The odd couple: using biomedical and intersectional approaches to address health inequities

ABSTRACT

Background: Better understanding and addressing health inequities is a growing global priority.

Objective: In this paper, we contribute to the literature examining complex relationships between biological and social dimensions in the field of health inequalities. Specifically, we explore the potential of intersectionality to advance current approaches to socio-biological entwinements.

Design: We provide a brief overview of current approaches to combining both biological and social factors in a single study, and then investigate the contributions of an intersectional framework to such work.

Results: We offer a number of concrete examples of how intersectionality has been used empirically to bring both biological and social factors together in the areas of HIV, post-traumatic stress disorder, female genital circumcision/mutilation/cutting, and cardiovascular disease.

Conclusion: We argue that an intersectional approach can further research that integrates biological and social aspects of human lives and human health and ultimately generate better and more precise evidence for effective policies and practices aimed at tackling health inequities.

KEYWORDS:

• Intersectionality
• biomedicine
• health inequity
• interdisciplinary

Responsible Editor Isabel Goicolea, Umeå University, Sweden

SPECIAL ISSUE Gender and Health Inequality - intersections with other relevant axes of oppression

Responsible Editor Isabel Goicolea, Umeå University, Sweden

SPECIAL ISSUE Gender and Health Inequality - intersections with other relevant axes of oppression

Acknowledgments

GE: I would like to acknowledge collaborators Janice Du Mont, Robin Mason, Jan Angus, Caroline Pukall, Allan Gorden, Sheila Dunn, and our community advisory group. JS: My deepest appreciation goes to my participants, who warmly welcomed me into their homes and offices, and responded to my questions with thoughtfulness, respect, and grace. The project would not be what it is without their honesty, perspectives, and generosity of time and spirit.

Availability of data and material

Data included in this paper is available from the corresponding author on reasonable request.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics and consent

Written consent for publication was obtained from the participants of all of the research examples we discuss. GE: The study on FGC was approved by the University of Toronto Health Sciences Research Ethics Board, original protocol #22151. UK: The study on PTSD was approved by the University of North Carolina - Chapel Hill, IRB #08-0578. JS: The Committee on Human Research, the official Institutional Review Board at the University of California, San Francisco, approved the study.

Funding information

We would like to acknowledge the following funding. OH: CIHR Mid-Career Research Chair - New Perspectives on Sex/Gender; Michael Smith Foundation for Health Research Senior Scholar in Population Health. GE: My study on FGC was funded by CIHR-IGH [grant no. 191876]. UK: NINR Institutional NRSA [grant no. 5 T32 NR007091-12]. JS: Agency for Healthcare Research and Quality Dissertation Research Grant [R03 HS10582], a Doctoral Dissertation Improvement Grant from the National Science Foundation [SES-0114986], a National Institute on Aging grant (Sharon Kaufman, Principal Investigator) [R01 AG20962], and intramural support from the UCSF School of Nursing. RR: While working on this manuscript I was supported by a CIHR Doctoral Award (CGS-D), a CIHR PHARE Doctoral Fellowship, and a CIHR IMPART Doctoral Fellowship.

Paper context

This paper contributes to literature examining complex relationships between biological and social dimensions in the field of health inequalities by exploring how to combine biomedicine and intersectionality. It offers examples in HIV, post-traumatic stress disorder (PTSD), female genital circumcision/mutilation/cutting (FGC), and cardiovascular disease (CVD). The paper provides evidence to show how an intersectional approach can further research that integrates biological and social aspects of human health and generate more precise evidence for effective policies and practices aimed at tackling health inequities.

Additional information

Notes on contributors

Olena Hankivsky

The author order reflects the contributions to the manuscript. The lead author wrote the first draft and each contributing author provided case examples. OH and LD worked on subsequent versions and edits of the paper. OH led the overall design and drafting of the paper. LD, GE, LW, UK, JS, and RR played major roles in determining the frame for the paper and writing the examples. All authors provided critical feedback and approved the final manuscript.