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Intersectionality and risk for ischemic heart disease in Sweden: Categorical and anti-categorical approaches

  • Maria Wemrell
  • Shai Mulinari
  • Juan Merlo
Publishing year: 2017-01-24
Language: English
Pages: 213-222
Publication/Series: Social Science and Medicine
Volume: 177
Document type: Journal article
Publisher: Elsevier

Abstract english

Intersectionality theory can contribute to epidemiology and public health by furthering understanding of power dynamics driving production of health disparities, and increasing knowledge about heterogeneities within, and overlap between, social categories. Drawing on McCall, we relate the first of these potential contributions to categorical intersectionality and the second to anti-categorical intersectionality. Both approaches are used in study of risk of ischemic heart disease (IHD), based on register data on 3.6 million adults residing in Sweden by 2010, followed for three years. Categorical intersectionality is here coupled with between-group differences in average risk calculation, as we use intersectional categorizations while estimating odds ratios through logistic regressions. The anti-categorical approach is operationalized through measurement of discriminatory accuracy (DA), i.e., capacity to accurately categorize individuals with or without a certain outcome, through computation of the area under the curve (AUC). Our results show substantial differences in average risk between intersectional groupings. The DA of social categorizations is found to be low, however, due to outcome variability within and overlap between categories. We argue that measures of DA should be used for proper interpretation of differences in average risk between social (or any other) categories. Tension between average between-group risk and the DA of categorizations, which can be related to categorical and anti-categorical intersectional analyses, should be made explicit and discussed to a larger degree in epidemiology and public health.


  • Public Health, Global Health, Social Medicine and Epidemiology


  • Swedish genes?
  • Multilevel analysis of individual heterogeneity
  • Social Epidemiology
  • ISSN: 1873-5347
maria wemrell
E-mail: maria [dot] wemrell [at] med [dot] lu [dot] se

Postdoctoral fellow

Social Epidemiology



Department of Gender Studies


Department of Gender Studies
Visiting address: Allhelgona Kyrkogata 14, House M, Lund
Postal address: Box 117, 221 00 Lund, Sweden
Phone +46 46-222 00 00 (operator)
Fax: 046-222 40 04

Faculty of Social Sciences