Intersectional parental health inequities one year after childbirth: race/ethnicity, sex/gender and social class in the elfe birth cohort

Social inequities in health are shaped by interlocking systems of oppression that differentially structure experiences across populations and over the life-course. This study examines intersectional inequities in parental health one-year post-birth, focusing on the articulation of race/ethnicity, sex/gender, and social class. Using data from a French population-based birth study, Elfe cohort, we applied intersectional multilevel analysis (I-MAIHDA) to self-reported mental (SF-12 MCS) and physical (SF-12 PCS) health scores among 24,108 parents (mean age 32.8 ± 5.3, included in 2011) nested in 42 intersectional strata. Substantial intersectional inequities were observed in parental health in the cohort, with a more pronounced gradient for mental health than physical health. Inequities were primarily driven by additive effects, on average: racialized parents scored lower on both mental and physical health than non-racialized parents; women scored lower on mental health than men; and parents from less advantaged social classes scored lower on physical health compared to the most advantaged ones. The magnitude of racial/ethnic inequities was comparable to that of sex/gender in mental health and social class in physical health. Additionally, the protective effect of sex/gender on mental health seemed modulated by social class (significant interaction effect). We further open a critical reflection on how categorization choices shape the visibility of health inequities. These findings highlight how systemic forces-racism, sexism, and classism-jointly structure parental health around childbirth. They underscore the importance of intersectional approaches that account for the intertwining effects of social positions within society when studying population health.