Healthcare and Prejudice: Breaking the Glass Ceiling of Intersectionality

This article was exclusively written for The European Sting by Ms. Sneha Das, a 21 year old third year medical student from the Institute of Post-Graduate Medical Education & Research, Kolkata, Indi. 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.

The first public health camp I ever attended was organised by my father and his students in Swarnakoli, an obscure village of West Bengal, India. During the course of this camp, I noticed something interesting-

Married women older than 40 years attended the camp.

Girls younger than 15 years attended the camp.

But I could find no women between 15 and 40 years of age attending the camp.

Did that mean, the village had no women in that particular age group? Certainly not. Later we learnt that the villagers didn’t want those women to come in contact with us, ‘outsiders’, thus depriving a particularly vulnerable group of quality healthcare that was rare in those parts.

This brings us to the larger question of ‘intersectionality’,an approach to understand how different aspects of a person’s social and political identities combine to create different modes of discrimination and how this influences healthcare and health equity.

Studies have shown that intersecting and overlapping social identities can often be the fundamental cause for health disparity at many places but such discriminations, though inadvertent, are seldom acknowledged. For example,a black woman might face discrimination from a healthcare establishment not distinctly due to her race (because the establishment does not discriminate against black men) nor distinctly due to her gender (because it does not discriminate against white women),but due to a combination of the two factors.

A viable solution to this conundrum is to increase awareness regarding this issue amongst the medical community and to enable greater, more diverse representation from people of all walks of life among healthcare-providers themselves. Interaction with our immediate colleagues and the international community would remove our ingrained biases and help us understand the stories of our patients, thus better equipping us to deal with their care.

At the same time, we need to realise that these biases may exist both among doctors as well as patients and are equally detrimental to healthcare systems. For example,according to a study by the ICMR, women are the obstetric surgeons of choice for many patients in Asian countries but are rarely encouraged in other surgical specialities.

Our duty as healthcare providers is not only to counter these misplaced notions but also to understand why they exist in the first place. A greater understanding of the patient community, fostering effective doctor-patient communication and empathising with the patients’ situation can go a long way to counter the biases that patients may have against a doctor’s capability. Building a rapport is often the cornerstone of a fruitful doctor-patient relationship and if we can make our patients have faith in a doctor’s expertise over all other factors, we will have done our work and done it well.

And at the end of the day,providing quality healthcare to everyone irrespective of their circumstances, should remain our ultimate goal. A better understanding of how the intersectionality of various biases may contribute to healthcare disparities would further enable us to fulfil our roles as doctors and enlighten our path to this end.

About the author

Sneha Das is a 21 year old third year medical student from the Institute of Post-Graduate Medical Education & Research, Kolkata, India. She is currently serving as an Executive Board member of the South-Asian Medical Students’ Association (also called the SAMSA). She is an avid organizer of multiple health camps for the underprivileged and wishes to pursue public health associated research work.