The Role of Intersectionality in Advancing Health Equity

Consider a 62-year-old neurodivergent Black woman living in a low-income urban neighborhood. She faces numerous challenges: systemic racism in her community, ageist stereotypes from healthcare providers, and barriers to accessing care tailored to her neurodivergence. Her struggle illustrates why intersectionality—a concept coined by legal scholar Kimberlé Crenshaw—is critical for understanding and addressing health inequities. Intersectionality examines how overlapping identities such as race, gender, age, neurodivergence, and socioeconomic status interact with systems of oppression, shaping unique healthcare experiences and outcomes.

Health disparities are rarely caused by a single factor. Instead, they arise from the compounded effects of multiple forms of discrimination and privilege. For individuals navigating complex identities, traditional approaches to health equity often fall short. For example, healthcare initiatives targeting women, older adults, or neurodivergent individuals may overlook the distinct needs of those who exist at the intersection of these groups. This gap perpetuates inequities, leaving the most vulnerable behind.

Research increasingly highlights the importance of intersectionality in advancing health equity. A systematic review in the Cochrane Library revealed significant limitations in public health interventions that fail to adopt an intersectional lens. Programs designed for single-identity groups, such as women or low-income populations, often neglect the compounded barriers faced by those with intersecting identities. For instance, an older neurodivergent woman of color might encounter not only systemic racism but also ableism and ageism in healthcare settings. Policies informed by intersectionality have been shown to better address these complexities, leading to more equitable health outcomes.

In a study published in PubMed, researchers analyzed cardiovascular health outcomes for 10,000 patients stratified by race, gender, age, and socioeconomic status. The findings revealed that older Black women in low-income neighborhoods faced disproportionately high rates of cardiovascular disease and poorer access to preventive care compared to their male counterparts or white women in similar socioeconomic conditions. These disparities were driven by structural racism, gender biases, economic disadvantage, and ageist assumptions about health risks. This study underscores the necessity of intersectional frameworks in designing healthcare policies and interventions.

Neurodivergence represents another critical demographic often overlooked in healthcare. A meta-synthesis in PsycINFO examined the unique challenges faced by neurodivergent individuals—such as those with autism spectrum disorder, ADHD, or learning disabilities—when intersecting with other marginalized identities. LGBTQ+ neurodivergent individuals from minority ethnic backgrounds reported facing compounded discrimination, including racism, ableism, and homophobia. Many participants described healthcare providers as ill-equipped to address their needs, leading to misdiagnoses or dismissive attitudes. One participant shared, “As a queer, neurodivergent person of color, I feel like no one in the healthcare system understands me. My mental health struggles are dismissed as personality quirks, and I’m left to navigate this alone.” Such testimonies highlight the pressing need for culturally competent, inclusive care.

Ageism further complicates the healthcare experiences of marginalized populations. Older adults, particularly those from low-income or neurodivergent backgrounds, often encounter barriers to accessing care. For example, telemedicine—a widely promoted solution for improving healthcare access—frequently excludes older patients due to assumptions about digital literacy and inaccessible platform designs. Neurodivergent individuals, who may require accommodations such as simplified navigation or sensory-friendly environments, are particularly disadvantaged. Without targeted interventions, these barriers continue to exacerbate disparities.

Despite its potential, the application of intersectionality in health equity research and practice faces several barriers. Data collection remains a significant challenge. Many studies fail to capture detailed information about intersecting identities such as neurodivergence, age, or sexual orientation, limiting the ability to analyze and address complex disparities. Methodological challenges also persist; while qualitative studies offer rich insights into lived experiences, they often lack the scalability of large quantitative datasets. Furthermore, translating intersectional research into actionable policies requires systemic reforms and sustained political commitment—both of which remain limited in many healthcare systems.

To address these challenges, several actionable steps are critical. First, healthcare systems must prioritize detailed data collection on multiple social identities. Without such data, the most vulnerable populations remain invisible in research and policymaking. Second, healthcare providers need comprehensive training in cultural competence and neurodivergence awareness. This includes understanding how biases related to race, age, and neurological diversity intersect to affect health outcomes. Third, policymakers must focus on dismantling structural barriers in healthcare. For example, making telemedicine platforms accessible to older and neurodivergent patients could dramatically improve healthcare access. Similarly, expanding community health programs in underserved neighborhoods can disproportionately benefit older, neurodivergent women of color.

Intersectionality is not just an academic concept—it is a practical and necessary framework for dismantling systemic inequities in healthcare. By acknowledging and addressing the unique challenges faced by those with intersecting identities, health equity efforts can become more inclusive and effective. The research is clear: interventions that ignore intersectionality risk perpetuating the very disparities they aim to resolve. Embracing this framework is not only a matter of fairness but also a vital step toward creating a healthcare system that works for everyone.

References

• Cochrane Library. (2022). Intersectionality and health equity: Addressing multiple inequalities in public health.

• PubMed. (2023). Structural racism and intersectionality in cardiovascular health outcomes.

• PsycINFO. (2024). Mental health disparities in LGBTQ+ communities of color: An intersectional perspective.