Retooling the master's tools: Translating the theory of intersectionality into methods for empirical health disparities research

In 2003, the Institute of Medicine released a pivotal report entitled Unequal Treatment, which documented vast and long-standing inequalities in the health status of racial minorities compared to non-Hispanic whites. Although the report was influential in bringing the issue of health disparities to the front of the public health agenda, disparities have continued to widen. Crenshaw's theory of intersectionality has the potential to transform health disparities research by providing a framework for understanding the interlocking, cumulative effects of multiple inequalities on health. However, there is a lack of clearly defined intersectional research methodology in the field of public health. The process of translating intersectionality theory into study designs, measures, and analytic techniques poses three key challenges for public health researchers. First, researchers must be reflexive about their positions within the social hierarchies in which their projects are embedded and aware of the potential for their actions and instruments to reify structures of dominance. Second, researchers must determine how to ask questions about interdependent, mutually-constitutive identities without relying on additive models, which assume that identity categories are independent of one another. Third, since intersectionality is a relatively novel theoretical approach in public health, researchers must establish baselines for empirical intervention research. New forms of "popular methodology” are challenging current practices in the collection, use, and deployment of health and social data. Emerging methods using social network analysis, geographic information systems, and data visualization of digital information hold great potential to enhance the practice of intersectional health research. The field of descriptive sociology seeks to link narratives, numbers, images, and geocodes in ways that engage with and analyze daily social transactions (e.g., Sociological Images). With the proliferation of computer-assisted analysis software for mixed methods research (such as Dedoose, formerly EthnoNotes) and open-access visualization tools (such as Gephi), methods that were once the domain and expertise of the academy are becoming increasingly democratized. Intersectional methods may be the key to addressing persistent inequalities and improving the health of the most marginalized populations in our society.