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Understanding the micro and macro politics of health: Inequalities, intersectionality & institutions - A research agenda

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  • Gkiouleka, Anna
  • Huijts, Tim
  • Beckfield, Jason
  • Bambra, Clare

Abstract

This essay brings together intersectionality and institutional approaches to health inequalities, suggesting an integrative analytical framework that accounts for the complexity of the intertwined influence of both individual social positioning and institutional stratification on health. This essay therefore advances the emerging scholarship on the relevance of intersectionality to health inequalities research. We argue that intersectionality provides a strong analytical tool for an integrated understanding of health inequalities beyond the purely socioeconomic by addressing the multiple layers of privilege and disadvantage, including race, migration and ethnicity, gender and sexuality. We further demonstrate how integrating intersectionality with institutional approaches allows for the study of institutions as heterogeneous entities that impact on the production of social privilege and disadvantage beyond just socioeconomic (re)distribution. This leads to an understanding of the interaction of the macro and the micro facets of the politics of health. Finally, we set out a research agenda considering the interplay/intersections between individuals and institutions and involving a series of methodological implications for research - arguing that quantitative designs can incorporate an intersectional institutional approach.

Suggested Citation

  • Gkiouleka, Anna & Huijts, Tim & Beckfield, Jason & Bambra, Clare, 2018. "Understanding the micro and macro politics of health: Inequalities, intersectionality & institutions - A research agenda," Social Science & Medicine, Elsevier, vol. 200(C), pages 92-98.
  • Handle: RePEc:eee:socmed:v:200:y:2018:i:c:p:92-98
    DOI: 10.1016/j.socscimed.2018.01.025
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    References listed on IDEAS

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    1. Sen, Amartya, 2001. "Development as Freedom," OUP Catalogue, Oxford University Press, number 9780192893307, Decembrie.
    2. Bauer, Greta R., 2014. "Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity," Social Science & Medicine, Elsevier, vol. 110(C), pages 10-17.
    3. Huijts, Tim & Eikemo, Terje Andreas & Skalická, Vera, 2010. "Income-related health inequalities in the Nordic countries: Examining the role of education, occupational class, and age," Social Science & Medicine, Elsevier, vol. 71(11), pages 1964-1972, December.
    4. Krieger, N., 2012. "Methods for the scientific study of discrimination and health: An ecosocial approach," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 936-945.
    5. Bowleg, L., 2012. "The problem with the phrase women and minorities: Intersectionality-an important theoretical framework for public health," American Journal of Public Health, American Public Health Association, vol. 102(7), pages 1267-1273.
    6. Beckfield, Jason & Bambra, Clare, 2016. "Shorter lives in stingier states: Social policy shortcomings help explain the US mortality disadvantage," Social Science & Medicine, Elsevier, vol. 171(C), pages 30-38.
    7. Tim Huijts & Gerbert Kraaykamp, 2012. "Immigrants’ Health in Europe: A Cross-Classified Multilevel Approach to Examine Origin Country, Destination Country, and Community Effects," International Migration Review, Wiley Blackwell, vol. 46(1), pages 101-137, March.
    8. Collins, Pamela Y. & von Unger, Hella & Armbrister, Adria, 2008. "Church ladies, good girls, and locas: Stigma and the intersection of gender, ethnicity, mental illness, and sexuality in relation to HIV risk," Social Science & Medicine, Elsevier, vol. 67(3), pages 389-397, August.
    9. Meyer, I.H., 2001. "Why lesbian, gay, bisexual, and transgender public health?," American Journal of Public Health, American Public Health Association, vol. 91(6), pages 856-859.
    10. Julie Fish, 2008. "Navigating Queer Street: Researching the Intersections of Lesbian, Gay, Bisexual and Trans (LGBT) Identities in Health Research," Sociological Research Online, , vol. 13(1), pages 104-115, January.
    11. Hankivsky, Olena, 2012. "Women’s health, men’s health, and gender and health: Implications of intersectionality," Social Science & Medicine, Elsevier, vol. 74(11), pages 1712-1720.
    12. Agénor, Madina & Krieger, Nancy & Austin, S. Bryn & Haneuse, Sebastien & Gottlieb, Barbara R., 2014. "At the intersection of sexual orientation, race/ethnicity, and cervical cancer screening: Assessing Pap test use disparities by sex of sexual partners among black, Latina, and white U.S. women," Social Science & Medicine, Elsevier, vol. 116(C), pages 110-118.
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