g., upper- or middle-class SES) status social identities intersect to yield disparity and advantage.7,20  (Bowleg, 2012, pp 1269)

Whether using language such as “social determinants of health,”31 “social discrimination or social inequality,”9,32 “fundamental causes,”33-35 “structural factors or influences,”36 or “ecological or ecosocial influences,”37,38 an ever-growing chorus of public health scholars have advocated for a greater focus on how social-structural factors beyond the level of the individual influence health. (Bowleg, 2012, pp 1269)

This too is a core tenet of intersectionality. Moreover, a central consideration of intersectionality is how multiple social identities at
the individual level of experience (i.e., the micro level) intersect with multiple-level social inequalities at the macro structural level. (Bowleg, 2012, pp 1269)

Abstract

Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). Public health’s commitment to social justice makes it a natural fit with intersectionality’s focus on multiple historically oppressed populations. Yet despite a plethora of research focused on these populations, public health studies that reflect intersectionality in their theoretical frameworks, designs, analyses, or interpretations are rare. Accordingly, I describe the history and central tenets of intersectionality, address some theoretical and methodological challenges, and highlight the benefits of intersectionality for public health theory, research, and policy. (Am J Public Health. 2012;102:1267–1273. doi:10. 2105/AJPH.2012.300750)

Important quotation

Further compounding the issue is that the word minority is multidefinitional. Although
it typically modifies race/ethnicity in the United States, minority also can reference populations such as lesbian, gay, bisexual, and transgender (LGBT) people; people with physical and mental disabilities; or, depending on geographic context, White people. Thus, in addition to being vague, the term minority in conjunction with women obscures the existence of multiple intersecting categories as exemplified by, for instance, a low-income Latina lesbian with a physical disability. Pp 1267

Black gay or bisexual man might influence health. Acknowledging the existence of multiple intersecting identities is an initial step in understanding the complexities of health disparities for populations from multiple historically oppressed groups. The other critical step is recognizing how systems of privilege and oppression that result in multiple social inequalities (e.g., racism, hetero- sexism, sexism, classism) intersect at the macro social-structural level to maintain health disparities. Pp 1267

Enter intersectionality. Intersectionality is
a theoretical framework for understanding how multiple social identities such as race, gender, sexual orientation, SES, and disability intersect at the micro level of individual experience to reflect interlocking systems of privilege and oppression (i.e., racism, sexism, heterosexism, classism) at the macro social- structural level.4-7 Far from being just an exercise in semantics, intersectionality provides the discipline of public health with a critical unifying interpretive and analytical framework for reframing how public health scholars conceptualize, investigate, analyze, and address disparities and social inequality in health. Pp 1267

This priority is further reflected in public health and biomedical journals, which are replete with health disparities research. Yet a key omission from most policy and research is first and foremost the recognition of multiple intersecting social identities and next an acknowledgment of how the intersection of multiple interlocking identities
at the micro level reflects multiple and interlocking structural-level inequality at the macro levels of society. Pp 1267

The need for intersectionality as a unifying public health framework is further underscored by the relative dearth of theory and research that specifically address the multiple and interlocking influence of systems of privilege and oppression such as racism, sexism, and heterosexism. Instead, most public health research typically examines each system independently, “thus impairing efforts to understand the health of people whose lives cut across these diverse realisms of experiences.”9(p99) Pp 1267

Indeed, intersectionality departs from traditional biomedical, biobehavioral, and psychosocial paradigms that have shaped medicine, public health, and the other social sciences in several key ways. A comprehensive discussion of these differences is beyond the scope of this article. Instead, I refer readers to Weber and Parra-Medina’s15 excellent chapter on intersectionality and women’s health in which they elucidate the differences between the traditional biomedical, biobehavioral, and psychosocial paradigms and intersectionality. Pp 1268

(15. Weber L, Parra-Medina D. Intersectionality and women’s health: charting a path to eliminating health disparities. In: Segal MT, Demos V, Kronenfeld, eds. Gender Perspectives on Health and Medicine (Advances in Gender Research, Volume 7). Bingley, UK: Emerald Group Publishing; 2003:181-230.)

I consider the core tenets of intersectionality most relevant to public health to be as follows: (1) social identities are not independent and unidimensional but multiple and intersecting, (2) people from multiple historically oppressed and marginalized groups are the focal or starting point, and (3) multiple social identities at the micro level (i.e., intersections of race, gender, and SES) intersect with macrolevel structural factors (i.e., poverty, racism, and sexism) to illustrate or produce disparate health outcomes. Pp 1269

Yet despite its emphasis on multiple socially disadvantaged statuses as a focal point, intersectionality does not presume that all interlocking identities are equally disadvantaged. Rather, intersectionality considers how low (e.g., racial minority, LGBT persons) and high (e.g., upper- or middle-class SES) status social identities intersect to yield disparity and advantage.7,20  pp 1269

(20. Nash JC. Re-thinking intersectionality. Fem Rev. 2008;89:1-15.

Social-Structural Context of Health

Whether using language such as “social determinants of health,”31 “social discrimination or social inequality,”9,32 “fundamental causes,”33-35 “structural factors or influences,”36 or “ecological or ecosocial influences,”37,38 an ever-growing chorus of public health scholars have advocated for a greater focus on how social-structural factors beyond the level of the individual influence health. Pp1269

This too is a core tenet of intersectionality. Moreover, a central consideration of intersectionality is how multiple social identities at
the individual level of experience (i.e., the micro level) intersect with multiple-level social inequalities at the macro structural level. Pp 1269

From an intersectionality perspective, a middle- class Latina lesbian’s negative experiences at her physician’s office are linked to multiple and interlocking sexism, heterosexism, and racism at the macro level. Her microlevel experiences at the intersection of her race/ ethnicity, sexual orientation, and gender cor- respond with empirically documented evi- dence of the heterosexism that lesbian and bisexual women often encounter when they seek health care services39,40 and the inter- section of racism and sexism well documented in research on racial/ethnic minority women’s health care experiences.9,41,42 las, with the exception of a 1988 study focused on Black lesbian and bisexual women’s experiences of disclosing their sexual identity to physicians,43 much of the research on lesbian and bisexual women’s experiences in health care settings stems from research with predominantly White middle-class lesbian and bisexual women. Similarly, much of the research on racial/ethnic minority women’s experiences in health care settings does not include or report sexual orientation data or presumes heterosexuality, thereby limiting an in-depth understanding of women’s experiences in health care settings beyond the intersections of gender and race.

pp 1269-1279

Intersectionality stands to benefit public health in at least 5 noteworthy ways. First, intersectionality provides a unifying language and theoretical framework for public health scholars who are already engaged in investigating intersections of race, ethnicity, gender, sexual orientation, SES, and disability to reduce and eliminate health disparities. Having scholars from diverse disciplines incorporate the intersectionality framework as an analytical perspective regardless of methodological approach16 and explicitly use the word intersectionality in their titles, keywords, abstracts, or articles would facilitate a cohesive body of theoretical and empirical knowledge about multiple intersecting social categories and social inequality that could inform health policy, practice, and interventions and further theoretical and methodological advancement and refinement of intersectionality.

Second, intersectionality prompts public health scholars to conceptualize and analyze disparities and social inequalities in health in the complex and multidimensional ways that mirror the experiences of the populations for whom adverse health outcomes are most disproportionate. From intersectionality’s perspective, single or dual analytical categories such as race and gender offer limited explanatory power. Intersectionality also provides a theoretical lens for interpreting novel or unanticipated findings. This was the conclusion that Kertzner et al.64 reached when they determined that their additive social stress model showed no diminished well-being among racial/ethnic minority lesbians or gay men: “Studying identity intersection (Black poor women) will be more informative than studying Blacks, women and poor individuals separately.”(p508)

Third, intersectionality’s focus on the importance of macrolevel social-structural factors aligns well with contemporary advocacy to consider the substantial effect of factors beyond the level of the individual on health. SES, for example, is one of the best predictors of health status.65 Furthermore, intersectionality expands this focus to consider the intersection of multiple-level social-structural factors as well as the intersection between multiple microlevel and macrolevel factors. Privileging a focus on structural-level factors rather than an exclusive focus on the individual is likely to facilitate the development of structural-level interventions more likely to affect the “fundamental causes” (e.g., poverty, social discrimination) of social inequalities in health in the United States.15,21,33-35,66

Fourth, because intersectionality takes the experiences of historically oppressed or mar- ginalized populations as its vantage point, it can facilitate and inform the development of well- targeted and cost-effective health promotion messages, interventions, and policies.

Finally, the intersectionality perspective naturally summons and supports the collection, analysis, and presentation of surveillance and health data that allow examination of multiple interlocking social identities across several categories beyond race and gender.

TOWARD AN INTERSECTIONALITY- INFORMED PUBLIC HEALTH

Intersectionality is critical to public health because it “embraces rather than avoids the complexities that are essential to understanding social inequities, which in turn manifest in health inequities.”13(p279) This makes the relative invisibility of intersectionality within the discipline of public health all the more puzzling. The discipline of public health, like intersectionality, is interdisciplinary. More importantly, public health’s commitment, as the American Public Health Association’s68 mission statement affirms, to “working to improve the public’s health and to achieve equity in health status for all”(p1) is an ideal mesh with intersectionality’s social justice bent.13 Complex multidimensional issues such as entrenched health disparities and social inequality among people from multiple historically oppressed and marginalized populations beg novel and complex multidimensional approaches. Intersectionality is the critical, unifying, and long overdue theoretical framework for which public health has been waiting. pp1272

13. Hankivsky O, Christoffersen A. Intersectionality and the determinants of health: a Canadian perspective. Crit Public Health. 2008;18(3):271--283.

 Title:

The Problem with the Phrase women and minorities: Intersectionality-an important theoretical framework for Public Health

Writer:

Lisa Bowleg, PhD

Year:

2012

Reference:

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.

My summary

I know about the social determinants of health that notify that a health disparity is not only influenced by individual dimensions, but also social, cultural, health systems and health policy and other layer dimensions in one country. The introduction of intersectionality emphasized that every layer of these social determinants of health cannot be extracted from other layers and embedded in one individual.

For instance, a low educated woman with in a monogamous marriage with HIV with negative-HIV husband, not only deal with a gender inequality because of her gender, but also she was embedded with the marital values as a wife, HIV negative-label on woman as a sex worker and her financial dependence on her husband. This condition will differ with a well-educated woman with HIV status on her first deceased husband and negative-HIV status on her second husband. Both of them may deal with privileges and challenges in accessing a health service.

Therefore, applying intersectionality in data analysis or framework may help to understand health inequity and health inequality within micro level of individual that cannot be extracted or can be interlocked with the macro level of social structural level categories-beyond individual level (ex. racism, sexism, heterosexual hegemony and morality), therefore, a public health has to learn to appreciate every unique experience, especially for marginalized groups.

Important quotation:

Intersectionality is the critical, unifying, and long overdue theoretical framework for which public health has been waiting (Bowleg, 2012, pp 1272)

Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). (Bowleg, 2012, pp 1267)

a low-income Latina lesbian with a physical disability

key omission from most policy and research is first and foremost the recognition of multiple intersecting social identities and next an acknowledgment of how the intersection of multiple interlocking identities
at the micro level reflects multiple and interlocking structural-level inequality at the macro levels of society. (Bowleg, 2012, pp 1267)

most public health research typically examines each system independently, “thus impairing efforts to understand the health of people whose lives cut across these diverse realisms of experiences.”9(p99) (Bowleg, 2012, pp 1267)

(9. Krieger N, Rowley DL, Herman AA, Avery B, Phillips MT. Racism, sexism, and social class: implications for studies of health, disease , and well-being. Am J Prev Med. 1993;9(6):82-122. )

I consider the core tenets of intersectionality most relevant to public health to be as follows: (1) social identities are not independent and unidimensional but multiple and intersecting, (2) people from multiple historically oppressed and marginalized groups are the focal or starting point, and (3) multiple social identities at the micro level (i.e., intersections of race, gender, and SES) intersect with macrolevel structural factors (i.e., poverty, racism, and sexism) to illustrate or produce disparate health outcomes. (Bowleg, 2012, pp 1269)

Yet despite its emphasis on multiple socially disadvantaged statuses as a focal point, intersectionality does not presume that all interlocking identities are equally disadvantaged. Rather, intersectionality considers how low (e.g., racial minority, LGBT persons) and high (e.g., upper- or middle-class SES) status social identities intersect to yield disparity and advantage.7,20  (Bowleg, 2012, pp 1269)

Whether using language such as “social determinants of health,”31 “social discrimination or social inequality,”9,32 “fundamental causes,”33-35 “structural factors or influences,”36 or “ecological or ecosocial influences,”37,38 an ever-growing chorus of public health scholars have advocated for a greater focus on how social-structural factors beyond the level of the individual influence health. (Bowleg, 2012, pp 1269)

This too is a core tenet of intersectionality. Moreover, a central consideration of intersectionality is how multiple social identities at
the individual level of experience (i.e., the micro level) intersect with multiple-level social inequalities at the macro structural level. (Bowleg, 2012, pp 1269)

Abstract

Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). Public health’s commitment to social justice makes it a natural fit with intersectionality’s focus on multiple historically oppressed populations. Yet despite a plethora of research focused on these populations, public health studies that reflect intersectionality in their theoretical frameworks, designs, analyses, or interpretations are rare. Accordingly, I describe the history and central tenets of intersectionality, address some theoretical and methodological challenges, and highlight the benefits of intersectionality for public health theory, research, and policy. (Am J Public Health. 2012;102:1267–1273. doi:10. 2105/AJPH.2012.300750)

Important quotation

Further compounding the issue is that the word minority is multidefinitional. Although
it typically modifies race/ethnicity in the United States, minority also can reference populations such as lesbian, gay, bisexual, and transgender (LGBT) people; people with physical and mental disabilities; or, depending on geographic context, White people. Thus, in addition to being vague, the term minority in conjunction with women obscures the existence of multiple intersecting categories as exemplified by, for instance, a low-income Latina lesbian with a physical disability. Pp 1267

Black gay or bisexual man might influence health. Acknowledging the existence of multiple intersecting identities is an initial step in understanding the complexities of health disparities for populations from multiple historically oppressed groups. The other critical step is recognizing how systems of privilege and oppression that result in multiple social inequalities (e.g., racism, hetero- sexism, sexism, classism) intersect at the macro social-structural level to maintain health disparities. Pp 1267

Enter intersectionality. Intersectionality is
a theoretical framework for understanding how multiple social identities such as race, gender, sexual orientation, SES, and disability intersect at the micro level of individual experience to reflect interlocking systems of privilege and oppression (i.e., racism, sexism, heterosexism, classism) at the macro social- structural level.4-7 Far from being just an exercise in semantics, intersectionality provides the discipline of public health with a critical unifying interpretive and analytical framework for reframing how public health scholars conceptualize, investigate, analyze, and address disparities and social inequality in health. Pp 1267

This priority is further reflected in public health and biomedical journals, which are replete with health disparities research. Yet a key omission from most policy and research is first and foremost the recognition of multiple intersecting social identities and next an acknowledgment of how the intersection of multiple interlocking identities
at the micro level reflects multiple and interlocking structural-level inequality at the macro levels of society. Pp 1267

The need for intersectionality as a unifying public health framework is further underscored by the relative dearth of theory and research that specifically address the multiple and interlocking influence of systems of privilege and oppression such as racism, sexism, and heterosexism. Instead, most public health research typically examines each system independently, “thus impairing efforts to understand the health of people whose lives cut across these diverse realisms of experiences.”9(p99) Pp 1267

Indeed, intersectionality departs from traditional biomedical, biobehavioral, and psychosocial paradigms that have shaped medicine, public health, and the other social sciences in several key ways. A comprehensive discussion of these differences is beyond the scope of this article. Instead, I refer readers to Weber and Parra-Medina’s15 excellent chapter on intersectionality and women’s health in which they elucidate the differences between the traditional biomedical, biobehavioral, and psychosocial paradigms and intersectionality. Pp 1268

(15. Weber L, Parra-Medina D. Intersectionality and women’s health: charting a path to eliminating health disparities. In: Segal MT, Demos V, Kronenfeld, eds. Gender Perspectives on Health and Medicine (Advances in Gender Research, Volume 7). Bingley, UK: Emerald Group Publishing; 2003:181-230.)

I consider the core tenets of intersectionality most relevant to public health to be as follows: (1) social identities are not independent and unidimensional but multiple and intersecting, (2) people from multiple historically oppressed and marginalized groups are the focal or starting point, and (3) multiple social identities at the micro level (i.e., intersections of race, gender, and SES) intersect with macrolevel structural factors (i.e., poverty, racism, and sexism) to illustrate or produce disparate health outcomes. Pp 1269

Yet despite its emphasis on multiple socially disadvantaged statuses as a focal point, intersectionality does not presume that all interlocking identities are equally disadvantaged. Rather, intersectionality considers how low (e.g., racial minority, LGBT persons) and high (e.g., upper- or middle-class SES) status social identities intersect to yield disparity and advantage.7,20  pp 1269

(20. Nash JC. Re-thinking intersectionality. Fem Rev. 2008;89:1-15.

Social-Structural Context of Health

Whether using language such as “social determinants of health,”31 “social discrimination or social inequality,”9,32 “fundamental causes,”33-35 “structural factors or influences,”36 or “ecological or ecosocial influences,”37,38 an ever-growing chorus of public health scholars have advocated for a greater focus on how social-structural factors beyond the level of the individual influence health. Pp1269

This too is a core tenet of intersectionality. Moreover, a central consideration of intersectionality is how multiple social identities at
the individual level of experience (i.e., the micro level) intersect with multiple-level social inequalities at the macro structural level. Pp 1269

From an intersectionality perspective, a middle- class Latina lesbian’s negative experiences at her physician’s office are linked to multiple and interlocking sexism, heterosexism, and racism at the macro level. Her microlevel experiences at the intersection of her race/ ethnicity, sexual orientation, and gender cor- respond with empirically documented evi- dence of the heterosexism that lesbian and bisexual women often encounter when they seek health care services39,40 and the inter- section of racism and sexism well documented in research on racial/ethnic minority women’s health care experiences.9,41,42 las, with the exception of a 1988 study focused on Black lesbian and bisexual women’s experiences of disclosing their sexual identity to physicians,43 much of the research on lesbian and bisexual women’s experiences in health care settings stems from research with predominantly White middle-class lesbian and bisexual women. Similarly, much of the research on racial/ethnic minority women’s experiences in health care settings does not include or report sexual orientation data or presumes heterosexuality, thereby limiting an in-depth understanding of women’s experiences in health care settings beyond the intersections of gender and race.

pp 1269-1279

Intersectionality stands to benefit public health in at least 5 noteworthy ways. First, intersectionality provides a unifying language and theoretical framework for public health scholars who are already engaged in investigating intersections of race, ethnicity, gender, sexual orientation, SES, and disability to reduce and eliminate health disparities. Having scholars from diverse disciplines incorporate the intersectionality framework as an analytical perspective regardless of methodological approach16 and explicitly use the word intersectionality in their titles, keywords, abstracts, or articles would facilitate a cohesive body of theoretical and empirical knowledge about multiple intersecting social categories and social inequality that could inform health policy, practice, and interventions and further theoretical and methodological advancement and refinement of intersectionality.

Second, intersectionality prompts public health scholars to conceptualize and analyze disparities and social inequalities in health in the complex and multidimensional ways that mirror the experiences of the populations for whom adverse health outcomes are most disproportionate. From intersectionality’s perspective, single or dual analytical categories such as race and gender offer limited explanatory power. Intersectionality also provides a theoretical lens for interpreting novel or unanticipated findings. This was the conclusion that Kertzner et al.64 reached when they determined that their additive social stress model showed no diminished well-being among racial/ethnic minority lesbians or gay men: “Studying identity intersection (Black poor women) will be more informative than studying Blacks, women and poor individuals separately.”(p508)

Third, intersectionality’s focus on the importance of macrolevel social-structural factors aligns well with contemporary advocacy to consider the substantial effect of factors beyond the level of the individual on health. SES, for example, is one of the best predictors of health status.65 Furthermore, intersectionality expands this focus to consider the intersection of multiple-level social-structural factors as well as the intersection between multiple microlevel and macrolevel factors. Privileging a focus on structural-level factors rather than an exclusive focus on the individual is likely to facilitate the development of structural-level interventions more likely to affect the “fundamental causes” (e.g., poverty, social discrimination) of social inequalities in health in the United States.15,21,33-35,66

Fourth, because intersectionality takes the experiences of historically oppressed or mar- ginalized populations as its vantage point, it can facilitate and inform the development of well- targeted and cost-effective health promotion messages, interventions, and policies.

Finally, the intersectionality perspective naturally summons and supports the collection, analysis, and presentation of surveillance and health data that allow examination of multiple interlocking social identities across several categories beyond race and gender.

TOWARD AN INTERSECTIONALITY- INFORMED PUBLIC HEALTH

Intersectionality is critical to public health because it “embraces rather than avoids the complexities that are essential to understanding social inequities, which in turn manifest in health inequities.”13(p279) This makes the relative invisibility of intersectionality within the discipline of public health all the more puzzling. The discipline of public health, like intersectionality, is interdisciplinary. More importantly, public health’s commitment, as the American Public Health Association’s68 mission statement affirms, to “working to improve the public’s health and to achieve equity in health status for all”(p1) is an ideal mesh with intersectionality’s social justice bent.13 Complex multidimensional issues such as entrenched health disparities and social inequality among people from multiple historically oppressed and marginalized populations beg novel and complex multidimensional approaches. Intersectionality is the critical, unifying, and long overdue theoretical framework for which public health has been waiting. pp1272

13. Hankivsky O, Christoffersen A. Intersectionality and the determinants of health: a Canadian perspective. Crit Public Health. 2008;18(3):271--283.