Original article| Volume 22, ISSUE 1, e91-e98, January 2012

Download started.


Can We Capture the Intersections? Older Black Women, Education, and Health

Published:October 10, 2011DOI:



      Race/ethnicity, gender, and socioeconomic status are the three most prominent factors to predict health outcomes. Despite the fact that persistent health inequalities are found between groups, we know little about how the interrelatedness of these social positions influences the health of older adults.


      In this study, we apply a feminist intersectional approach to the study of health inequalities, treating social variables as multiplicative rather than additive to capture the mutually constitutive dimensions of race/ethnicity, gender, and education.


      This paper makes use of data from the National Social Life, Health and Aging Project, a nationally representative sample of 3,005 community-dwelling U.S. adults aged 57 to 85 years old, to explore intersections of race, gender, and education. We use a combination of stratified analysis with an interaction term to test multiplicative effects.


      First, our findings confirm that Black women with less than a high school education have the poorest self-rated health. Second, at the bivariate level, we find highly educated White men are not the converse of lower educated Black women. Third, at the multivariate level, we find being Black and female has an effect on health beyond those already accounted for by race and gender.


      This research demonstrates the explanatory power of an intersectionality approach to deepen understanding of the overlapping, simultaneous production of health inequalities by race, class, and gender.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Women's Health Issues
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bird C.E.
        • Rieker P.R.
        Gender and health: The effect of constrained choices and social policies.
        Cambridge University Press, New York2008
        • Bonilla-Silva E.
        • Baiocchi G.
        Anything but racism: How sociologists limit the significance of racism.
        in: Vera H. Feagin J. Handbook of the sociology of racial and ethnic relations. Springer, New York2007: 79-100
        • Caldwell C.H.
        • Guthrie B.J.
        • Jackson J.S.
        Identity development, discrimination, and psychological well-being among African American and Caribbean Black adolescents.
        in: Schulz A.J. Mullings L. Gender, race, class and health: Intersectional approaches. Jossey-Bass, San Francisco2006: 163-191
        • Calasanti T.
        Theorizing feminist gerontology, sexuality, and beyond.
        in: Bengtson V.L. Gans D. Putney N.M. Silverstein M. Handbook of theories of aging. 2nd ed. Springer, New York2009: 471-486
        • Choo H.Y.
        • Ferree M.M.
        Practicing intersectionality in sociological research: A critical analysis of inclusions, interactions, and institutions in the study of inequalities.
        Sociological Theory. 2010; 28: 129-149
        • Clark D.O.
        • Maddox G.L.
        Racial and social correlates of age-related changes in functioning.
        Journal of Gerontology: Social Sciences. 1992; 47B: S222-S232
        • Cole S.R.
        • Kawachi I.
        • Mallerd S.J.
        • Berkman L.F.
        Test of item-response bias in the CES-D scale: Experience from the New Haven EPESE Study.
        Journal of Clinical Epidemiology. 2000; 53: 285-289
      1. Collins, P. H. (2011, February). Black feminism, intersectionality, and social justice. Paper presented at Eastern Sociological Society 81st Annual Meeting, Philadelphia.

        • Cornwell B.
        • Schumm P.
        • Laumann E.
        • Graber J.
        Social networks in the NSHAP study: Rationale, measurement, and preliminary findings.
        Journals of Gerontology: Series B. 2009; 64B: i47-i55
        • Cornwell E.Y.
        • Waite L.J.
        Social disconnectedness, perceived isolation, and health among older adults.
        Journal of Health and Social Behavior. 2009; 50: 31-48
        • Crimmins E.M.
        • Saito Y.
        • Ingegneri D.
        Trends in disability-free life expectancy in the United States, 1970–90.
        Population and Development Review. 1997; 23: 555-572
        • Dannefer D.
        Cumulative advantage/disadvantage and the life course: Cross-fertilizing age and social science theory.
        Journal of Gerontology. 2003; 33: 630-636
        • Davis K.
        Intersectionality as buzzword: A sociology of science perspective on what makes a feminist theory successful.
        Feminist Theory. 2008; 9: 67-85
        • Dubrow J.K.
        How can we account for intersectionality in quantitative analysis of survey data? Empirical illustration for Central and Eastern Europe.
        Ask. Society. Research. Methods. 2008; 17: 85-100
        • England P.
        • Farkas G.
        • Kilbourne B.S.
        • Dou T.
        Explaining occupational sex segregation and wages: Findings from a model with fixed effects.
        American Sociological Review. 1988; 53: 544-558
        • Farmer M.M.
        • Ferraro K.F.
        Are racial disparities in health conditional on socioeconomic status?.
        Social Science & Medicine. 2005; 60: 191-204
        • Gee G.C.
        A multilevel analysis of the relationship between institutional and individual racial discrimination and health status.
        American Journal of Public Health. 2008; 98: S48-S56
        • Geronimus A.T.
        The weathering hypothesis and the health of African-American women and infants: Evidence and speculations.
        Ethnicity and Disease. 1992; 2: 207-221
        • Gorman B.K.
        • Read J.G.
        Gender disparities in adult health: An examination of three measures of morbidity.
        Journal of Health and Social Behavior. 2006; 47: 95-110
        • House J.S.
        • Kessler R.C.
        • Herzog A.R.
        Age, socioeconomic status, and health.
        The Milbank Memorial Quarterly. 1990; 68: 383-411
        • Kelley-Moore J.A.
        • Ferraro K.F.
        The Black/White disability gap: Persistent inequalities in later life?.
        Journal of Gerontology: Social Sciences. 2004; 59: S34-S43
        • King D.K.
        Multiple jeopardy, multiple consciousness: The context of a Black feminist ideology.
        Signs. 1988; 14: 42-72
        • Kilbourne B.S.
        • Farkas G.
        • Beron K.
        • Weir D.
        • England P.
        Returns to skill, compensating differentials, and gender bias: Effects of occupational characteristics on the wages of White women and men.
        American Journal of Sociology. 1994; 100: 689-719
        • Land K.C.
        • Yang Y.
        Morbidity, disability and mortality.
        in: Binstock R.C. George L.K. Handbook of aging and social sciences. 6th ed. Academic Press, San Diego2006: 41-58
        • Lantz P.M.
        • Lynch J.W.
        • House J.S.
        • Lepkowski J.M.
        • Mero R.P.
        • Musick M.A.
        • et al.
        Socioeconomic disparities in health change in a longitudinal study of US Adults: The role of health-risk behaviors.
        Social Science & Medicine. 2001; 53: 29-40
        • LaVeist T.A.
        Racial segregation and longevity among African Americans: An individual-level analysis.
        Health Service Research. 2003; 38: 1719-1734
        • Link B.G.
        • Phelan J.
        Social conditions as fundamental causes of disease.
        Journal of Health and Social Behavior. 1995; 35: 80-94
        • Luft R.E.
        • Ward J.
        Toward an intersectionality just out of reach: Confronting challenges to intersectional practice.
        Advances in Gender Research: Perceiving Gender Locally, Globally, and Intersectionally. 2009; 13: 9-37
        • Marmot M.G.
        • Ryff C.D.
        • Bumpass L.L.
        • Shipley M.
        • Marks N.F.
        Social inequalities in health: Next questions and converging evidence.
        Social Science & Medicine. 1997; 44: 901-910
        • Matthews S.
        • Manor O.
        • Power C.
        Social inequalities in health: Are there gender differences?.
        Social Science & Medicine. 1999; 48: 49-60
        • McDonough P.
        • Williams D.R.
        • House J.S.
        • Duncan G.J.
        Gender and the socioeconomic gradient in mortality.
        Journal of Health and Social Behavior. 1999; 40: 17-31
        • Mirowsky J.
        • Ross C.E.
        Education and self-rated health: Cumulative advantage and its rising importance.
        Research on Aging. 2008; 30: 93-122
        • Mullings L.
        On our own terms: Race, class, and gender in the lives of African American women.
        Routledge, New York1997
        • O’Muircheartaigh C.
        • Eckman S.
        • Smith S.
        Statistical design and estimation for the National Social Life, Health and Aging Project.
        Journal of Gerontology: Social Sciences. 2009; 64B: i12-i19
        • Perreira K.M.
        • Deeb-Sossa N.
        • Harris K.M.
        • Bollen K.
        What are we measuring? An evaluation of the CES-D across race/ethnicity and immigrant generations.
        Social Forces. 2005; 83: 1567-1602
        • Read J.G.
        • Gorman B.K.
        Gender inequalities in US adult health: The interplay of race and ethnicity.
        Social Science & Medicine. 2006; 62: 1045-1056
        • Reskin B.F.
        • Padavic I.
        Women and men at work.
        2nd ed. Pine Forge, Thousand Oaks, CA2002
      2. Richardson, L., & Brown, T. (2011, February). Intersectionality of race, gender and age in hypertension trajectories across the life course. Presented at Eastern Sociological Society 81st Annual Meeting, Philadelphia.

        • Ro A.
        • Choi K.
        Effects of gender discrimination and reported stress on drug use among racially/ethnically diverse women in northern California.
        Women’s Health Issues. 2010; 20: 211-218
        • Ross C.E.
        • Mirowsky J.
        Sex differences in the effect of education on depression: Resource multiplication or resource substitution?.
        Social Science & Medicine. 2006; 63: 1400-1413
        • Sarkisian N.
        • Gerstel N.
        Kin support among blacks and whites: Race and family organization.
        American Sociological Review. 2004; 69: 812-837
      3. Schulz A.J. Mullings L. Gender, race, class, & health: Intersectional approaches. Jossey-Bass, San Francisco2006
        • Shuey K.M.
        • Willson A.E.
        Cumulative disadvantage and black-white disparities in life-course health trajectories.
        Research on Aging. 2008; 30: 200-225
        • Smith S.
        • Jaszczek A.
        • Graber J.
        • Lundeeen K.
        • Leitsch S.
        • Wargo E.
        • O’Muircheartaigh C.
        Instrument development, study design implementation, and survey conduct of the National Social Life, Health and Aging Project.
        Journal of Gerontology: Social Sciences. 2009; 64B: i20-i29
        • Turvey C.L.
        • Wallace R.B.
        • Herzog R.
        A revised CES-D measure of depressive symptoms and a DSM-Based measure of major depressive episodes in the elderly.
        International Psychogeriatrics. 1999; 11: 139-148
      4. Waite, L. J., Laumann, E. O., Levinson, W., Tessler Lindau, S., McClintock, M. K., O’Muircheartaigh, C. A., et al. National social life, health, and aging project (NSHAP) [Computer file]. ICPSR20541–v5. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2010-07-28. doi:10.3886/ICPSR20541.

      5. Weber, L. (2011, February). When intersectionality meets biomedicine: Tensions, conflicts, and possibilities. Paper presented at Eastern Sociological Society 81st Annual Meeting, Philadelphia.

        • Weber L.
        • Fore E.
        Race, ethnicity, and health: An intersectional approach.
        in: Vera H. Feagin J. Handbook of the sociology of racial and ethnic relations. Springer, New York2007: 191-218
        • Weber L.
        • Parra-Medina D.
        Intersectionality and women’s health: Charting a path to eliminating health disparities.
        in: Texler Segal M. Demos V. Kronenfeld J.J. Gender perspectives on health and medicine: Key themes. Elsevier, Oxford, UK2003: 181-229
        • Williams D.R.
        • Neighbors H.W.
        • Jackson J.S.
        Racial/ethnic discrimination and health: Findings from community studies.
        American Journal of Public Health. 2008; 98: S29-S37
        • Willson A.E.
        • Shuey K.M.
        • Elder Jr., G.H.
        Cumulative advantage processes as mechanisms of inequality in life course health.
        American Journal of Sociology. 2007; 112: 1886-1924
        • Wright E.O.
        • Baxter J.
        • Birkelund G.E.
        The gender gap in workplace authority: A cross-national study.
        American Sociological Review. 1995; 60: 407-435
        • Yang Y.
        • Lee L.
        Sex and race disparities in health: Cohort variations in life course patterns.
        Social Forces. 2009; 87: 2093-2124


      Susan W. Hinze, PhD, is Associate Professor of Sociology and Director of Women's and Gender Studies at Case Western Reserve University, Cleveland, OH. Her research interests include the influence of patient race/ethnicity, social class and gender on physician decision-making, and the gendered career and family paths of physicians.


      Jielu Lin, MS, is a doctoral candidate in the Department of Sociology at Case Western Reserve University, Cleveland, OH. Her main area of interest is age and the life course, with a focus on how cumulative dis/advantage processes shape the pattern of individual health trajectories.


      Tanetta Andersson, MA, is a doctoral candidate and instructor in the Department of Sociology at Case Western Reserve University, Cleveland, OH. Her research interests are rooted in the nexus between race, class, and gender statuses, inequality, and life chances (education and health).