Intersectionality: A critical framework for mainstream health psychology

Key Question Being Explored in This Insight:

How might embracing intersectionality in mainstream health psychology transform our understanding and approach to health equity and social justice issues?

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Institution: George Washington University

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How might embracing intersectionality in mainstream health psychology transform our understanding and approach to health equity and social justice issues?

Image courtesy of interviewee. November 20, 2024

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The speaker discusses the limitations of health psychology, which typically focuses on individual-level factors, neglecting the broader structural issues that influence health outcomes. They emphasize that understanding health requires acknowledging systemic inequalities, such as racism and sexism, and using frameworks like intersectionality to address these issues.

Intersectionality disrupts the traditional "single axis" approach in psychology by underscoring how various identities and power dynamics intersect to affect individuals’ health. The speaker argues that mainstream psychology often overlooks the experiences and knowledge of marginalized groups, which can lead to a narrow understanding of health and wellness.

Furthermore, the speaker highlights the philosophical differences between traditional psychology—rooted in positivist frameworks—and critical frameworks centered on social justice and intersectionality. They note a growing backlash against critical race theory and similar frameworks in the U.S., which complicates the progress of research in these areas.

Ultimately, the speaker sees promise in the application of intersectionality to challenge established knowledge and promote a more inclusive understanding of health. They express hope that advocates will continue to advance this work despite the challenges, bringing excitement to the interplay of activism and research in health psychology.

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Here are five key points from the video regarding health psychology, intersectionality, and their philosophical differences:

1. **Individual vs. Structural Analysis**: Traditional health psychology focuses on the individual as the primary unit of analysis, emphasizing personal behaviors, attitudes, and perceptions regarding health (e.g., attitudes about condoms in HIV prevention). In contrast, intersectionality stresses the importance of examining larger structural inequalities and systemic factors that influence health outcomes, such as racism.

2. **Philosophical Paradigms**: The video highlights the philosophical differences between health psychology, which is rooted in positivist and post-positivist frameworks concerned with data manipulation and verification, and critical frameworks like intersectionality that originate from activist perspectives. This distinction emphasizes the contrasting approaches to understanding and analyzing health-related issues.

3. **Focus on Power Dynamics**: Intersectionality places significant emphasis on the dynamics of power and privilege, arguing that health outcomes are shaped by an individual's location within a matrix of power that includes factors such as race, socioeconomic status, and access to resources like food and housing. This perspective challenges the single-axis view that traditional psychology might adopt.

4. **Centering Marginalized Voices**: An important aspect of intersectionality is its commitment to centering the experiences and perspectives of historically marginalized and oppressed groups when addressing health issues. This contrasts with conventional psychology that may prioritize the viewpoints of more privileged groups, thereby overlooking the unique challenges faced by marginalized populations.

5. **Critique of Universalization in Research**: The video critiques the tendency in traditional psychology to generalize findings across diverse populations, often based on studies conducted primarily with Western, educated, industrialized, rich, and democratic (WEIRD) populations. Intersectionality emphasizes the need for a convideo-sensitive understanding of health outcomes and cautions against applying findings universally without considering the specific sociopolitical and cultural convideos.

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Here are some key quotes and phrases from the video you :

1. **Individual Unit of Analysis**: "One of the problems with health psychology and psychology as a discipline is that the individual is the primary unit of analysis."

2. **Traditional Health Psychology View**: "When we're talking about health, we're defining health and thinking about health primarily as a property of individuals, what they do, how they think."

3. **Limits of Health Psychology**: "One of the things that intersectionality... do so well is state that the individual happens, exists, or we can't understand health by just focusing on individual level factors. There's a larger system."

4. **Role of Structural Inequality**: "One of the things that intersectionality does... is the role of structural inequality and inequity. And so I'm talking about racism and so on and so forth."

5. **Different Paradigms**: "Psychology as a discipline... is very much rooted in the sort of positivist and post positivist frameworks... whereas critical frameworks really come out of activism frameworks."

6. **Power Dynamics**: "It has a lot to do with power... and the dominance of biomedical perspectives."

7. **Trustworthy Knowledge**: "It has a lot to do with epistemology in terms of what is considered trustworthy knowledge... historically that's been knowledge that comes from... historically white western men."

8. **Importance of a Structural Focus**: "I think having a social justice framework is really important."

9. **Intersectionality Complicates Everything**: "Intersectionality complicates everything."

10. **Disrupting Single Axis Views**: "Intersectionality was not developed for research... it disrupts this notion of this sort of single axis view."

11. **Matrix of Power**: "It's about how one's location in the sort of matrix of power sort of shapes your health outcomes."

12. **Centering Marginalized Groups**: "Intersectionality... sort of center the position of historically marginalized groups."

13. **Convideoual Understanding**: "Those studies need to be understood within a very specific geographic historical sociopolitical convideo."

14. **Critique of Universalization**: "We can't do what psychology loves to do... we were very much interested in these sort of general universal theories."

15. **Backlash Against Critical Race Theory**: "It's important to realize that intersectionality comes outta critical race theory... the backlash against critical race theory has been vociferous."

16. **Promise of Intersectionality**: "There's a reason why mainstream organizations... have seen the promise of intersectionality for disrupting taken for granted knowledge."

These quotes encapsulate the central themes of how intersectionality critiques traditional health psychology, emphasizes the importance of structural factors in health, and calls for a focus on marginalized groups in understanding health outcomes.

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One of the problems with health psychology

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and psychology as a discipline is

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that the individual is the primary unit of analysis.

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And so what this means is

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that when we're talking about health, we're defining health

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and thinking about health primarily as a property

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of individuals, what they do, how they think.

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Uh, I'm an HIV prevention, researcher.

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And so for example, if we take a traditional health

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psychology view of something like HIV prevention,

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it's about your attitudes about condoms,

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whether you perceive HIV as a risk, a lot

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of social cognitive stuff, for example.

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Right? And one of the things that intersectionality

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and critical frameworks in general do so well is state

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that the individual happens, exists,

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or we can't understand health

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by just focusing on individual level factors.

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There's a larger system.

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And one of the things that intersectionality does

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and zeroes our attention to is the role

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of structural inequality and inequity.

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And so I'm talking about racism

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and racism as it intersects with sexism and heterosexism

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and so on and so forth.

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So that's one of the things that Intersectionally does

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especially well in terms of showing the limits of health,

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psychology and psychology.

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They come out of very different traditions,

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psychology as a discipline.

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And, you know, health psychology is, is a subfield of

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that is very much rooted in the sort of positivist

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and post positivist frameworks of, you know, data

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and what you can verify.

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And all of that versus critical frameworks really come out

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of, well, a lot of these are sort of social justice,

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activism frameworks.

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So they're coming out of very different, paradigms.

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Um, psychology is coming out of the, the university

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and is very much concerned with, manipulation

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of variables and controlling of statistical variables

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and testing and verifying theories.

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Critical theories like, or critical frameworks such

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as intersectionality are very much normative.

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And so they're taking certain things like racism

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as a logical prior, that's not something we have

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to do in experiment and say, my goodness,

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whether or not it exists.

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And so they're coming at very sort of different tracks.

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Um, and so that's important to keep

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that in mind when we think about, you know,

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mainstream psychology and, and or health psychology

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and intersectionality.

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They're, they're, they're so philosophically different.

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It has a lot to do with power.

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It has a lot to do with, you know, the dominance

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of biomedical perspectives.

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It has a lot to do with epistemology in terms of

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what do we value and what do we claim as

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as trustworthy knowledge?

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And historically that's been knowledge that comes from,

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you know, historically white western men,

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in the university system.

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And we certainly don't trust as knowledgeable sources

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or trustworthy sources, indigenous knowledge, for example.

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And certainly not the knowledge

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of groups who've been historically oppressed

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at multiple intersections.

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And so, yeah, there is a bit of a sort of a,

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a power clash there.

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I think that this structural focus is really important.

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It has implications for, improving health on a,

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you know, on a larger population level.

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Um, for example, I think having a

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social justice framework is really important.

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You know, having said that, it's November 14th.

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We, I am speaking to you, from the us

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and so this is a very, we're in a very sort

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of tenuous situation in terms of, on the one hand, those

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of us who've been doing this work

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for years have been talking about the importance

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of focusing on structure, structure

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and social justice at a time when those are very much the,

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the, the pushback on that is formidable

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and to talk about power.

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Um, and so, you know, I, it's, it's hard

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to answer a question about how mainstream,

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psychology will, will, will, could benefit

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because it's sort of, I'm waiting to see what

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the American Psychological Association

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with the divisions on health psychology, how they,

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how they respond to this moment.

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Um, and so I I, I'd be remiss without an, if I answered

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that question as if everything was going was going

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to be fine as usual, it's not.

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Intersectionality complicates everything. That's number one.

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The second thing is intersectionality we need

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to always keep in mind is intersectionality was not

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developed for research.

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It doesn't come out of that tradition.

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So one of the things it does is it disrupts this notion

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of this sort of single axis view.

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So for example, that you can focus on

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whatever health topics you pick one only through the prism

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of, say, racial group intersectionality complicates that

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and says, well, no, we need to look at health outcomes,

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for people at different sociodemographic intersections.

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So that's one of the things it does it

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because it brings power to the fore.

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Um, that that's another thing that intersectionally does.

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It's really important. It says, well, no,

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we can't just focus on people's sort

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of intersectional identities.

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Everybody has an intersectional identity.

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It's about how one's location in the sort of matrix

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of power sort of shapes your health outcomes, right?

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Whether you have access to health outcomes,

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where do you have, I mean, whether you have access

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to health one, do you have access to food?

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Do you have access to housing?

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It's this sort much larger thing, larger, framework.

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And then another thing that intersectionality does

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that mainstream psychology could benefit from would be this,

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this focus on centering.

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And by that I mean intersectionality

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and a lot of critical frameworks sort of center the position

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of historically marginalized groups.

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And so that means you're trying to understand

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whatever the health issue is,

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whether it's maternal morbidity

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and mortality, whether it's HIV diabetes,

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you name it from the vantage point of the,

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the oppressed group and not the vantage point of say,

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you know, a group that has far more privilege

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and of course their health outcomes are gonna be better.

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So that's another thing that,

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that an intersectional, view does.

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That's that traditional psychology research does it.

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So many of the theories, the sort

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of croce theories in psychology, well validated

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and also excellent studies.

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And so it's, I wanna be clear that I'm not saying,

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those studies were garbage.

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I'm not saying that. But what,

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what it says is, well, wait a minute.

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Those studies need

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to be understood within a very specific geographic

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historical sociopolitical context.

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And we can't do what psychology loves to do.

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We is universalize,

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we were very much interested in these sort of general

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universal theories.

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And it says, wait a minute, wait a minute,

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let's hold tight on those, assumptions.

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Because a lot of the things that we've taken

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for granted in health psychology are based on,

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Heinrich's notion of the weird populations.

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And so these are the western educated,

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industrialized rich democracies.

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And I always wanna add, preface that with another w white,

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so many studies in psychology are normed on middle

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class white college students

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and then ex generalized to everyone else.

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And so that's one of the things that intersectionality does

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so well for in terms of disrupting the sort of taken

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for granted, aspects of knowledge.

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It's important to realize that intersectionality comes outta

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cri critical race theory.

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And if you know anything about what's been going on in the

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us, the backlash of, against, critical race theory,

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has been vociferous.

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And now with the Trump administration, we're expecting,

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you know, incredible draconian rollbacks.

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And so I'm not sure where it goes next.

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Um, I think that it has been, it's had so much promise.

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There's a reason why, mainstream organizations such

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as the National Institutes of Health, for example, has been

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so interested and committed to funding this research

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because they also have seen the promise of intersectionality

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for disrupting, taken for granted knowledge.

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Um, and so where it goes next is I think that people

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who are passionate about this are going

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to continue doing the work.

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It's so exciting to be working in a field that on one hand,

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because it comes out of activism

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and was not developed for research,

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brings all all manner of intellectual challenges about how

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to do this, how to basically take this framework from this

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track, this critical track,

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and sort of fit it into this much more, you know,

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traditional positivist, track.

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I mean, that to me is, is incredibly exciting.

Rethinking Health: Beyond Individual Perspectives

00:00:00 - One of the problems with health psychology and psychology as a discipline is that the individual is the primary unit of analysis. And so what this means is that when we're talking about health, we're defining health and thinking about health primarily as a property of individuals, what they do, how they think. I'm an HIV prevention, researcher. And so for example, if we take a traditional health psychology view of something like HIV prevention, it's about your attitudes about condoms, whether you perceive HIV as a risk, a lot

00:00:34 - Right? And one of the things that intersectionality and critical frameworks in general do so well is state that the individual happens, exists, or we can't understand health by just focusing on individual level factors. There's a larger system. And one of the things that intersectionality does and zeroes our attention to is the role of structural inequality and inequity. And so I'm talking about racism

00:01:06 - and so on and so forth. So that's one of the things that Intersectionally does especially well in terms of showing the limits of health, psychology and psychology. They come out of very different traditions, psychology as a discipline. And, you know, health psychology is, is a subfield of that is very much rooted in the sort of positivist and post positivist frameworks of, you know, data and what you can verify. And all of that versus critical frameworks really come out

Contrasting Paradigms: Psychology and Intersectionality

00:01:39 - activism frameworks. So they're coming out of very different, paradigms. psychology is coming out of the, the university and is very much concerned with, manipulation of variables and controlling of statistical variables and testing and verifying theories. Critical theories like, or critical frameworks such as intersectionality are very much normative. And so they're taking certain things like racism

00:02:09 - to do in experiment and say, my goodness, whether or not it exists. And so they're coming at very sort of different tracks. and so that's important to keep that in mind when we think about, you know, mainstream psychology and, and or health psychology and intersectionality. They're, they're, they're so philosophically different. It has a lot to do with power. It has a lot to do with, you know, the dominance of biomedical perspectives. It has a lot to do with epistemology in terms of

00:02:43 - as trustworthy knowledge? And historically that's been knowledge that comes from, you know, historically white western men, in the university system. And we certainly don't trust as knowledgeable sources or trustworthy sources, indigenous knowledge, for example. And certainly not the knowledge of groups who've been historically oppressed at multiple intersections. And so, yeah, there is a bit of a sort of a, a power clash there. I think that this structural focus is really important.

Addressing Structural Inequalities in Health Psychology

00:03:16 - you know, on a larger population level. for example, I think having a social justice framework is really important. You know, having said that, it's November 14th. We, I am speaking to you, from the us and so this is a very, we're in a very sort of tenuous situation in terms of, on the one hand, those of us who've been doing this work for years have been talking about the importance of focusing on structure, structure

00:03:47 - the, the pushback on that is formidable and to talk about power. and so, you know, I, it's, it's hard to answer a question about how mainstream, psychology will, will, will, could benefit because it's sort of, I'm waiting to see what the American Psychological Association with the divisions on health psychology, how they, how they respond to this moment. and so I I, I'd be remiss without an, if I answered

00:04:16 - to be fine as usual, it's not. Intersectionality complicates everything. That's number one. The second thing is intersectionality we need to always keep in mind is intersectionality was not developed for research. It doesn't come out of that tradition. So one of the things it does is it disrupts this notion of this sort of single axis view. So for example, that you can focus on whatever health topics you pick one only through the prism of, say, racial group intersectionality complicates that

Intersectionality and Health Equity

00:04:48 - for people at different sociodemographic intersections. So that's one of the things it does it because it brings power to the fore. that that's another thing that intersectionally does. It's really important. It says, well, no, we can't just focus on people's sort of intersectional identities. Everybody has an intersectional identity. It's about how one's location in the sort of matrix of power sort of shapes your health outcomes, right? Whether you have access to health outcomes,

00:05:18 - to health one, do you have access to food? Do you have access to housing? It's this sort much larger thing, larger, framework. And then another thing that intersectionality does that mainstream psychology could benefit from would be this, this focus on centering. And by that I mean intersectionality and a lot of critical frameworks sort of center the position of historically marginalized groups. And so that means you're trying to understand whatever the health issue is,

00:05:48 - and mortality, whether it's HIV diabetes, you name it from the vantage point of the, the oppressed group and not the vantage point of say, you know, a group that has far more privilege and of course their health outcomes are gonna be better. So that's another thing that, that an intersectional, view does. That's that traditional psychology research does it. So many of the theories, the sort of croce theories in psychology, well validated

Contextualizing Psychological Research Through Intersectionality

00:06:21 - And so it's, I wanna be clear that I'm not saying, those studies were garbage. I'm not saying that. But what, what it says is, well, wait a minute. Those studies need to be understood within a very specific geographic historical sociopolitical context. And we can't do what psychology loves to do. We is universalize, we were very much interested in these sort of general universal theories. And it says, wait a minute, wait a minute, let's hold tight on those, assumptions. Because a lot of the things that we've taken

00:06:56 - Heinrich's notion of the weird populations. And so these are the western educated, industrialized rich democracies. And I always wanna add, preface that with another w white, so many studies in psychology are normed on middle class white college students and then ex generalized to everyone else. And so that's one of the things that intersectionality does so well for in terms of disrupting the sort of taken

00:07:26 - It's important to realize that intersectionality comes outta cri critical race theory. And if you know anything about what's been going on in the us, the backlash of, against, critical race theory, has been vociferous. And now with the Trump administration, we're expecting, you know, incredible draconian rollbacks. And so I'm not sure where it goes next. I think that it has been, it's had so much promise. There's a reason why, mainstream organizations such

Exploring the Intersection of Activism and Research in Psychology

00:07:58 - so interested and committed to funding this research because they also have seen the promise of intersectionality for disrupting, taken for granted knowledge. and so where it goes next is I think that people who are passionate about this are going to continue doing the work. It's so exciting to be working in a field that on one hand, because it comes out of activism and was not developed for research, brings all all manner of intellectual challenges about how

00:08:38 - track, this critical track, and sort of fit it into this much more, you know, traditional positivist, track. I mean, that to me is, is incredibly exciting.

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