What is “intersectionality” and how does it relate to wellness?
“Intersectionality” was first used to describe marginalization, discrimination, and the variety of disparities related to power and resource differentials due to culture, ethnicity, gender, race, sexual orientation etc. (Hankivsky), and has been used as a reference point for a variety of theories and methodologies dating to the civil rights and feminist movements. When we discuss issues related to wellness and intersectionality we raise questions about the ways in which privilege, be it economic, education, gender, race, sexual orientation etc. relate to varied manifestations of wellness, from defining characteristics to access.
Many authors conclude that notions of wellness are broader and deeper than being disease free (Kirkland), and that overall wellness is contextual (Bowleg) and may indeed be a luxury for those who are more resourced (Petrzela). As it relates to public health in higher education these two concepts are critical to the way in which we raise the bar for the health and wellbeing of all students. This means that instead of looking at wellness by a traditional framework of six to eight dimensions (National Wellness Institute; SAMHSA) in order to fully appreciate the bread and depth of manifestations of wellness for our students we must also look at intersectionality. Focusing on these principles promotes inclusion in defining wellness, and barriers to wellness and wellbeing. Further, when looking at issues related to substance use disorder, and collegiate recovery these principles are integral to reducing stigma associated with alcoholism and addiction.
So, what do intersectionality and wellness mean for a young person in recovery?
According to the SAMHSA dimensions of wellness:
- Emotional—Coping effectively with life and creating satisfying relationships
The young person in recovery has relationships with sober same aged peers on and off campus, and is free of concern or resentment about the lack of social substance use in their life, regardless of their age.
- Environmental—Good health by occupying pleasant, stimulating environments that support well-being
The young person in recovery enjoys a campus environment that is supportive of substance free living and learning and socializing in a variety of venues that protect and promote recovery, with peers in recovery, as well as allies and friends, creating an environment in which the low using majority, as well as those in recovery, are comfortable and supported.
- Financial—Satisfaction with current and future financial situations
The young person in recovery has a plan for self-sufficiency that reflects an accurate assessment of financial needs and resources.
- Intellectual—Recognizing creative abilities and finding ways to expand knowledge and skills
The young person in recovery is challenged to pursue opportunities presented in the academic arena through guidance, mentorship, and support, growing in their capacity to learn, understand, and express complex concepts.
- Occupational—Personal satisfaction and enrichment from one’s work
The young person in recovery maintains employment that increases self-confidence and feelings of self-worth by providing opportunities to practice skills related to task performance and completion, building collegial relationships with others and specific skills related to the tasks at hand, whether for remuneration or not.
- Physical—Recognizing the need for physical activity, healthy foods, and sleep
The young person in recovery uses physical activity as a tool for health and engages in personal recreational activity for functional fitness, maintains a healthy diet, and a balanced schedule of sleep, work, and play.
- Social—Developing a sense of connection, belonging, and a well-developed support system
The young person in recovery has connections to a recovery community of same aged peers, and a connection to a variety of recovery supports on and off campus, providing a feeling of “fitting in”, as well as a safety net to call upon when needed.
- Spiritual—Expanding a sense of purpose and meaning in life
The young person in recovery has a sense that they are not in it alone, has a sense of faith and optimism.
According to the principles of intersectionality (Hankivsky):
- Intersecting Categories
Since the young person in recovery does not live a siloed life, their recovery experience in higher education should not be viewed in a siloed manner, and their status as a person in recovery should be viewed with equal importance and value as other aspects of identity. Additionally, aspects of identity are cumulative and synergistic offering a nuanced richness unique to each individual.
- Multi-level Analysis
A young person in recovery has a role at the grassroots level as part of a recovery community, while also being a part of a same aged peer group, as well as other identifiable societal group relationships at the campus, community, and national level. The relationship between these roles for the individual and the effect on recovery is an important area for analysis since each may promote or impede recovery success.
For the young person in recovery, power may come from feelings of confidence and success in recovery, though stigma, age, socio-economic status and other variables may mitigate a sense of power and lead to feelings of oppression, and stigma may lead to acts of oppression. Personal areas of exploration, and environmental supports lie in reducing stigma in order to decrease oppression and increase power.
Reflexivity acknowledges the importance of power to sense of self, and in relation to societal roles. An environment that embraces reflexivity provides authentic experience for the young person in recovery to act as expert in the arenas that that know best and have the deepest experience.
- Time and Space
It is clear that all of us exist in the moment and are thus driven by the context of the time and space we occupy. That said, we are also each a product of our time and space. Young people in recovery had little voice on campus ten years ago – now there are almost 200 Collegiate Recovery Communities (CRCs) across the nation, Young People in Recovery (YPR) affect national policy, and stigma around substance use disorder and associated tragedies is changing as family members of overdose victims speak out through the media, and in obituaries of loved ones lost. Young people in recovery experience oppression, stigma, support, and therefore the recovery experience in a different way today than they might have ten years ago because today there is a space for their voice and a place for them on campus.
- The Diversity of Knowledges
Intersectionality and wellness meet most clearly and closely when the young person in recovery is an active participant in the planning, implementation, and evaluation of policies and programs related to their own recovery, the collegiate recovery community, and has an active role in the hierarchal structure of the campus in order to ensure integration and sustenance of collegiate recovery efforts. Acting in the role of expert and exercising the knowledge gained by their experience is an important leveling point.
- Social Justice
Having a place at the table in proportion to their presence in the population, acting with power and knowledge based on expertise, experience, and training, these are the ways in which the young person in recovery gains equity in the academy. Rather than invisibility and marginalization, young people in recovery are embraced for the value they may add to the effort.
Identifying ways in which rules and policies and procedures may create an infrastructure of equity will ensure the sustainability of efforts to reduce stigma and create inclusion. For the young person in recovery these formal processes are critical.
- Resistance and Resilience
Maintaining identity as separate from the system of higher education allows the young person in recovery to point out areas in need of change, resist marginalization, and offer opportunities for maintaining a group identity that provides a helpful pulse check for ongoing efforts.
Collegiate recovery efforts have some wonderful research to lean on for foundational and theoretical frameworks (e.g. the social ecological model; model of planned behavior change), and the more emerging fields of wellness and intersectionality offer some additional avenues for program benchmarking and planning.
Kirkland, Ann. What Is Wellness Now? University of Michigan, Journal of Health Politics, Policy and Law (http://jhppl.dukejournals.org/content/39/5/957.full.pdf)
Hankivsky, Olena, Ph.D. Intersectionality 101, Institute for Intersectionality and Policy Research (https://www.sfu.ca/iirp/documents/resources/101_Final.pdf)
Bowleg, Lisa. The Problem With the Phrase Women and Minorities: Intersectionality-an Important Theoretical Framework for Public Health, American Journal of Public Health 102(7):1267-73 · May 2012 (https://www.researchgate.net/publication/224976637_The_Problem_With_the_Phrase_Women_and_Minorities_Intersectionality-an_Important_Theoretical_Framework_for_Public_Health)
Petrzela, Natalia Mehlman. When Wellness Is a Dirty Word,The Chronicle of Higher Education, The Chronicle Review, May 01, 2016
National Wellness Institute, http://www.nationalwellness.org/?page=Six_Dimensions