Structural Intersectionality as a New Direction for Health Disparities Research.

Area of Science:

• Public Health
• Sociology
• Health Disparities

Background:

• Existing research highlights structural racism and sexism as key determinants of population health.
• Intersectionality frameworks offer a lens to examine how multiple social inequalities co-occur and impact health.
• A macro-level approach is needed to measure and understand systemic inequalities' effects on health.

Purpose of the Study:

• To introduce and apply a structural intersectionality approach to population health.
• To investigate how intersecting dimensions of structural oppression shape health at a macro level.
• To analyze the variation and covariation of structural inequalities across U.S. states.

Main Methods:

• Utilized administrative data on macrolevel structural racism, structural sexism, and income inequality in U.S. states.
• Linked state-level data with individual data from the Behavioral Risk Factor Surveillance System.
• Estimated multilevel models with 420,644 individuals nested in 76 state-years.

Main Results:

• Structural inequalities vary significantly across U.S. states and intersect in complex ways.
• These macrolevel inequalities individually and jointly influence population health outcomes.
• Black women consistently experienced the poorest health outcomes in relation to these intersecting structural inequalities.

Conclusions:

• Structural intersectionality provides a valuable framework for studying population health.
• Future research should further explore the mechanisms through which structural oppression impacts health.
• Interventions addressing intersecting structural inequalities are crucial for reducing health disparities.