Intersections of Race, Class and Health

Susan Hinze
in  The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society, 1-6, edited by William Cockerham, Robert Dingwall and Stella R. Quah: Wiley-Blackwell, March 2014

A large and rapidly growing body of literature has investigated the relative importance of social class and race/ethnicity for health outcomes. However, close examination of how social class intersects with race/ethnicity to produce health is of critical importance and a more recent focus in health research. The enduring survival gap between those in the upper social echelons and those in the lower social echelons persists across times and places, even as causes of mortality shift from infectious disease to chronic illness. Being disadvantaged by social class and underrepresented minority status is double jeopardy, but moving beyond an additive approach to an intersectional approach – especially once gender is included – reveals race and social class as relationships not captured in additive models. Although race/ethnicity and social class have independent effects on health status and health care treatment, their connectedness puts disadvantaged minority groups at risk as income inequality increases in the United States.

Can We Capture the Intersections? Older Black Women, Education and Health
Hinze, Susan W.; Lin, Jielu;  Andersson, Tanetta
Women’s Health Issues 22(1):91-98, 2012


Despite the fact that persistent health inequalities are found between groups, we know little about how the interrelatedness of these social positions influences the health of older adults. In this study, we apply a feminist intersectional approach to the study of health inequalities, treating social variables as multiplicative rather than additive to capture the mutually constitutive dimensions of race/ethnicity, gender, and education. Using the National Social Life, Health and Aging Project, a nationally representative sample of 3,005 community-dwelling U.S. adults aged 57 to 85 years old, we confirm that Black women with less than a high school education have the poorest self-rated health. We also find highly educated White men are not the converse of lower educated Black women. Finally, we find being Black and female has an effect on health beyond those already accounted for by race and gender. This research demonstrates the explanatory power of an intersectionality approach to deepen understanding of the overlapping, simultaneous production of health inequalities by race, class, and gender.



Medical Sociology Through the Lens of Human Rights
Susan W. Hinze and Heidi Taylor
Pp. 118-128 in  Handbook of Sociology and Human Rights, edited by David Brunsma, Brian Gran and Keri Iyall. Boulder, CO: Paradigm Publishers. 2012


Medical sociology is uniquely positioned to lay bare the ways in which myriad inequities around the world strip individuals, and particularly the disenfranchised, of their basic right to health and well-being. By making the case for a right to health, the right to health care and the right to autonomy from medical sovereignty, medical sociologists can help lay a solid foundation for the human rights paradigm.



Hurt Running from Police? No Chance of (Pain) Relief: The Social Construction of Deserving Patients in Emergency Departments
Hinze, Susan W.; Webster, Noah J.; Chirayath, Heidi T.; Tamayo-Sarver, Joshua H.
Research in the Sociology of Health Care,  27: 235-261. 2009


Do physician perceptions of patient “deservingness” factor into the decision to prescribe opioid analgesics? Using a data set of 398 physicians randomly selected from the American College of Emergency Physicians membership list, we explore how a range of patient social context variables influence a physician’s decision to prescribe opioids for three conditions: ankle fracture, back pain, and migraine headache. Being hurt running from the police, former and current drug or alcohol use, and frequent ER visits reduce the likelihood of opioid prescription. Having a reliable relationship with a primary care provider, and being injured in a ladder fall or intramural collegiate basketball game increase the likelihood of opioid prescription. Factor analyses for each of the three conditions reveal two scales: socially stigmatizing characteristics and socially accepted characteristics. Discussion centers on what places people at risk for inadequate pain control. Our work contributes to the expanding literature on social conditions as a fundamental cause of illness.