Intersectionality in healthcare

Importance of intersectionality
Real world issues without intersectionality
Intersectionality training
Benefits of intersectionality
Conclusion
References
Further reading


Importance of intersectionality

What is intersectionality? This relatively new term has to do with each individual’s unique experiences of discrimination and stigma, experiencing intersecting layers of oppression from different social identities. This could include race, gender, religion and class.

Why is this important in healthcare? On the patient side, people may be treated differently by healthcare workers and professionals, employers, co-workers, neighbors or family – depending on a disease associated with their socio-economic status, racial identity or their identification with other oppressed minority groups. These intersecting identities could lead to devaluation, stereotyping, judgment and discrimination of the patient.

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On the health care side, like an article in The Lancet says it, “Unconscious bias can contribute to a systematic underestimation of qualified candidates’ abilities. The result, in either case, could be feelings of guilt and shame or fear of being judged that prevent the individual from accessing or entering the health care system as a patient or professional. .

This is where an intersectional framework becomes useful in health care. It helps diagnose disease without resorting to easily stereotyped assumptions about systemic biases against disadvantaged and marginalized patients.

Simply, by examining the intersecting ways in which healthcare institutions themselves marginalize and discriminate against certain oppressed groups and exercise or implement power structures that perpetuate such oppression, intersectionality helps to understand and address this evil by bringing these factors to the forefront of consciousness. That is, it argues that the root of critical health care disparities is the failure, at the institutional level, to understand that social problems and health care inequalities do not exist. or do not affect the life of the individual in isolation, but are intrinsically linked to subordinate oppressed individuals and groups.

Real world issues without intersectionality

The place of a given patient in a health system depends mainly on the health professional who accompanies him. Although these may be culturally sensitive and easily adaptable to the demands of different cultures, with the humility to learn from others of very different identities may not be enough to understand how power and prejudice affect the social system to cause injustice. and oppression. This is where intersectionality comes into its own.

In other words, none of these issues can be addressed or even considered in isolation. Examples abound, including the fact that black men receive a higher level of care than black women in hospitals not otherwise notable for their sensitivity to black patients.

Image Credit: TommyStockProject/Shutterstock.com

Image Credit: TommyStockProject/Shutterstock.com

Worse still, the CDC has estimated that a black woman in America is 400% more likely to die during pregnancy or childbirth than others. Many of them are preventable because they are caused by unequal standards of treatment for black women, due in most cases to unconscious physician biases.

This illustrates the intersection of black and female identity in lowering the doctor’s personal standard of care for the patient, compared to someone who is not black, not a woman or not either.

During the ongoing coronavirus disease 2019 (COVID-19) pandemic, black and Latinx communities were much more likely to be infected than any other ethnic group. Underlying factors include lower average income, lack of adequate housing, front-line jobs in the essential low-income category that precluded working from home, lack of private transportation, and lack of health care benefits. job-related health were all responsible for this fracture. , which led to extremely privileged positions for those who already had a multitude of opportunities.

Intersectionality training

To ensure that such a framework is applied, health care professionals should be educated from the earliest days of their training on how race, gender, socioeconomic class, and disabilities of various types interact with with each other – intersect – causing health inequalities and exaggerating them in health care.

With such training, healthcare professionals can become more aware of how they view themselves and their patients in ways shaped by their position, beliefs, attitudes, and experiences. “Unconscious bias training will not address discrimination that results from explicit and intentional biases, but can increase awareness of how inequalities are reproduced, without deliberate action challenging the larger structures and systemic practices that go beyond individuals.”

Another way to ensure health care sees people through an intersectional lens is to constantly take note of key decision makers in health systems. How is their role and influence mediated or affected by their other identities, position, professional role, class, gender, and geographic location? The interplay between these identities can affect their ability to access leadership, their experience of leadership within the system, and the extent to which people are allowed or encouraged to use their talents within their respective organizations and facilities.

Intersectionality and Health Explained

Benefits of intersectionality

Identify the context

Intersectionality allows people to understand inequality more deeply by examining the complex interactions of social and other identities that intensify subordination and devaluation. That is, it gives value to the context in which the discrimination or inequity occurs and not to the objective act taken in isolation.

In people sensitive to such realizations, it could lead to an openness to hearing the experiences of those on the other side, those who experience prejudice and systemic prejudice first-hand. This could help avoid such discriminatory and critical viewpoints (interactional justice) and ensure that all stakeholders have a voice in making decisions that affect them (procedural justice).

In this way, it helps draw attention to the underlying root causes or drivers of inequality and the power structures that support discrimination and marginalization at all levels of society.

Develop good policies

Knowing the different causes that interact to cause a denial of adequate health care will, in turn, help to design policies that target those who need it, namely those who are deprived of equal rights and access to health care through unjust policies.

Promote research

Intersectional approaches are also essential in research to ensure that results are achieved in an equal way. Medical programs are often based on studies that primarily include white people, and diagnostic and treatment standards are therefore often biased in favor of whiteness.

Participatory research will help researchers and participants to jointly own the process of transformation, if combined with the action of reflexivity – reflecting on the accuracy and validity of the standards used in the research and on the experiences reported by people from other walks of life, both on the researcher and study participant side.

Better teach public health

In public health education, this is key to revealing health care disparities and their roots in power structures, social and economic privilege, and unjust or discriminatory policies already in place.

Improve job satisfaction

Finally, an intersectional lens can help understand the constraints that exist among health managers and frontline providers due to many different factors. These may include job dissatisfaction, job insecurity, being treated like outsiders or an inferior position or skills, or performance due to gender, ethnicity, education or immigration status.

Conclusion

Intersectionality analysis ensures we take seriously who has voice and agency in action, and if and how system adaptation and transformation differentially impacts staff and audiences“Increasing diversity in student and staff composition, as well as promoting a diverse organizational protocol, must be combined with ensuring that programs are inclusive and foster a more diverse learning culture. Meanwhile, medical research, as well as medical education, needs to focus more on achieving socially just outcomes.

References

Further reading

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