
Understanding the role of social identity/position in access to primary care providers: An intersectionality approach using multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA)
Abstract
Primary care (PC) in Canada is concerned with addressing Canadian health needs, especially the most vulnerable. The roles of social identities and positions in having a PC provider has been treated primarily as independent and additive, instead of interdependent and intersecting. A quantitative intersectionality approach using multilevel analysis of individual heterogeneity and discriminatory accuracy examined whether respondents to the Canadian Community Health Survey (2015-2019) had a PC provider based on membership in intersectional strata (constructed using gender, age, immigration status, race, and income). This study found that not all between-stratum variance in the outcome could be explained by additive effects of gender, age, immigration status, race, and income. For 40 intersectional strata, the predicted probability obtained through intersectional methods differed from that obtained through additive methods. There is a need to adopt an intersectional lens to develop research tools, conduct quantitative research, and create targeted interventions to improve PC access.