Florida State University, Tallahassee, FL, USA.
Duke University, Durham, NC, USA.
J Health Soc Behav. 2021 Sep;62(3):350-370. doi: 10.1177/00221465211032947. Epub 2021 Aug 6.
This article advances the field by integrating insights from intersectionality perspectives with the emerging literatures on structural racism and structural sexism-which point to promising new ways to measure systems of inequality at a macro level-to introduce a approach to population health. We demonstrate an application of structural intersectionality using administrative data representing macrolevel structural racism, structural sexism, and income inequality in U.S. states linked to individual data from the Behavioral Risk Factor Surveillance System to estimate multilevel models (N = 420,644 individuals nested in 76 state-years) investigating how intersecting dimensions of structural oppression shape health. Analyses show that these structural inequalities: (1) vary considerably across U.S. states, (2) intersect in numerous ways but do not strongly or positively covary, (3) individually and jointly shape health, and (4) are most consistently associated with poor health for black women. We conclude by outlining an agenda for future research on structural intersectionality and health.
本文通过将交叉性视角的洞见与关于结构性种族主义和结构性性别歧视的新兴文献相结合,推进了这一领域的研究——这些文献为在宏观层面衡量不平等体系提供了有前途的新方法——从而为人口健康引入了一种新的方法。我们使用代表美国各州宏观层面结构性种族主义、结构性性别歧视和收入不平等的行政数据,并结合来自行为风险因素监测系统的个体数据,展示了结构性交叉性的应用,以估计多层次模型(N = 420644 人嵌套在 76 个州-年),研究结构性压迫的交叉维度如何塑造健康。分析表明,这些结构性不平等:(1)在美国各州之间差异很大;(2)以多种方式相互交叉,但没有强烈或积极的共变;(3)单独和共同塑造健康;(4)与黑人妇女健康状况不佳最密切相关。我们最后概述了关于结构性交叉性和健康的未来研究议程。