定量健康差异研究中的交叉性：实证研究中挑战与局限的系统评价
Intersectionality in quantitative health disparities research: A systematic review of challenges and limitations in empirical studies.
作者信息
Harari Lexi, Lee Chioun
机构信息
Department of Sociology, University of California-Riverside, Riverside, CA, USA.
Department of Sociology, University of California-Riverside, Riverside, CA, USA.
出版信息
Soc Sci Med. 2021 May;277:113876. doi: 10.1016/j.socscimed.2021.113876. Epub 2021 Mar 24.
RATIONALE
Quantitative health disparities research has increasingly employed intersectionality as a theoretical tool to investigate how social characteristics intersect to generate health inequality. Yet, intersectionality was not designed to quantify, predict, or identify health disparities, and, as a result, multiple criticisms against its misapplication in health disparities research have been made. As such, there is an emerging need to evaluate the growing body of quantitative research that aims to investigate health disparities through an intersectional lens.
METHODS
We conducted a systematic review from earliest records to January 2020 to (i) describe the scope of limitations when applying intersectionality to quantitative health disparities research, and (ii) identify recommendations to improve the future integration of intersectionality with this scholarship. We identified relevant publications with electronic searches in PubMed and CA Web of Science. Studies eligible for inclusion were English-language publications that used quantitative methodologies to investigate health disparities among adults in the U.S. while explicitly claiming to adopt an intersectional perspective. Out of 1279 articles reviewed, 65 were eligible for inclusion.
RESULTS
Our review found that, while the value of intersectionality to the study of health disparities is evident, the existing research struggles with meeting intersectionality's fundamental assumptions. In particular, four limitations were found to be widespread: narrowing the measurements of intersectionality, intersectional groups, and health outcomes; placing primacy on the study of certain intersectional groups to the neglect of others; overlooking underlying explanatory mechanisms that contribute to the health disparities experienced by intersectional groups; and, lacking in the use of life-course perspectives to show how health disparities vary across different life stages.
CONCLUSION
If the goal of health equality is to be achieved among diverse intersectional groups, future research must be assisted by the collection and examination of data that overcomes these limitations.
理论依据
定量健康差异研究越来越多地采用交叉性理论作为一种理论工具，以探究社会特征如何相互交织从而产生健康不平等。然而，交叉性理论并非旨在量化、预测或识别健康差异，因此，针对其在健康差异研究中的错误应用出现了诸多批评。因此，迫切需要对旨在通过交叉性视角研究健康差异的大量定量研究进行评估。
方法
我们进行了一项系统综述，涵盖最早记录至2020年1月的文献，目的是：（i）描述将交叉性理论应用于定量健康差异研究时的局限性范围；（ii）确定改进交叉性理论与该学术领域未来整合的建议。我们通过在PubMed和科学引文索引（SCI）数据库中进行电子检索来识别相关出版物。纳入的研究需为英文出版物，采用定量方法研究美国成年人的健康差异，同时明确声称采用交叉性视角。在审查的1279篇文章中，65篇符合纳入标准。
结果
我们的综述发现，虽然交叉性理论对健康差异研究的价值显而易见，但现有研究在满足交叉性理论的基本假设方面存在困难。具体而言，发现四个普遍存在的局限性：缩小交叉性、交叉群体和健康结果的衡量范围；将重点置于某些交叉群体的研究而忽视其他群体；忽视导致交叉群体健康差异的潜在解释机制；以及缺乏运用生命历程视角来展示健康差异如何在不同生命阶段变化。
结论
如果要在不同的交叉群体中实现健康平等的目标，未来的研究必须借助收集和审查能够克服这些局限性的数据来推进。
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