How I approach intersectionality in hematopoietic stem cell transplantation.

Area of Science:

• Health Services Research
• Social Determinants of Health
• Health Equity

Background:

• Intersectionality is a framework analyzing how multiple social inequalities (e.g., race, gender, socioeconomic status) intersect to create health disparities.
• Systemic biases in healthcare, including diagnostic, therapeutic, and prognostic paradigms, can be identified using intersectional analysis.
• Hematopoietic stem cell transplantation (HSCT) is a complex, high-cost procedure where intersectional identities and biases significantly impact patient care and outcomes.

Purpose of the Study:

• To highlight the utility of intersectionality as a framework for understanding and addressing health inequities.
• To examine how intersectional identities and systemic biases manifest in healthcare systems, research, and clinical practice, using HSCT as a case study.
• To advocate for the application of an intersectional approach by transplant clinicians to improve outcomes for marginalized patient populations.

Main Methods:

• Conceptual analysis of intersectionality in healthcare.
• Case study examination of hematopoietic stem cell transplantation (HSCT) to illustrate systemic biases.
• Review of how clinical algorithms and risk assessments may perpetuate inequities due to underrepresentation in data.

Main Results:

• Intersectional identities and systemic biases contribute to unequal health outcomes, particularly evident in complex procedures like HSCT.
• Clinical algorithms derived from non-diverse datasets can embed and perpetuate health inequities.
• Transplant teams are well-positioned to identify and mitigate biases through an intersectional lens.

Conclusions:

• An intersectional approach is crucial for identifying and rectifying systemic biases in healthcare.
• Applying intersectionality in HSCT can lead to more equitable care and improved outcomes for patients facing marginalizing social determinants of health.
• Adopting an intersectional framework is essential for delivering effective, compassionate, and equitable care to all patients.