Health equity at the intersections: Exploring the U.S. discourse and implications for practice

This sociological dissertation critically examines the U.S. public health discourse of health equity from an intersectional lens. Intersectionality is a conceptual framework that seeks to understand the simultaneous and varied impacts that multiple social inequalities (e.g. by race, class, sexuality, age) have on health and well-being. I used a qualitative methodology to analyze health equity reports (8) from governmental and non-governmental organizations, key informant interviews (20) with health equity activists and scholars, and related archival materials. I found that health inequalities are theorized, and interventions largely conceived, in ways that do not readily acknowledge the intersecting nature of race, class, and other social formations when considering their contribution to health outcomes. Inattention to these interconnections can compound health inequalities by excluding viable rationales for disparities and health equity. However, conceptualization of the social determinants--such as housing, education, and transportation--within the context of place provided a potent way of thinking relationally about the ways in which various structural conditions come together to affect health across multiple inequalities. Such intersectional framing holds promise in producing more comprehensive and effective interventions to achieve health equity