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Investigating the methodological applicability of intersectionality to physical activity and smoking in Canada Abichahine, Hayfa

Abstract

BACKGROUND: In Canada, substantial health inequities have been documented by income, education, gender, race, and sexuality. Researchers examining such inequities have typically employed ‘additive’ analyses where these variables are treated independently of one another. Some scholars have argued that the additive approach cannot fully illuminate health inequities by class, gender, race, and sexuality, calling for ‘multiplicative’ approaches inspired by intersectionality theory to replace additive approaches. PURPOSE: I investigate the applicability of intersectionality theory for explicating two health practices - physical exercise and smoking - using Canadian data. I predict that intersections of classism, patriarchy, racism, and heterosexism at macro levels of Canadian society affect the incidence of exercise and smoking at the individual level, in the case of physical exercise as a desirable pursuit which is facilitated by the privilege that accrues to multiple dominant-group identities and in the case of smoking as a coping mechanism for dealing with the oppressive stressors that accrue to multiple subordinate-group identities. METHODS: Informed by the theoretical underpinnings of current intersectional scholarship, I compare the ability of the additive and intersectional approaches to explicate these two health practices in Canada. Using nationally-representative data from the Canadian Community Health Survey Cycles 2.1 and 3.1 and binary logistic regression modelling, I examine and compare the main effects of class, race, gender, and sexuality (additivity) and then four-, three-, and two-way interaction effects between class, race, gender, and sexuality (multiplicativity) as predictors of physical activity and smoking. RESULTS: I find that results from the additive models are consistent with previous empirical research on physical activity and smoking. The interaction models produce statically significant three- and two-way interactions for physical activity and smoking that are complex in nature and consistent with some but not all of the predictions derived from intersectionality theory. CONCLUSION: This study challenges prevailing understandings of social causes of health behaviours by class, gender, race, and sexuality that have been generated by additive modes of analysis. The study also suggests that, in regard to physical activity and smoking, some but perhaps not all tenets of intersectionality are potentially useful in explaining these health practices.

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Attribution-NonCommercial-NoDerivatives 4.0 International

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