Intersectionality and tackling barriers to health care

This article was exclusively written for The European Sting by Ms. Rajvi Chaudhary, a fresh graduate from Medical College Baroda and SSG Hospital, India. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

First thing first, what is intersectionality? What does this long word describes and who was the first person to use it and why? Intersectionality term was conceptualized and coined by Kimberlé Crenshaw, law professor and social theorist in 1989 in a paper for the University of Chicago Legal Forum, called “Demarginalizing The Intersection Of Race And Sex: A Black Feminist Critique Of Antidiscrimination Doctrine, Feminist Theory And Antiracist Politics.” as a way to help explain the oppression of African-American women. While the theory began as an exploration, primarily, of the oppression of black women within society and how they both exist at an intersection,and experience intersecting layers of different forms of oppression.¹ 

Intersectionality is a framework that conceptualizes a person, group of people, or social problem as affected by a number of discriminations and disadvantages. It takes into account people’s overlapping identities and experiences in order to understand the complexity of prejudices they face. In other words, the intersectional theory asserts that people are often disadvantaged by multiple sources of oppression like their race, class, gender identity, sexual orientation, religion, and other identity markers.²

Today the analysis has expanded to include many more aspects of social identity and areas of interest but often we talk about intersectionality in health care. Intersectionality in health care includes devaluation and discrediting people based on the different social inequalities and or oppressive identities they hold in conjunction with their health condition and being stereotyped, judged, and discriminated against by societal actors like healthcare providers, employers and work colleagues, neighbors, and family and friends. These things can impact people’s self-confidence and self-esteem in the form of internalized shame, guilt, and fear of impending negative judgment and discriminatory behaviour from others.³ These types of problems related to intersectionality in health care need to be addressed with solutions in hand. So what can we do about it and how it should be addressed? 

The use of an intersectionality framework can improve diagnostic accuracy and protect against systematic biases that disproportionately affect marginalized patients including examples of patients’ intersectionality in medical curricula educates students on how experiences are shaped by the intersection of race, gender, class, and disability, which can create health inequities that are amplified by medical care. Importantly, intersectionality education and reflexivity skills training for medical students and doctors can make them aware of how their social positions, values, and experiences shape their professional identities and approaches to patient care.⁴

An intersectionality lens can also be woven into the everyday resilience framework by asking questions such as who are the actors in the health system, and how do intersecting aspects of their identity (such as gender, class, professional cadre, and location) influence their involvement in organizational processes and health system functioning? Does identity influence who takes up leadership roles and leadership experience at different levels of the health system, including whose capacities are drawn upon and built up through routine organizational processes?⁵

Intersectionality may seem theoretical, but it is meant to be utilized. No matter how or when we have become involved with equity work, it is always possible to more fully integrate intersectionality into our view of these issues.²

1. https://en.wikipedia.org/wiki/Intersectionality#Historical_background
2. https://www.ywboston.org/2017/03/what-is-intersectionality-and-what-does-it-have-to-do-with-me/
3. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-020-01318-w#Sec4
4. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32513-7/fulltext
5. https://resyst.lshtm.ac.uk/sites/resyst/files/content/attachments/2018-08-21/Resilience%20and%20intersectionality%20brief.pdf

About the author

Rajvi Chaudhary is a fresh graduate from Medical College Baroda and SSG Hospital, India. She is a member of MSAI, IFMSA. She had volunteered to supervise the national immunization day, January 2021 organized by WHO in rural areas of Vadodara, India for polio vaccination. She is deeply interested in how modifications in lifestyle, appropriate exercise, and diet bring positive change in everyone’s life which in turn decreases the chance of being physically as well as psychologically ill. She wants to get affiliated with research related to holistic medicine and wishes to bring the concept of wellness to the masses.