Abstract
OBJECTIVES: Intersectionality theory proposes that each combination of social categories derived from gender, race and nationality, such as immigrant White man or native-born Black woman, is associated with unique social experiences. We tested the potential of intersectionality theory for explicating racial inequalities in Canada by investigating whether Black-White health inequalities are conditioned by gender and immigrant status in a synergistic way.
METHODS: Our dataset comprised 10 cycles (2001–2013) of the Canadian Community Health Survey. We used binary logistic regression to model Black- White inequalities in hypertension, diabetes, self-rated health, self-rated mental health and asthma separately for native-born women, native-born men, immigrant women and immigrant men.
RESULTS: After controlling for potentially confounding factors we found that immigrant Black women had significantly higher odds of hypertension, diabetes and fair/poor self-rated health than immigrant White women. Native-born Black women and immigrant Black men had higher odds of hypertension and diabetes than native-born White women and immigrant White men respectively, and native-born White women were more likely than native-born Black women to report asthma. There were no statistically significant health differences between native-born Black and White men. Socio-economic status, smoking, physical activity and body mass index were implicated in some but not all of these racial health inequalities. None of the three-way interactions between racial identity, gender and immigration status was statistically significant.
CONCLUSION: We found relatively high risks of ill health for Black Canadians in three of the four samples. Overall, however, we found little support for the intersectional hypothesis that Black-White health inequalities in Canada are conditioned by gender and immigrant status in a synergistic way.
Key Words: Canada, Black, White, intersectionality, racial health inequalities, gender, immigration, socioeconomic status, health behaviours, body mass index
Résumé
OBJECTIFS : Selon la théorie de l’intersectionnalité, chaque combinaison de catégories sociales dérivées du sexe, de la race et de la nationalité, comme « homme blanc immigrant » ou « femme noire née au pays », est associée à des expériences sociales uniques. Nous avons testé la possibilité que la théorie de l’intersectionnalité explique les inégalités raciales au Canada en cherchant à déterminer si les inégalités de santé entre les Noirs et les Blancs sont conditionnées par le sexe et le statut d’immigrant de manière synergique.
MÉTHODE : Notre fichier comprenait 10 cycles (2001–2013) de l’Enquête sur la santé dans les collectivités canadiennes. Nous avons utilisé la régression logistique binaire pour modéliser les inégalités entre Noirs et Blancs pour ce qui est de l’hypertension artérielle, du diabète, de la santé autoévaluée, de la santé mentale autoévaluée et de l’asthme, et ce, séparément pour les femmes nées au pays, les hommes nés au pays, les femmes immigrantes et les hommes immigrants.
RÉSULTATS : Compte tenu des facteurs de confusion possibles, nous avons constaté que les femmes noires immigrantes avaient des probabilités sensiblement plus élevées d’hypertension artérielle, de diabète et de santé moyenne ou mauvaise autodéclarée que les femmes blanches immigrantes. Les femmes noires nées au pays et les hommes noirs immigrants avaient de plus fortes probabilités d’hypertension artérielle et de diabète que les femmes blanches nées au pays et que les hommes blancs immigrants, respectivement, et les femmes blanches nées au pays étaient plus susceptibles que les femmes noires nées au pays de dire faire de l’asthme. Il n’y avait aucun écart de santé significatif entre les hommes noirs et les hommes blancs nés au pays. Le statut socioéconomique, le tabagisme, l’activité physique et l’indice de masse corporelle étaient en cause dans certaines de ces inégalités raciales en matière de santé, mais non dans toutes. Aucune interaction triangulaire entre l’identité raciale, le sexe et le statut d’immigrant n’était significative.
CONCLUSION : Nous avons constaté des risques de mauvaise santé relativement élevés pour les Canadiens de race noire dans trois échantillons sur quatre. Dans l’ensemble cependant, nous avons trouvé peu de preuves à l’appui de l’hypothèse d’intersectionnalité selon laquelle les inégalités de santé entre Noirs et Blancs au Canada seraient conditionnées par le sexe et le statut d’immigrant de façon synergique.
Mots Clés: Canada, Noirs, Blancs, intersectionnalité, inégalités raciales en matière de santé, sexe, immigration, statut socioéconomique, comportement sanitaire, indice de masse corporelle
Footnotes
Acknowledgements: This research was supported by the Heart & Stroke Foundation of Canada under grant number G-13-0002797. Access to the master files of the Canadian Community Health Survey was facilitated by the Canadian Initiative on Social Statistics jointly administered by the Social Sciences and Humanities Research Council of Canada, the Canadian Institutes of Health Research and Statistics Canada. The analysis was conducted in Statistics Canada’s Vancouver and Lethbridge research data centres.
Conflict of Interest: None to declare.
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