Intersecting Inequalities: Exploring the Relationship between Subjective Social Status, Intersections of Racism and Sexism, and the Health Status of Black Women in Philadelphia
Socioeconomic status (SES) is commonly used to assess social status and is a key determinant of health outcomes (Adler et al., 1994; Adler & Ostrove, 1999; Williams & Collins, 1995). However, there are limitations to the objective assessment of SES using (income, education or occupation) (Braveman et al., 2005; Krieger, Rowley, Herman, & Avery, 1993). SES does not typically take into account institutional racism and sexism that creates differences in the social status gained by one’s education, income or occupation (Krieger, et al., 1993). Subjective social status (SSS), people’s perceptions of their social standing in comparison to others may capture more subtle aspects of SES, and reflect individuals’ perceptions of inequalities such as racism and sexism (Ghaed & Gallo, 2007; Lundberg & Kristenson, 2008; Singh-Manoux, Adler, & Marmot, 2003). Thus, SSS may be useful in exploring the role of social status in the disparate health of Black women. This study is one of the first to use an intersectionality framework of racism and sexism to explore the perception of SSS in 200 Black women between the ages of 18 – 70 (M= 43, SD= 12.8) as well as the role of SSS in their self reported health. Using a sample of adult Black women in Philadelphia the study used questionnaires and focus groups to investigate how Black women: (1) perceive and experience their social status (SSS); (2) experience and make meaning of racism, sexism and the intersection of racism and sexism; and (3) conceptualize experiences and perceptions of racism and sexism in their subjective social status, and in turn their self-reported health status. The women in the focus groups discussed several themes including: 1) the intersectional nature of racism and sexism; 2) discrimination based on intersectional racism and sexism in healthcare; and 3) contributors to subjective social status. They provided examples of how intersectional experiences of racism and sexism influenced their health. There was a positive correlation between SSS and self reported health status but there was no association between SES and health status. These findings support the role of subjective social status in the health of Black women.Dr.P.H., Community Health and Prevention -- Drexel University, 201
