Multidimensional Approaches to Examining Gender and Racial/Ethnic Stratification in Health

Extant research on health disparities has traditionally employed a unidimensional approach to stratification, focusing on gender and racial/ethnic inequality separately. Such studies implicitly assume that gender inequality is monolithic across racial/ethnic lines and that racial/ethnic stratification is similar for women and men. While informative, these traditional, unidimensional approaches artificially decouple gender and racial/ethnic inequality and, consequently, may obscure the gender-race/ethnicity-health relationship, thus limiting our understanding of the unique health experiences of women of color. This study extends prior research by using multidimensional approaches to examine whether gender and racial stratification combine in an additive or multiplicative fashion to shape functional health, consistent with double-jeopardy and intersectionality hypotheses, respectively. In addition, this study investigates the extent to which group differences in socioeconomic status (SES), health behaviors, and medical care explain gender-racial/ethnic disparities in health. We use data from the Health and Retirement Study, a nationally representative sample of older adults, to address these questions among a diverse sample of black, white, and Mexican American men and women. Results reveal that women of color have worse functional health than all other gender-racial/ethnic groups and that the joint impacts of gender and racial/ethnic oppression on functional health are additive among Mexican Americans and multiplicative among blacks. We find that multidimensional approaches—namely, double-jeopardy and intersectionality—as well as examination of various potential mediators of health disparities provide a better understanding of how health is shaped by multiple social locations.