Global Symposium on Health Systems Research Vancouver november 17 2016 Intersectionality as a research approach to understanding and promoting resilience and responsiveness in health systems Global Symposium on Health Systems Research Vancouver november 17 2016 OLENA HANKIVSKY, PhD, SIMON FRASER UNIVERSITY, OAH@SFU.CA

i. WHy INTERSECTIONALITY? Increasingly movement of people Increasingly diverse populations Increasingly interdependent world Persistent inequalities between and within countries Persistent weaknesses and biases within health care systems Better recognition of health damaging effects of discrimination Growing awareness that existing approaches and tools are inadequate for transforming the status quo SDG Agenda – Leaving No One Behind

II. DEFINITION OF INTERSECTIONALITY

One Possible Definition Intersectionality promotes an understanding of human beings as shaped by the interaction of different social locations (e.g. ‘race’/ethnicity, Indigeneity, gender, class, sexuality, geography, age, disability/ability, migration status, religion). These interactions occur within a context of connected systems and structures of power (e.g. laws, policies, state governments and other political and economic unions, religious institutions, media). Through such processes, interdependent forms of privilege and oppression shaped by globalization, colonialism, racism, homophobia, ableism and patriarchy are created. (Hankivsky, 2014)

INTERSECTIONALITY KEY Tenets Human lives cannot be reduced to single categories. The importance of any category or social location cannot be predetermined. Categories and social locations are linked. “Categories” are not coherent but fluid in their meaning. Multi-level analyses that link individual experiences to broader structures and processes across time and space are key to understanding power.

INTERSECTIONALITY KEY Tenets Privilege and penalty are simultaneously experienced – situation and context dependent. Self-reflexivity by scholars, researchers, policy actors, and activists is essential for the “doing” of intersectionality. Intersectionality informed research, policy and practice must be oriented towards social justice and transformational change. Operationalizing intersectionality – too difficult

III. Methods and Guidance

No longer an issue Scholarship – normative and operational health and health related research and policy guidance (e.g. Bowleg, 2008; Choo & Feree, 2010; Cole, 2009; Hancock, 2007; 2014; Hankivsky et al., 2012; Hankivsky 2012; Hankivsky & Cormier, 2009; McCall, 2005; Weber & Parra-Medina, 2003). Social justice praxis guidance – community organizations, NGOs, international bodies (e.g. UN, WHO), and bodies engaged with human rights discourse (e.g. Center for Women’s Global Leadership).

Research and POLICY INNOVATIONS Primers developed on intersectionality in qualitative, quantitative, mixed methods, and policy research: www.sfu.ca/iirp

Guiding Principles For Intersectionality-Informed analysis

What really matters Intersectionality does not prescribe any particular way to conduct research or “do” policy analysis – fluid, flexible Important – intersectionality informed stance (Bowleg, 2012), attention to principles (Hankivsky, 2012) counter intuitive solutions, and commitment to social justice.

EMPIRICAL VALIDITY Illuminates that human lives are embedded in multiple contexts – historical, cumulative and interlocking. Changes how problems/phenomenon are approached and analyzed. Greater insights into systems of marginalization, oppression/privilege. Generates more precise information for delivery of responsive – that is effective and efficient health systems and services. Empowers citizens, provides them with different ways to organize and advance individual and community resilience, innovative alliances and strategies.