Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK.
Health Place. 2022 May;75:102761. doi: 10.1016/j.healthplace.2022.102761. Epub 2022 Apr 6.
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.
健康地理不平等研究几乎完全专注于检验区域层面剥夺的影响,并且主要通过构成-背景视角、它们的相互关系以及垂直宏观经济和政治/政策驱动因素来构建。然而,在更广泛的健康不平等领域,交叉性最近已成为一种重要的理论和方法方法,用于检验多种不平等(如社会经济地位、性别、种族/民族和性取向或性别认同)对健康的并发和相互影响。同时,社会地理学一直在明确使用交叉性来分析相互构成的社会压迫形式如何与地点相互作用和相互关联。本文通过概述通过更明确地处理交叉不平等问题可以为健康地理不平等研究带来的益处,利用了这种“交叉转向”的分析空间。它认为:(1) 健康不平等的地理研究应该更明确和广泛地应用交叉镜头;相关地,(2) 地方需要被视为交叉性的一个方面,并纳入更广泛的健康不平等文献中。本文总结了关于地方和健康不平等理论的演变,并概述了交叉理论以及迄今为止为将这一观点纳入我们对健康不平等的理解而开展的工作。本文借鉴了关于地方和交叉性的社会地理学文献,探讨了这一视角如何被用来更全面地增强我们对地方效应的理解——以及如何将地方本身视为交叉不平等的一个要素。将这些不同的工作领域结合起来,本文最后考虑了对健康地理不平等理论的影响。