Academic Highlights - Intersectionality and Individual Health

Disability doesn’t discriminate: health inequities at the intersection of race and disability.

Holliman et. al., 2023

DOI: 10.3389/fresc.2023.1075775

Racism and ableism are distinct power structures, but interact within the lives, experiences and health of people who are marginalised within both. In this article, Holliman and colleagues interrogate the healthcare experiences of Black and Hispanic adults with disabilities in the USA. Specifically, the authors address the research question: Are Black and Hispanic adults with disabilities at increased risk of unmet healthcare needs compared to Black and Hispanic adults without disabilities? The authors analysed data from the nationally representative 2018 US National Health Interview Survey (NHIS), including a total sample of 5891 people over 18 years-old to examine outcomes by disability within each race/ethnicity group. This quantitative study does not provide an in-depth exploration of individuals’ experiences. However, it highlights how intersectional identities shape interactions with power structures across the population, and how this results in healthcare inequity. The study finds that within each racial/ethnic group, people with disabilities are more likely to significantly delay or forego care than their peers without disabilities. Notably, almost double the amount of people with disabilities (Black, non-Hispanic: 28.2%; Hispanic: 26.5%) forewent healthcare due to cost compared to people without disabilities. This highlights how intersectional identities additionally shape people’s interactions with the economy and access to financial resources. In sum, this study demonstrates that racism and ableism do not work separately, and instead meaningfully intersect in the lives of racially minoritised people with disabilities. 

A narrative exploration of the importance of intersectionality in a Black trans woman’s mental health experiences.

Shelton and Lester, 2022. 

DOI: 10.1080/26895269.2020.1838393

Black trans women have been disproportionately impacted by the erosion of civil rights and access to services experienced by minoritised people in the US in recent years. This marginalisation and the high threat of violence faced by Black trans women can have profound mental health impacts. In this context, Shelton and Lester provide an in-depth narrative exploration to address the research question: How does a Black trans woman’s experiences with mental health resources relate to the intersections of her trans and racial identities, and her socioeconomic status? The authors first provide a narrative review of trans adult mental health needs, highlighting that much existing literature on trans mental health neglects the role of gendered experiences, instead focusing on the role of discrimination faced by trans people. Further, the authors identify that limited literature takes an intersectional approach, often neglecting the role of racism, socioeconomic status, or both. Countering the single categorical axis of much of this literature, Shelton and Lester draw on the second author’s personal experiences as a Black trans woman a to explore the research question in depth. They present three narratives of experiences with mental healthcare drawn from Lester’s life, analysing the role of the multiple components of her life and identify in shaping these experiences. Through these narratives, the authors present a compelling analysis of the need to employ an intersectional approach in research, policy, and beyond. This is a potent article that intimately explores the lived experience of intersectionality in relation to mental health care, and a valuable resource to guide thinking on these topics.