Studying intersectionality quantitatively

Screen-shot-2013-05-31-at-00.15.091I came across a blog recently that details the complexity involved in studying intersectionality from a quantitative perspective. Anyone who has encountered such questions in their own work can identify with the frustrating nature of accounting for an anti-categorical approach that is already quite complicated in theory. And yes, I said anti-categorical. As a quantitative researcher, “anti-categorical” is paradoxical to what we do. We live by quantifying things!

So what is one to do if so quantitatively-inclined? How can we, as scholars, accurately represent intertwined identities in research? The very notion that social categories (e.g., race, SES, gender, sexual orientation) are not independent and unidimensional but rather multiple and mutually constitutive, is both reasonable and rational, but very difficult to measure. Over the years, I have had many conversations with people (just like me) who are overwhelmed at the idea of accounting for intersectionality from a quantitative perspective. “Oh the categories!” Or perhaps, “What size N would we need to have for something like that?!” While easily mind boggling, these questions also reflect a fundamental misunderstanding of the intersectional perspective.

Let’s review. First, as a health researcher it is important to acknowledge that the intersectionality framework did not originate from public health research, nor was it designed to specifically predict health outcomes or processes. However, its utility lies in the potential to examine and explore health disparities. The standard method of studying disparities is a comparative approach (e.g., Black/White or male/female differences). While useful to some extent, a comparative approach misses what I consider to be the most critically important questions. WHY are there mean differences between these two groups on say, chronic disease? To what extent is within-group variation shared between both groups? In other words, comparing health outcomes between two groups (A and B) can only give you half (at best) of the big picture. If we are concerned with preventative health strategies and fundamental causes, then we must also be concerned about questions that address the origins of such disparities.

researchmethodsB1Therefore, a significant challenge for intersectionality researchers is to adapt a perspective originally designed as an analytical theory into a model that might be useful to empirically examine say, social inequalities in health. Tall order, huh? Lisa Bowleg eloquently addresses this issue in a 2012 American Journal of Public Health publication:

“Thus, for public health and other social science researchers, the absence of theoretically validated constructs that can be empirically tested poses not only a major challenge but also tremendous opportunities for advancing the study of intersectionality from a public health perspective.”

Nice way to take lemons and make lemonade. Did you catch that? As public health researchers, there are great opportunities to uncovering ways to study intersectionality! So, back to the original question of how to actually do that in practice. There are several possibilities. Bowleg suggests more use of qualitative or mixed-methods research in public health research (I’m a fan of this idea). Given that I research intersections, I have devoted considerable thought to the topic and one approach that has been very rewarding and fruitful for me is within-group analysis. I’m sure you might be thinking, “But how can we possibly find out anything interesting about ____ people if we don’t compare them to ____ people??!” Ah yes. I’ve encountered different variations of this question over the years, and to that I reply, “It’s simple. No one group is monolithic.”

In essence, we are all complex and if I am concerned with Black women’s health, for example, I cannot fully understand Black women if I am only comparing health outcomes between Black and White women. Within-group research (studying only one group) allows us to understand the wonderful complexity that exists within a group of people who share one social identity. For example, Black women are extremely diverse. However, that diversity can easily get lost if you don’t take into account education, class background, geographic location, and other features of the social context that shape the human experience. Furthermore, there is a tremendous amount to be learned from understanding variability between risk and resiliency. Not all Black women develop diabetes, cardiovascular disease and die young, but some do. Why? And why does upward mobility not yield the same beneficial effects in terms of infant mortality for educated Black women, as for White women? These important questions require a thoughtful and deliberate approach to not only examining disparities, but actually doing something to help prevent them.

Natalie Sabik and I will be presenting our work on intersectionality and physical functioning among older African American women at the Intersections of Race, Culture, Health and Mental Health Conference at Boston College, October 18-19th.

Note: Just ordered Evelyn Simien’s Black Feminist Voices in Politics – an intersectional analysis. Can’t wait to read!

Why we should be talking about hair

barbie-with-natural-hairThere is a pervasive sentiment that hair is a superficial aspect of beauty. Yet for many women of color, hair is quite the contrary. Hair is an expression of self – who I am and where I’ve been. Before I get too deep, let’s take a moment to recognize the obvious – all women, regardless of race, view hair differently. For Black women, however, this view may be shaped by historical significance (e.g., Black is Beautiful movement), family influences and social upbringing (preferences for straight and non-straight styles) or matters of convenience. Google ‘Black women and hair’ and I’m sure you’ll get more information than you could ever imagine about the complexity of Black women’s hair. Therefore, to downplay its relevance in our social conversation is insensitive and dismissive of the real way that hair matters to the lives of African American women.

Recently I came across this article, and while it saddened me, it certainly did not surprise me. Shaming anyone, much less a 7-year old child, about the way she chooses to wear her hair is unacceptable. I could deconstruct the baseless rationale given by the Deborah Brown Community School administrators regarding their harassment of Tiana Parker about her decision to wear locs. But that’s too easy. Instead, I wonder how different Millard Jones is from the rest of us. I wonder how, consciously or unconsciously, we as a society are imparting negative messaging about hair and beauty into the minds of our little girls and disempowering them in the process. Even more, I wonder what type of behavior we are modeling as Black women. When we run through the rain or avoid exercise/swimming because we don’t want to get our hair wet and ‘revert’ – are we sending a positive message? And while I overstand that economic considerations, such as salon costs and time for hair maintenance can be prohibitive, I would like to propose an alternative. Let’s shift the conversation. Let’s pen a new narrative for the mental and physical health of our children. Let’s model active behavior that can be achieved regardless of hairstyle. Let’s reaffirm that beauty comes from within. Let’s allow our girls to see reflections of themselves – in us.

I don’t claim to be wise, but if there is one thing I am certain of – children pay attention to what you do, not necessarily to what you say. So if we are telling our daughters, nieces and granddaughters that they are beautiful, but still we complain about doing their kinky hair, give them chemical relaxers at age 5, tell them to be careful not to ‘sweat their hair out’ and encourage them to wear their hair in ‘acceptable’ styles, then we are no better than the Deborah Brown Community School administrators. We are all reproducing a damaging cycle to the psyche that devalues the natural beauty of Black hair.

Perhaps if I were so inclined, I would design a public health intervention to visit cities and rural towns across the nation on a U R Enough Crusade. I don’t need tons of funding or a complicated research plan; just one bullhorn and a single message: You are enough. Your hair is enough. The way your hair grows out of your head is enough. Whatever way you choose to rock your ‘do, know that your hairstyle does not dictate your self-worth or value. That is all. Even without the bullhorn, I hope this message spreads (as it seems to be doing):

May your hair be enough to make you feel pretty, valued and empowered!

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Retirement years not so golden?

Have we all been bamboozled by the delusions of a good life post-retirement? It’s an interesting point. While I think there is value in productive roles throughout the lifespan, I believe there are multiple ways to achieve that productivity. Work is only one, of many productive roles. Furthermore, given the amount that Americans work, it still doesn’t address why we are among the lowest in life expectancy, compared to other industrialized nations.

This suggests that we not only promote older adults to work longer, but we also need to re-consider our work policies like workplace flexibility and part-time work that would allow older adults to remain engaged in work roles, while still transitioning to other roles that may be equally important (e.g., work-family balance is still important for grandparents).

From the NPR Special Series on Retirement:

One in four retirees think life in retirement is worse than it was before they retired, according to a poll by NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health released today. The poll shows stark differences between what pre-retirees think retirement will be like, and what retirees say is actually the case.

“Those of us over 50 and working are optimistic about our future health and health care, but that optimism is not necessarily shared by those who have already retired,” said Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation. “Many people who have already retired say their health is worse, and they worry about costs of medical treatment and long-term care. Insights from the poll can help policy makers and others think about how to meet the needs of aging Americans. There are changes we can make to our health care system, finances and communities that might help ensure that our retirement years will be as fulfilling as we hope.”

The poll focuses on views and experiences related to retirement among people over age 50, including not only people who have retired, but also people who plan to retire (“pre-retirees”) and those who do not plan to do so. It was conducted by researchers at the Harvard School of Public Health.

Findings show that a large majority of retirees say life in retirement is the same (44%) or better (29%) than it was during the five years before they retired. Many retirees say their stress is less, their relationships with loved ones are better, their diet is improved and the amount of time they spend doing favorite activities is increased—yet 25 percent of retirees say life is worse.

“The poll shows that a significant number of people who are near retirement may be underestimating the challenges of retirement,” said Robert Blendon, professor of Health Policy and Political Analysis at the Harvard School of Public Health. “When you compare what people think retirement will be like with what retirees say it actually is like, there are big differences. Pre-retirees may underestimate the degree to which their health and finances may be worse in retirement.”

The poll shows only 14 percent of pre-retirees predict that life overall will be worse when they retire, compared to the 25 percent of retirees who say it actually is worse. Only 13 percent of pre-retirees thought their health would be worse, while 39 percent of retirees say it actually is. Less than a quarter of pre-retirees (22%) predict their financial situation will be worse, while a third of retirees (35%) said it actually is.

Findings also show that pre-retirees expect to retire later than those who are already retired and some expect never to fully retire. A sizeable majority of pre-retirees (60%) expect to retire at age 65 or older, while only 26% of current retirees polled said they waited to retire at age 65 or older. More than one in 10 pre-retirees (15%) say they never expect to fully retire.