CERGAS Seminar "Using an intersectional life course perspective to understand and address health inequalities"

In this talk I will outline the concept of intersectionality and how it can be integrated with a life course perspective to understand health inequalities, particularly where age and ageing is a key concern. Intersectionality, which examines the interconnected nature of social categories such as gender, ethnicity, and socioeconomic status, has traditionally overlooked the dynamics of ageing. Ageing entails different social roles, life stages, transitions, and the accumulation of advantages or disadvantages throughout life.

The key features of an intersectional life course approach will be outlined. I will focus on one increasingly popular method in particular: Multilevel Analysis of Individual Heterogeneity and Discriminatory accuracy (MAIHDA). MAIHDA nests individuals within their intersectional strata in order to estimate how much variability in an outcome is attributable to intersectional subgroups, and to assess the nature and extend of intersectional inequalities. Our research group has recently extended this method to model intersectional trajectories. An example analysis will be shared, using data from people aged 15-103 in the nationally representative United Kingdom Household Longitudinal Study (n=78,991) from 2009-2022. Intersectional variables are ethnicity (10 categories), gender (2 categories), educational (3 categories) and generation (5 categories), resulting in 330 intersectional groups in total.

The findings suggest that mental health shows clear generational effects, whereas physical health is mainly driven by age. Physical health varies more between than within people over time, showing significant intersectional inequalities. Mental health is more volatile within individuals over time, and intersectional inequalities play a much smaller role. Low education women typically experienced the worse health trajectories, and for mental health, this is particularly the case for generation Z. Pakistani and Bangladeshi ethic groups stood out as having the worst physical and mental health. The results suggest a complex picture of mental and physical health over the life course, which can provide valuable information for intervention and policy to target and tailor approaches to address the nuances of health inequalities over the life course.

In concluding the talk, I will argue that an intersectional life course perspective offers transformative potential, not just in conceptual terms, but as a powerful empirical tool for dissecting and addressing the multifaceted and dynamic nature of health inequalities.

 

Dr Dan Holman is a Senior Lecturer in Sociology and Public Health in the Department of Sociological Studies at The University of Sheffield, and is also affiliated with the Healthy Lifespan Institute, which is dedicated to understanding and preventing multimorbidity and frailty. He is an interdisciplinary researcher focussed on the interface between public health, sociology and social science.

Dr Holman’s overall research interest is in health inequalities and their social determinants, especially in relation the ageing process. He has made various theoretical, empirical, methodological and policy contributions to intersectional health research. These are detailed on his website http://intersectionalhealth.org. He has acted as PI on the Economic and Social Research Council project Chronic Disease and Healthy Ageing at the Intersections (2018-2021), as well as Co-I on multiple other Economic and Social Research Council and National Institute for Health Research projects focussed on health inequalities, ageing and intersectionality.