Intersections of Social Inequalities in Health

[Guest guest]

[Editors note: This is to introduce a paper " A Methodology to Analyse the

Intersections of Social Inequalities in Health " (Gita Sen, Aditi Iyer, Chandan

Mukherjeec 2009)

This study may provide much needed insights into issues related to access to

treatment for women living with HIV in India. According to the findings of this

study, in the case of non-treatment and discontinuation of treatment has

gender and class implications.

Treatment versus non-treatment is strongly governed by gender bias, with all

women being affected by it, while class differences at this level only operate

to distinguish the poorest women from non-poor women. The poorest women and even

poor women remain at the bottom. However, poor men are able to hold on to their

gender advantage, are not as badly affected by discontinuation, and are

significantly better off than poor women.

While applying the finding of this study to understand access to treatment for

people living with HIV, it appears that there may be a gender bias in access to

ARV treatment in India. One of the policy challenge of NACP IV may be to

address gender bias in access to ARV treatment]

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A Methodology to Analyse the Intersections of Social Inequalities in Health

Gita Sen a; Aditi Iyer b; Chandan Mukherjee c

a Centre for Public Policy, Indian Institute of Management, Bangalore , India

b Indian Institute of Management , Bangalore , India

c Centre for Development Studies, Trivandrum , India

DOI: 10.1080/19452820903048894 - URL:

http://dx.doi.org/10.1080/19452820903048894

Journal of Human Development and Capabilities - Volume 10, Issue 3 November 2009

, pages 397 - 415

Abstract

An important issue for health policy and planning is the way in which multiple

sources of disadvantage, such as class, gender, caste, race, ethnicity, and so

forth, work together to influence health.

Although 'intersectionality' is a topic for which there is growing interest and

evidence, several questions as yet remain unanswered. These gaps partly reflect

limitations in the quantitative methods used to study intersectionality in

health, even though the techniques used to analyse health inequalities as

separable processes can be sophisticated.

 

In this paper, we discuss a method we developed to analyse the intersections

between different social inequalities,

including a technique to test for differences along the entire span of the

social spectrum, not just between the extremes.

We show how this method can be applied to the analysis of intersectionality in

access to healthcare, using cross-sectional

data in Koppal, one of the poorest districts in Karnataka , India.

 

In addition to the obvious benefit of deepening our insights into social

inequalities and how they interact, the study of

intersectionality using our approach has the potential to provide critical

guidance for policies and programmes.

By giving precise insights into who is affected and how in different settings,

it provides a scalpel for policies rather than the current hatchet.

It enables policies and programmes to identify whom to focus on, whom to

protect, what exactly to promote and why.

It also provides a simple way to monitor and evaluate the impact of policies and

programmes on different sub-groups from the most disadvantaged through the

middle layers to those with particular advantages.

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