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Keywords

Health Disparities, Health Inequities, Intersectionality, Social Disadvantage, Self-Reported Health Status

Abstract

Health disparities along the gender, race and class are particularly important to monitor and study given the predicted differential distribution of health along these social identities. Intersectionality is a theoretical framework that allows public health and health disparities researchers to account for the simultaneous, mutually constitutive, reinforcing and multidimensional effects of gender, class, and race with the aim to better understand health disparities. Disparities along gender, race and class have been noted in self-reported health status (SRHS) which has been shown to be a strong predictive factor of mortality, morbidity and mental health independent of other physiologic, behavioral and psychosocial risk factors. To assess SRHS disparities through an intersectional lens, a quantitative application of the framework was applied to a secondary data analysis of the 2010 Medical Expenditure Panel Survey (MEPS) Household Component. Two models were constructed to assess the relationship between the probability of reporting a poor/fair health status and two versions of a variable denoting socially disadvantaged populations. The first model explored the relationship between poor/fair health status and a variable of interest that denoted low-income females of any minority racial group where the referent comprised of those individuals who did not meet the socially disadvantaged criteria for the model. The second model explored the relationship between poor/fair health status and a variable of interest that identified low-income females of five different racial groups (White, Black, Asian, Native [NativeAmerican/Alaskan Native & Native Hawaiian & other Pacific Islander], and Multiracial) compared to the referent (which was composed of those who did not meet the criteria to be in any of the social disadvantaged groups pertaining to the model). The models were estimated using survey-weighed logit regression with average marginal effects at varying levels of age (25, 45, and 65) and years of education (12 or 16 years). Results show that for the two models the social disadvantage variables had a positive relationship with the probability of reporting a poor/fair health status. For both models, the magnitude of the social disadvantage effect on the probability of reporting a poor/fair health status increased with age and was moderated by education levels, with higher levels of education reducing the magnitude of the social disadvantage effect. The second model results show that Black low-income females had an almost ten percentage point increase in the probability of reporting a poor or fair health status compared to the referent, the largest magnitude noticed in the results. It is important to study the joint effects of the social positions occupied by those bearing the burden of health disparities; applying the intersectional framework may elucidate on new ways to present, address and target health disparities. Keywords: Health Disparities, Health Inequities, Intersectionality, Social Disadvantage, Self-Reported Health Status


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