Modeling the Intersectionality of Processes in the Social Production of Health Inequalities

Background: The recent pair of studies by Bauer and Scheim make substantial contributions to the literature on intersectionality and health: a validation study of the Intersectional Discrimination Index and a study outlining a promising analytic approach to intersectionality that explicitly considers the roles of social processes in the production of health inequalities.

Rationale: In this commentary, I situate Bauer and Scheim's contribution within the wider landscape of intersectional scholarship. I also respond to emerging concerns about the value of descriptive intersectional approaches, in particular the critique that such approaches blunt the critical edge and transformative aims of intersectionality. Finally, I outline important future directions for intersectional scholarship modeling social processes, in particular, the need for addressing structural determinants of inequalities intersectionally.

Conclusions: Whether a study is descriptive or analytic, engagement with theory is essential in order to maintain the critical and transformative edge of intersectionality. Theories of population health such as fundamental causes, social production, and ecosocial theory, should be framed and applied in explicitly intersectional terms. As the field moves toward intersectional evaluations of social processes, attention should be given to all ecological levels but especially the structural/institutional level. This attention includes considering interactions between intersectional social strata and contexts and considering the roles of structural-level discrimination in shaping population health outcomes intersectionally.