PUB - Publikationen an der Universität Bielefeld

Gendered health inequalities have historically been a focus of social epidemiology. However, gender analysis in these investigations has been limited to sex-specific or sensitive analyses, thereby neglecting gender as a socially constructed, multidimensional concept. The emergence of intersectionality as a theoretical approach, originating from social activism and sociology, is allowing to better research the complexity of gender and related health inequalities. This synthesis deconstructs the conceptual, epistemological and methodological levels of applying an intersectional approach to measuring gender as a social determinant of health in social epidemiology. To balance the complexity of intersectionality and the need for pragmatic operationalisation in the given discipline, I focus on migration as an exemplary axis of inequalities. Five papers (Pub-A to E) support this synthesis, organised in three work packages (WP): operationalising gender as a relational, multidimensional and multilevel social construct (WP1), exploring migration status as an exemplary intersectional axis of gendered health inequalities (WP2) and an intersectional analysis of gendered health inequalities in migrant and non-migrant populations (WP3). Deconstructing the process of applying an intersectional perspective, I identified relevant entry-points for linking the concepts stemming from different disciplines: a) social justice as the connecting value for knowledge production, b) situated intersectionality that provides pragmatic yet context-specific social stratifications for meaningful epidemiological and intersectional analysis and c) intercategorical intersectional approaches to operationalise intersectional premises related to gender, migration and health in quantitative terms. The empirical analyses of the contributing papers comprehensively map and critically assess the plethora of gender measures available for social epidemiology (Pub-A) – also for migrant health studies (Pub-B). In an exemplary focus on Germany, potentials of migration-specific health research (Pub-C) and a context-specific, relational gender score have been explored (Pub-D). Finally, the findings suggest that intersectional health inequalities in relation to gender and migration status exist and as such health inequalities need to be conceptualised intersectionally, on a global scale as well as for Germany (Pub-B & E). Applying this intersectional approach holds the potential to go beyond unidimensional, isolated gender analysis in social epidemiology. Developing this approach and consolidating its application could contribute to a deeper understanding of the complex health inequalities related to gender, migration, and additional social determinants of health.