# Two Variable Inequalities Essay About Myself

Sizeable health inequalities by race [1,2], gender [3,4] and class [5] have been recorded in Canada. Consistent with traditional sociological understandings of social inequality, these axes of inequality have for the most part been considered individually, with researchers only considering potential interconnectedness when investigating whether class mediates associations between race and health or gender and health. Whether class influences health differently for visible minority Canadians and White Canadians or race influences health differently for men and women, for example, has not yet been investigated. When statistical interactions such as these *have *received analytical attention - for example, whether class influences health differently for Canadian men and women [3] - they have not been adequately theorized. Intersectionality theory, an influential theoretical tradition inspired by the feminist and antiracist traditions, demands that inequalities by race, gender, and class (and sexuality as well) be considered in tandem rather than distinctly. This is because these fundamental axes of inequality in contemporary societies are considered to be intrinsically entwined; they mutually constitute and reinforce one another and as such cannot be disentangled from one another. Intersectionality theory presents a new way of understanding social inequalities that possesses potential to uncover and explicate previously unknown health inequalities. This paper describes the results of an original empirical investigation of the degree to which the self-rated health of Canadians varies by race, gender, class, and/or sexual orientation in ways that are consistent with predictions of intersectionality theory. The remainder of this background section describes some of the central principles of this theoretical tradition followed by a description of the analytical strategy used to apply these principles in an empirical investigation of inequalities in self-rated health in Canada.

### Intersectionality theory

In the forward to a recent book on new theories and methods for studying race, class, and gender, Lynn Weber [6] describes how American women of color in the 1970s and early 1980s, many from working class backgrounds, came to critique the patriarchy tradition within gender studies for privileging gender over race and class (and subsequently critiqued the stratification tradition for privileging class over gender and race, etc.). They argued that these axes of inequality are in fact analytically inseparable, and that "the multidimensionality and interconnected nature of race, class, and gender hierarchies were especially visible to those who faced oppression along more than one dimension of inequality" [6:xii]. These scholars envisioned axes of inequality pertaining to gender, race, and class that *intersect *with one another, i.e., that are interlocked, dependent upon one another, and mutually constituted [7]. Power relationships along the lines of gender, race, and class were thought to be mutually defining and mutually reinforcing rather than analytically distinct systems of oppression, together forming a "matrix of domination" [8]. By the mid-1980s, lesbians of color had bridged the gap between gay and lesbian studies and the growing body of race, gender, and class research that had to that point ignored heterosexism [6], and axes of inequality pertaining to national origin, citizenship status, religion, disability, and age also received some attention. The contributions of these various scholars gave rise to what is now known as "intersectionality theory." Landry [9] notes, however, that intersectionality theory does not provide a set of propositions that together form an explanation; rather, intersectionality theory currently consists of a loose set of principles or assumptions that are being applied and tested by many researchers in a variety of contexts.

Founded upon analyses of relations of power in general and inspired by theories of racism, patriarchy, classism, and heterosexism in particular, in American intersectionality discourse the disadvantaged groups along the inequality axes of race, gender, class, and sexual orientation are assumed to be visible minorities from various backgrounds (especially African Americans), women, members of the lower and working classes, and gays, lesbians, and bisexuals. These comprise implicit intersectionality assumptions of "directionality."

Intersectionality theorists argue that our identities based on race, gender, class, and sexuality accompany us in every social interaction [7]. The principle of "simultaneity" maintains that all of the axes and their corresponding identities should be incorporated into social analyses.

"Race, class and gender may all structure a situation but may not be equally visible and/or important in people's self-definitions... This recognition that one category may have salience over another for a given time and place does not minimize the theoretical importance of assuming that race, class and gender as categories of analysis structure all relationships" [7:560-1].

That is, while some axes and identities may be more pertinent to a specific social context or outcome than are others, simultaneity implies that a social researcher should never discard an axis of inequality before investigating its potential relevance for the problem at hand.

Intersections between axes are thought to create complex social locations that are more central to the nature of social experiences than are any of the axes of inequality considered singly.

"People experience race, class, gender and sexuality differently depending upon their social location in the structures of race, class, gender and sexuality. For example, people of the same race will experience race differently depending upon their location in the class structure as working class, professional managerial class or unemployed; in the gender structure as female or male; and in structures of sexuality as heterosexual, homosexual or bisexual" [10:326-7].

Thus "multiplicativity" should supplant additivity [10]. Racism x sexism x classism x sexism should replace racism + sexism + classism + sexism [11,12]. A lower-class Black lesbian is necessarily all of these things, and their mutual manifestation represents a unique state of being and a unique set of social experiences and structural constraints.

"Race, class, gender and sexuality are not reducible to individual attributes to be measured and assessed for their separate contribution in explaining social outcomes, an approach that Elizabeth Spelman calls "pop-bead metaphysics," where a woman's identity consists of the sum of parts neatly divisible from one another. The matrix of domination seeks to account for the multiple ways that women experience themselves as gendered, raced, classed and sexualized" [10:327].

Experiences of gender are racialized, sexualized, and classed; experiences of class are gendered, racialized, and sexualized, etc.

From the abovementioned principles of directionality, simultaneity, and multiplicativity arise new versions of double jeopardy and triple jeopardy, renamed "multiple jeopardy" by Deborah King [11], wherein disadvantaged identities experienced in tandem are seen to result in inordinate, i.e., even more than additive, amounts of disadvantage. Thus complex social locations comprised of disadvantaged identities held in tandem are thought to lead to multiplicative disadvantage; that is, combinations of these identities are thought to have an aggravating rather than a simply cumulative or mitigating effect. In addition, because of the relational nature of intersectional theories, some complex locations, such as the one inhabited by wealthy heterosexual White men, in turn experience multiplicative advantage.

Despite the immense popularity of intersectionality theory in humanities and social sciences circles and the large and growing body of intersectionality research that includes applications of both qualitative and quantitative methodologies, very little quantitative research has explicitly applied intersectionality theory to health outcomes. However, many health determinants researchers have unintentionally addressed simultaneity and multiplicativity by identifying two-way statistical interactions between axes of inequality in regression modeling. In Canada, Zheng Wu and colleagues [2] identified interactions between race and socioeconomic status for depression. In the United States, Ostrove and colleagues [13] identified interactions between socioeconomic status and race as predictors of self-rated health and depression, Nomagushi [14] found interactions between race and gender on the effect of marital dissolution on depression, and Read and Gorman [15] determined that the gender gap in health differs widely by racial/ethnic group. But only a few quantitative studies have explicitly studied illness states associated with complex social positions arising from intersections between three axes of inequality [16-19], none of them Canadian, and no studies have studied intersections between all four of the primary axes of inequality of intersectionality theory. Given the seeming complicity of all of race [2,20-23], gender [3,4,24], class [5,25-29], and sexual orientation [30-33] in North American health inequalities, this lack of attention to health inequalities that accrue to multiple combinations of inequality identities represents an important gap in the health determinants literature.

### Analytical strategy

Modeling the main effects of inequality identities (additivity) and then statistical interactions between them (multiplicativity) in multivariate regression models on health can establish whether two-way or three-way statistical interactions (intersections) between axes of inequality contribute to explaining variability in health above and beyond the additive approach to health inequalities that currently dominates health determinants research. This paper uses a two-stage analytical strategy, the first additive and the second multiplicative, applied to a large representative survey dataset from Canada in order to investigate health outcomes associated with intersections between race, gender, class, and sexual orientation.

First, the strength and direction of the main effects in additive regression models such as Race + Gender + Class + Sexual Orientation = Health addresses the principles of simultaneity and directionality. Simultaneity suggests that all four identities will make significant contributions to these models before and/or after controlling for one another while directionality implies that non-Whites, women, lower-class people, and non-heterosexuals will manifest the poorer health outcomes.

Second, simultaneity and multiplicativity imply that the inequality identities should interact meaningfully with one another as predictors of health, that is, statistical interactions between the inequality variables of race, gender, class, and sexual orientation should manifest significant effects above and beyond their main effects in the abovementioned additive models. The existence of interactions speaks to multiplicativity. The qualities of the interactions themselves speak to multiple jeopardy and directionality. At least three multiplicative scenarios are possible for a given statistical interaction: 1. two or more axes of inequality manifest directions of some kind or other in additive models and then display an aggravating effect in the interaction between them, 2. two or more axes manifest given directions in additive models and then display a mitigating effect in their interaction, and 3. an interaction manifests itself between two or more axes but not all of the axes display independent effects in additive models. Aggravating effects support the assumption of multiple jeopardy and reinforce the directionality identified in the additive models whereas non-aggravating effects run contrary to the assumption of multiple jeopardy and complicate directionality. Finally, contributions to predicted variability in the models address multiplicativity by providing an indication of the "value added" of the statistical interactions; comparisons of R^{2 }values between regression models with and without the cross-product terms can be used to assess the magnitude of their contributions to explaining variability in health above and beyond the contributions of the main effects.

The solution of a linear inequality in two variables like Ax + By > C is an ordered pair (x, y) that produces a true statement when the values of x and y are substituted into the inequality.

**Example**

Is (1, 2) a solution to the inequality

$$2x+3y>1$$

$$2\cdot 1+3\cdot 2\overset{?}{>}1$$

$$2+5\overset{?}{>}1$$

$$7>1$$

The graph of an inequality in two variables is the set of points that represents all solutions to the inequality. A linear inequality divides the coordinate plane into two halves by a boundary line where one half represents the solutions of the inequality. The boundary line is dashed for > and < and solid for ≤ and ≥. The half-plane that is a solution to the inequality is usually shaded.

**Example**

Graph the inequality

$$y\geq -x+1$$

**Video lesson**

Graph the linear inequality

$$y \geq 2x -3$$

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