This chapter focuses on current academic definitions of ‘intersectionality’ and highlights why the term is important for the delivery of health interventions for ethnic minority groups. In recognition of recent research on intersectionality, additional dimensions of difference and marginality for ethnic minority groups are discussed here (Reimer-Kirkham and Sharma, 2011; Mwangi and Constance-Huggins, 2017; Collins and Bilge, 2020).

A brief exploration of some of the current health interventions and studies that employ an intersectional approach is provided. However, it is argued that few in the UK facilitate a focus on this approach. Furthermore, few apply the theory to examine the interconnected ways in which multiple aspects of identity impact on health and access to healthcare interventions for ethnic minority people (Tomalin et al, 2019).

This chapter sets the context for Chapter 5, in which a research case study is presented about why intersectionality theory is important for addressing misconceptions about ethnic minority people as being hard to reach in health intervention delivery.

Intersectionality theory

‘Intersectionality’ refers to the intersections and interconnectedness of social identity, and recognises that inequalities cannot be explained by one identity, condition or location (Crenshaw, 1989, 1991). While the concept and theory were originally intended to address the effects of sex/gender and race/ethnicity within the legal profession, it has been extended to other domains, notably in the study of health (Bowleg, 2012).

However, as yet, it has not been widely employed in the study of health inequalities (Smith et al, 2016). Despite this, use of this approach is needed and important, because it can allow health researchers and practitioners to focus on the ways in which features of social identity are interrelated and can be detrimental to health and healthcare access (Heard et al, 2019). It also allows for the ‘study of health at different intersections of identity, social position processes of oppression or privilege, and policies or institutional practices’ (Bauer, 2014: 10). This approach is also vital for understanding ethnic health inequalities because, as outlined in Chapter 2, the various axes of inequalities are often studied in isolation (Bowleg, 2012). Furthermore, the ‘lived experiences of [health] that involves ongoing intersections across all of these different axes are often misunderstood’ (Smith et al, 2016: 6). So now let's look at the concept of intersectionality and current approaches that can assist us in the study of ethnicity and health.