Refining and embedding the Intersectional "MAIHDA" approach to intersectionality in quantitative social science research.
Lead Research Organisation:
University of Sheffield
Department Name: Sheffield Methods Institute
Abstract
There are big inequalities in our society, in a range of different things. Regarding health, we know that, in the UK, white people are generally more healthy than non-white people, and rich people are more healthy than poorer people. Beyond health, there are similar inequalities everywhere - in rates of unemployment, in income, in education levels, and so on.
What is less well known is how these inequalities vary and interact. For instance, we know there is an ethnicity gap in health, but is that the same for men and women? Is it the same for rich women and poorer women? As we combine characteristics to produce smaller and smaller groups, it becomes clear that the inequalities in our society are complicated. And that complexity matters: it's important that we know who has worse health, so that we can target policies to the right people; it's important that we know who is being failed by our education system, so we can think about how the system could be changed to be more equitable. Fundamentally, in order to improve social justice, we need to first understand who is currently being let down by society. And that needs to be more than just a comparison of broad categories of people.
The MAIHDA method is a statistical model that allows us to do this: it lets us to see which combinations of characteristics are associated with advantage, and which are associated with disadvantage. This innovative method has been incrementally developed between 2016 and 2022, and has already informed us about the nature of inequalities in a range of health outcomes.
However, the method remains in its infancy, and this grant will refine the method to allow it to be used in situations that it has never been used before. This includes evaluating government policies to see which groups benefit from a particular policy, and which groups benefit less or even are harmed. The project will also allow us to consider how complex inequalities have changed over time, and how they vary from place to place. We will test our methodological refinements using real datasets which will act as exemplars in how these methods could be used going forward, relating to (among other things) obesity, covid-19, and environmental pollutants.
We are also keen to expand the use of the method beyond health inequalities. As such, we will collaborate with academics and researchers in academic research centres and non-academic organisations, to implement the MAIHDA methods in other social science subject areas. This will include the analysis of carers, and how being a carer affects different groups of people in different ways. It will include an analysis of water quality in the United States, to see how different groups of people, in different places, are affected by poor-quality, polluted drinking water. And we will consider how educational inequalities vary for different groups of people, to see which groups are being let down by the education sector.
Finally, a key part of this grant is training. We want to upskill researchers, in academia and beyond, to be able to use this method and our refinements to it in the future. As such we will produce a wide variety of online training materials, and run both online and in-person training courses, aimed at established academics, PhD students, and non-academic research organisations. These materials will be developed with other stakeholders to ensure that they meet the needs of those organisations and individuals.
What is less well known is how these inequalities vary and interact. For instance, we know there is an ethnicity gap in health, but is that the same for men and women? Is it the same for rich women and poorer women? As we combine characteristics to produce smaller and smaller groups, it becomes clear that the inequalities in our society are complicated. And that complexity matters: it's important that we know who has worse health, so that we can target policies to the right people; it's important that we know who is being failed by our education system, so we can think about how the system could be changed to be more equitable. Fundamentally, in order to improve social justice, we need to first understand who is currently being let down by society. And that needs to be more than just a comparison of broad categories of people.
The MAIHDA method is a statistical model that allows us to do this: it lets us to see which combinations of characteristics are associated with advantage, and which are associated with disadvantage. This innovative method has been incrementally developed between 2016 and 2022, and has already informed us about the nature of inequalities in a range of health outcomes.
However, the method remains in its infancy, and this grant will refine the method to allow it to be used in situations that it has never been used before. This includes evaluating government policies to see which groups benefit from a particular policy, and which groups benefit less or even are harmed. The project will also allow us to consider how complex inequalities have changed over time, and how they vary from place to place. We will test our methodological refinements using real datasets which will act as exemplars in how these methods could be used going forward, relating to (among other things) obesity, covid-19, and environmental pollutants.
We are also keen to expand the use of the method beyond health inequalities. As such, we will collaborate with academics and researchers in academic research centres and non-academic organisations, to implement the MAIHDA methods in other social science subject areas. This will include the analysis of carers, and how being a carer affects different groups of people in different ways. It will include an analysis of water quality in the United States, to see how different groups of people, in different places, are affected by poor-quality, polluted drinking water. And we will consider how educational inequalities vary for different groups of people, to see which groups are being let down by the education sector.
Finally, a key part of this grant is training. We want to upskill researchers, in academia and beyond, to be able to use this method and our refinements to it in the future. As such we will produce a wide variety of online training materials, and run both online and in-person training courses, aimed at established academics, PhD students, and non-academic research organisations. These materials will be developed with other stakeholders to ensure that they meet the needs of those organisations and individuals.
Organisations
Publications
Bright S
(2024)
Corrigendum to "An analysis of intersectional disparities in alcohol consumption in the US" [Soc. Sci. Med. Volume 363, December 2024, 117514].
in Social science & medicine (1982)
Bright S
(2024)
An analysis of intersectional disparities in alcohol consumption in the US
in Social Science & Medicine
Evans C
(2024)
A tutorial for conducting intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA)
in SSM - Population Health
Evans CR
(2024)
Clarifications on the intersectional MAIHDA approach: A conceptual guide and response to Wilkes and Karimi (2024).
in Social science & medicine (1982)
Mattsson H
(2024)
Mapping socio-geographical disparities in the occurrence of teenage maternity in Colombia using multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).
in International journal for equity in health
| Description | Influence Scottish Longitudinal Study policy on Statistical Disclosure Control for MAIHDA analyses |
| Geographic Reach | National |
| Policy Influence Type | Contribution to new or improved professional practice |
| Description | BRC-funded PhD studentship using MAIHDA |
| Amount | £27,989 (GBP) |
| Funding ID | NIHR 203327 |
| Organisation | National Institute for Health and Care Research |
| Sector | Public |
| Country | United Kingdom |
| Start | 01/2024 |
| End | 01/2027 |
| Description | ESRC Midlands Graduate School DTP-funded PhD studentship |
| Amount | £90,500 (GBP) |
| Funding ID | ES/Y001877/1 |
| Organisation | Economic and Social Research Council |
| Sector | Public |
| Country | United Kingdom |
| Start | 09/2024 |
| End | 03/2028 |
| Description | 1-day Training course at University of Sheffield |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Postgraduate students |
| Results and Impact | This was a 1-day training course, aimed at training other academics and research focused practitioners in the use of MAIHDA, using either stata or R, delivered by PI Andrew Bell and Co-I George Leckie. The course was run in collaboration with the White Rose Doctoral Training Partnership, but was open to all, and a number of attendees came who were non-academic researchers (e.g. from NatCen) and post-doctoral academics from across the UK. In total 13 people attended. Feedback from the event was overwhelmingly positive, with all respondents to an online feedback form "Strongly agreeing" that the course was well organised, that the speakers were engaging and insightful, and that it would be useful for the participants professional development. All said they would recommend the course. A number of participants are intending to use the MAIHDA methods in their future research. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://intersectionalhealth.org/an-introduction-to-multilevel-modelling-for-intersectionality-resea... |
| Description | Dissemination newsletters from project |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Other audiences |
| Results and Impact | We have produced and disseminated three project newsletters to wide ranging audiences, including to South Yorkshire Housing Association, NHS Providers, Association of Directors of Adult Social Services, and local government. |
| Year(s) Of Engagement Activity | 2018,2019 |
| Description | Intersectionality and health website |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Other audiences |
| Results and Impact | A project website was set up which includes updates on project activities and outputs. The website regularly gets international visitors from around the world. The website gets around 250 views a month. The website was significantly updated to include details about the new MAIHDA project. Attached to the website is a newsletter which now incorporates updates from the MAIHDA project. |
| Year(s) Of Engagement Activity | 2020,2021,2022,2023,2024 |
| URL | http://intersectionalhealth.org |
| Description | Presentation at State University New York |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Postgraduate students |
| Results and Impact | Clare Evans gave a presentation entitled "Multilevel Models of Intersectional Inequities: Introducing MAIHDA and Reimagining Multilevel Methods" at the Department of Epidemiology and Biostatistics, Albany School of Public Health, State University of New York, on 25th April 2024. The event was hybrid, with 10 in-person attendees and 43 attending via Zoom. The majority of participants were faculty, students, and staff from the School of Public Health, but we also had participation from faculty, students, and staff from other departments at the University at Albany including Sociology, Psychology, and Human Biology; representatives from our major research centers, including the Center for the Elimination of Minority Health Disparities (CEMHD), the Institute for Social and Health Equity (ISHE), the Center for Social and Demographic Analysis (CSDA), the Center for Collaborative HIV Research in Practice and Policy (CCHRPP), and the Center for Human Services Research (CHSR); some of our state partners from the NYS Department of Health, NYS Office of Mental Health, and NYS Division of Criminal Justice Services; and external collaborators from other universities, including Emory and UNC Greensboro. Those that attended in person were excited and discussing afterwards how they plan to share the recording with their students and how it might be relevant to their research. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Presentation to Canadian Association of Psychosocial Oncology |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Third sector organisations |
| Results and Impact | Co-I Clare Evans was invited to deliver a webinar, titled: "Overcoming Combination Complexity and Expanding Diversity in Research: An Introduction to MAIHDA". The aim was to introduce the MAIHDA method to a group that hadn't used it before. CAPO is an organisation that brings together clinicians, researchers, patients and others to help understand, study and treat various aspects of Cancer. The talk was well received, and there have since been a number of expressions of interest in following up with Dr Evans in integrating MAIHDA into their work. Dr Gilla Shapiro (University of Toronto), who invited Dr Evans to give the talk, said there were some "MAIHDA converts", and that she was planning to rework some of her analyses and grant proposals to use the approach. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.capo.ca/event-5565547 |
| Description | Seminar at AQRiE Data and Methods talk series |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Postgraduate students |
| Results and Impact | I was invited to present at the "Advanced Quantitative Research in Education" Thematic Hub at the University of Edinburgh. The online seminar was attended by approx 35 people, from a range of disciplinary backgrounds. Participants learned about the basic MAIHDA method, as well as the longitudinal extension of MAIHDA that was published as part of the grant. I know of at least one paper published by an attendee since that has used the method thanks to the learning from this session - that paper in Criminology where the MAIHDA method has not (to my knowledge) been previously applied. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.ed.ac.uk/education/rke/our-research/advanced-quantitative-research/our-events/aqrie-rese... |
| Description | Seminar at Health Foundation |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | This was a presentation as part of the Health Foundation's regular Seminar Series. The seminar introduced the MAIHDA method to researchers and practicioners at the Health Foundation, with approximately 50 HF staff in attendance. There was interested and liverly discussion afterwards, and followup emails to discuss using the method going forward - discussions on this are ongoing. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Seminar at UCL Epidemiology (online) |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Other audiences |
| Results and Impact | I was invited to give a seminar at the UCLInstitute of Epidemiology and Health Care monthly methods seminar. Approximately 30 people attended online, mostly academics (faculty and postrgraduate). The talk was a success, with useful discussion after the session, suggesting attendees had learned about the MAIHDA method and agreed about its value, with one person stating their mind had been changed about the value of the method as a result of the talk. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Seminar at University of Manchester Social Statistics |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Other audiences |
| Results and Impact | I was invited to give a seminar at the University of Manchester Social Statistics seminar series.Approximately 15 people attended in person, with a further 15 online, mostly academics (faculty and postrgraduate) at Manchester. The talk was a success, with useful discussion after the session, suggesting attendees had learned about the method and agreed about its value. |
| Year(s) Of Engagement Activity | 2024 |
| Description | WRDTP Research Methods Showcase |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Postgraduate students |
| Results and Impact | The advanced research methods showcase is a cross-cohort event, that all 1st year White Rose DTP students have to attend. This years' event included a panel discussing intersectionality, and both Andy Bell (PI) and Natalie Bennett (RA) were invited to participate in this panel (as well as providing more specific methods-focused talks. Over 100 PhD students attended, and there was lively discussion and questions both during the panel and after. The panel consisted of a mix of qualitative and quantitative methods experts, and as a result the session encouraged students to think in more depth about the way intersectionality fits into both of these methods frameworks, which in the main they will not have encountered before, and this was made clear from informal discussion with students after the event. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Webinar by Professor Lisa Bowleg |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Postgraduate students |
| Results and Impact | Dr Dan Holman invited Professor Lisa Bowleg to give a webinar on intersectionality in relation to ageing research. The event was organised with the Healthy Lifespan Institute which the MAIHDA project partly sits in. The webinar was well-attended in person and online. There was lots of engagement and people commented afterwards that they felt energised by the ideas in the webinar, with a number of people swapping contact details. Participants shared plans for potential future research activities. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Webinar for Severe Maternal Morbidity Research Group, Stanford University School of Medicine |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Co-I Clare Evans was invited to give a talk entitled "Multilevel Models of Intersectional Inequities: Introducing MAIHDA and Reimagining Multilevel Methods" for the Maternal Morbidity Research Group at the Stanford University School of Medicine. The talk resulted in a number of ongoing connections with the research team, who are gearing up to do some MAIHDA-based work in future, with Dr Evans as a collaborator. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Workshop at Health Foundation, London |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Third sector organisations |
| Results and Impact | I was invited to the Health Foundation offices in London, to help them implement the use of MAIHDA in their study on patient satisfaction with primary care services. The session was a success, with useful discussion around the way forward in that analysis, and discussions about ways forward. Additionally, we agreed a plan to put together a short "tutorial" style blog post to discuss how MAIHDA could be used in Health Foundation settings, and we plan to continue working together on additional projects that the Health Foundation are working on in the coming months. |
| Year(s) Of Engagement Activity | 2024 |
