Placing intersectional inequalities in health.

Abstract

Research into geographical inequalities in health has focused almost exclusively on examining the effects of area-level deprivation and has been largely framed through a compositional-contextual lens, their inter-relationship and the influence of vertical macro-economic and political/policy drivers. However, in the broader health inequalities field, intersectionality has recently emerged as a critical theoretical and methodical approach which examines the concurrent and interacting influences on health of multiple axes of inequality (such as socio-economic status, gender, race/ethnicity and sexuality or gender-identity). Simultaneously, social geography has been explicitly using intersectionality to analyse how mutually constitutive forms of social oppression interact and interrelate with place. This paper exploits the analytical space opened up by this 'intersectional turn' by outlining the benefits for research into geographical inequalities in health that can be achieved by taking a more explicit approach to intersectional inequalities. It argues that: (1) geographical research into health inequalities should more explicitly and widely apply an intersectional lens; and relatedly that, in turn, (2) place needs to be considered as an aspect of intersectionality and integrated into the wider intersectional inequalities in health literature. The paper summarises the evolution of theories of place and health inequalities and outlines intersectional theory and the work to date that has been undertaken to integrate this perspective into our understanding of health inequalities. Drawing on the social geography literature into place and intersectionality, the paper explores how this perspective is being used to enhance our understanding of place effects more generally - and how place itself can be considered as an element of intersectional inequalities. Drawing these different bodies of work together, the paper concludes by considering the implications for theories of geographical inequalities in health.