Intersectionality research will look at how different positions of power affect mental and physical health and drug use.
By Ruth Steinhardt
Lisa Bowleg, professor of applied psychology at George Washington University’s Columbian College of Arts and Sciences, received a $3.7 million grant from the U.S. Department of Health and Human Services, the National Institutes of Health and the National Institutes on Drug Abuse for an intersectionality study focused on reducing drug use and poor health outcomes in black men. Whitman Walker Health, a DC-based federal qualified health center, is the study’s community partner.
The study, entitled “Reducing Black Men’s Drug Use and Co-Occurring Negative Mental and Physical Health Outcomes: Intersectionality, Social-Structural Stressors, and Protective Factors,” will examine the way stressors affect black men across a variety of demographics, including sexual identity and socioeconomic position.
There is a long history in psychology and public health studies about the effects of discrimination-related stress on mental and physical health outcomes, Dr. Bowleg said. But many of those studies, and the policies they influence, focus on structural stressors along a single axis—race, gender or sexual identity, for example—without taking into account the way multiple marginalized positions, and social inequalities based on them, intersect.
“If you’re a black, heterosexual man with a lower income, what does your stress look like, and what are your experiences with discrimination? And what does that experience look like compared to a black, high-income gay man?” Dr. Bowleg said. “The ultimate goal will be to develop very specific health and drug use interventions for Black men at different intersectional positions.”
Dr. Bowleg, whose research also has focused on HIV prevention in black heterosexual men, said that many public health interventions emphasize individual choice without accounting for the structural positions of the populations they hope to affect. For instance, she said, an earlier study she conducted in Philadelphia showed that her participants’ conceptions of masculinity often shaped their condom use—and those conceptions were often rooted in larger social-structural concerns.
“When you talk to black men you find a lot of their concerns are about structural stuff: unemployment, prison, police violence,” she said. “HIV prevention researchers are saying ‘Use condoms, use condoms,’ but there’s this much larger structural stuff that shapes people’s lives, and those just use a condom messages don’t address it.”
The study also will focus on resilience, Dr. Bowleg said—the self-protective factors, strategies, and structural resources that help some people in marginalized positions maintain good health outcomes despite the stress of intersectional discrimination.
“We have pretty good understanding of the stressors, but we often don’t ask about strengths and what’s protective,” Dr. Bowleg said. “There are going to be men who have all these experiences with discrimination and still stay mentally healthy or don’t rely on drugs to cope. So we want to understand how to replicate that.”
The study will run through April 2023 and will rely both on self-reported measures of discrimination at the intersection of race, gender, and sexual identity, and on biomarkers of stress and drug use.
Dr. Bowleg also will be the editor of the “Perspectives from the Social Sciences” section of the American Journal of Public Health beginning in September. She hopes her editorship, this study and other work she and her team are conducting on intersectionality and public health will have a “translational impact” for other health conditions and diverse populations such as girls and women of color.
“In psychology we tend to focus very much on the individual, but there’s a larger context influencing the extent to which an individual can be healthy and happy,” she said.