Intersectionality and Healthcare for Older People
How might the concept of intersectionality help us understand and improve the health care experiences of older people?
Many different individuals and groups contribute to the health care experiences of older people, these may include: various types of health care providers (personal support workers, nurses, doctors, physiotherapists, mental health professionals, audiologists, optometrists, administrative staff, etc.); informal caregivers (family, friends, partners, etc.); policymakers (governmental departments, hospital boards); community members (volunteer groups); social networks, and of course older people or patients themselves.
Health Care Providers
Discussions about who is responsible for the provision of health care often centered on health care providers such as doctors or nurses. However, the current healthcare landscape has shifted the focus of care provision to interdisciplinary teams, a variety of professionals who contribute to the health care experiences of older adults (Young et al., 2011).
Regardless of the healthcare provider role, it is important to understand intersectionality from the viewpoint of the older person (i.e. what identities intersect and contribute to health and quality of life). It is equally important for the provider to understand intersectionality in their own lives. We all have identities that intersect in various parts of our lives. These intersections impact us and our interactions with the people in our world.
Social Identity Wheel
The Social Identity Wheel is part of a learning activity developed by educators from the University of Michigan’s Equitable Teaching initiative. The activity was designed to encourage “students to identify social identities and reflect on the various ways those identities become visible or more keenly felt at different times, and how those identities impact the ways others perceive or treat them. The worksheet prompts [us] to fill in [our] various social identities (such as race, gender, sex, ability disability, sexual orientation, etc.) and further categorize those identities based on which matter most in [our] self-perception and which matter most in others’ perceptions of [us].”(Pabdoo, n.d.)
Please review the following diagram of the Social Identity Wheel and then complete the steps in the blue activity box below the diagram:
Activity: The Social Identity Wheel
Step 1: Consider
Consider how you position yourself in relation to the 11 identity categories that correspond with the different sections of the Social Identity Wheel pictured above.
Step 2: Contribute
Even the terms that we use to describe different aspects of identity may vary depending on our perspectives and experiences. Are there any terms that you would use in place of the ones currently named in the diagram? OR Are there any additional identity categories that you feel may be important that are not included in the wheel?
Step 3: Review and Respond
Once you have considered how you identify in relation to each of the categories (Step 1) AND thought about other relevant categories that might be added to the wheel (Step 2), next, review and respond to the 5 questions that appear in the centre of the Social Identity Wheel.
Step 4: Share (*Optional)
If you are completing this module as part of a group, it may be helpful to share some of your responses to Steps 1-3 with with another member of your group. If you are completing it on your own you may consider sharing your responses with someone you know that you feel safe and comfortable with. ****In either case, be sure only to share things that you feel comfortable and safe discussing. The step of sharing your responses is meant to be optional; you may also choose to use this exercise solely as a private, personal reflection.
Step 5: Make Connections
Some adaptations of the Social Identity Wheel activity have also included the category of “Professional Role/Identity.” How might your professional role/identity add to, shift, or intersect with your responses to questions 1-5 in the centre of the Social Identity Wheel?
Facilitating the Social Identity Wheel Activity
For a guide on various approaches to adapting and facilitating UMichigan’s Social Identity Wheel Activity and to access to a printable worksheet, click on the following links:
Social Identity Wheel Facilitation Guide
Social Identity Wheel Worksheet
Connect to a case story
What might be the barriers and facilitators to the individual(s) in your case story receiving equitable and accessible health care?
How might your own personal and professional identities act as barriers and facilitators to supporting the individual(s) in your case story?
Additional Resources
Hand MD, Ihara ES. (2024). Ageism, Racism, Sexism, and Work With Older Healthcare Clients: Why an Intersectional Approach Is Needed in Practice, Policy, Education, and Research. Int J Aging Hum Dev. 98(1):27-38. doi: 10.1177/00914150231171843. Epub 2023 Apr 27.
National Collaborating Centre for Determinants of Health. (2023). Let’s talk about applying intersectionality in public health [webinar]. Available at https://nccdh.ca/webinars/entry/lets-talk-about-applying-intersectionality-in-public-health#part_what-are-the-opportunities-to-apply-intersectionality-and-transform-public-health-action
Media Attributions
Image 1: University of Michigan. (n.d.). Social identity wheel. http://sites.lsa.umich.edu/inclusive-teaching/.