Iyer A, Sen G, Ostlin P
Indian Institute of Management Bangalore, Bangalore, India.
Glob Public Health. 2008;3 Suppl 1:13-24. doi: 10.1080/17441690801892174.
It is increasingly recognized that different axes of social power relations, such as gender and class, are interrelated, not as additive but as intersecting processes. This paper has reviewed existing research on the intersections between gender and class, and their impacts on health status and access to health care. The review suggests that intersecting stratification processes can significantly alter the impacts of any one dimension of inequality taken by itself. Studies confirm that socio-economic status measures cannot fully account for gender inequalities in health. A number of studies show that both gender and class affect the way in which risk factors are translated into health outcomes, but their intersections can be complex. Other studies indicate that responses to unaffordable health care often vary by the gender and class location of sick individuals and their households. They strongly suggest that economic class should not be analysed by itself, and that apparent class differences can be misinterpreted without gender analysis. Insufficient attention to intersectionality in much of the health literature has significant human costs, because those affected most negatively tend to be those who are poorest and most oppressed by gender and other forms of social inequality. The programme and policy costs are also likely to be high in terms of poorly functioning programmes, and ineffective poverty alleviation and social and health policies.
人们越来越认识到，社会权力关系的不同轴心，如性别和阶级，是相互关联的，不是相加的关系，而是交叉的过程。本文回顾了关于性别与阶级交叉及其对健康状况和获得医疗保健机会影响的现有研究。该综述表明，交叉分层过程可以显著改变任何一个不平等维度单独产生的影响。研究证实，社会经济地位衡量标准不能完全解释健康方面的性别不平等。一些研究表明，性别和阶级都会影响风险因素转化为健康结果的方式，但其交叉情况可能很复杂。其他研究表明，对负担不起的医疗保健的应对措施往往因患病个体及其家庭的性别和阶级状况而异。这些研究强烈表明，经济阶级不应单独进行分析，而且如果没有性别分析，明显的阶级差异可能会被误解。健康文献中对交叉性的关注不足会带来巨大的人力成本，因为受负面影响最大的往往是那些最贫穷且在性别和其他形式的社会不平等中受压迫最深的人。就运作不佳的项目以及无效的扶贫和社会与健康政策而言，项目和政策成本也可能很高。
