1. LEEFTIJD IMPROVEMENT of HEALTH and SOCIAL CARE with an INTERSECTIONALITY APPROACH to DIVERSITY JANNEKE VAN MENS-VERHULST PhD. www.vanmens.info/verhulst/en

2. PROMINENT INTERSECTIONALITY SCHOLARS Patricia Hill CollinsKimberle Crenshaw

3. LEEFTIJD I 1.Intersectionality approach 2.Intersectionality and Health 3.Quality Improvement 4. Critical remarks TOPICS OF TODAY In cooperation with Lorraine Radtke (University of Calgary)

4. RELIGION LEEFTIJD CLASS `RACE’/ ETHNICITY AGE SEXUAL PREFERENCE (DIS) ABILITY SEX/ GENDER

5. LEEFTIJD I What is a Category of Social Difference? Social position Social group Principle of social organization

6. LEEFTIJD Common Diversity Views Social differences are A.Dichotomous (either-or) B.Power neutral C.One-dimensional D.Static (unchangeable) E.Independent + hierarchically ordered

7. LEEFTIJD Intersectional Views Social differences are A.Continuous B.Power loaded C.Multi-dimensional/ layered D.Dynamic E.Intertwined

8. A. Continuous differences Feminine “characteristics” Masculine “characteristics” 100% 0% FEMININE MASCULINE Fem Masc WOMAN MAN

9. Continua in Ethnicity Fluency in Dutch Colour of skin 100% 0% 100% Native country (of parents) Nationality (passport) 100% 1 0% 0 or >1 Historical background of migration: Black, Migrant, Refugee (BMR) “Allochton” Autochton Phil. of life: Jewish-Christian tradition 0% 100%

10. B. Power-differentials within social categories One end is valued more highly than the other and functions as the standard The dominant pole is invisible There are privileged and minoritised positions within each category

11. The white knapsack (Peggy McIntosh 1988) 1. I can if I wish arrange to be in the company of people of my race most of the time. 6. I can turn on the television or open to the front page of the paper and see people of my race widely represented. 8. I can be sure that my children will be given curricular materials that testify to the existence of their race. 15. I do not have to educate my children to be aware of systemic racism for their own daily physical protection. 17. I can talk with my mouth full and not have people put this down to my color. 21. I am never asked to speak for all the people of my racial group. 41. I can be sure that if I need legal or medical help, my race will not work against me.

12. Sex differences but ….

13. Processes of “becoming” Acculturation Social representation Social positioning Socialisation Identification Internalisation Imitation

14. Dynamics of Privileging and Minoritisation biological cultural social interpersonal mental I D E N T I T Y

15. D. Social differences intersect and are operating simultaneously = intersectional S/G ECA SO

16. Other metaphors: Kaleidoscope and Mikado

17. Dynamics of Privileging and Minoritisation biological cultural social interpersonal mental STRESS STRESS

18. Intersectionality and Health Categories of social difference Powerdynamics Processes of becoming Stress Coping skills Health complaints Health (il)literacy

19. QUALITY IMPROVEMENT Less exclusion (neglect) b.o. alertness for:  Variety within social categories  Recognition of hybrids  Similarities in addition to differences Comprehensive understanding b.o.  Identity as a sociopsychobiological process influenced by social inequalities  Variety in the meaning of life transitions

20. Intersectionality tips for care professionals 1.Check patients’ self-identification 2.Apply holistic view during total caring process. 3.Apply knapsack analysis 4.Recognize patients’ strengths/ privileges (not only vulnerabilities)  empowerment 5.Put “the other question” 6.Utilize new opportunities for coalitions (f.e. for prevention resources) 7.Analyse your own situatedness

21. Research Implications Questions to be answered Who is included in this category; who not? What is the role of inequality/power? Where are there similarities? For Generation of hypotheses Sampling Operationalization Analysis Interpretation E.R.Cole, American Psychologist 2009 nr3

22. Critical remarks  Dissimilarities between the categories of social difference  Managerial problems with intersectionality: - how to organize it; - how to integrate it into health policy: what about categorically organized services? - how to include it in clinical guidelines  Simultaneous operation to be proved (instead of supposed)

23. LEEFTIJD I Thank you for your attention www.vanmens.info/verhulst/en