Over the past 6 months, I have been studying the Mind, Body and Health Inequalities module as part of my MSc in Inequality and Society at the University of Sunderland. It has been a thought-provoking module, challenging many of the assumptions we often make about health, illness and the role of healthcare.
The final assignment asked us to critically appraise health as a complex concept and explore how intersectionality helps us understand health inequalities.
Healthcare is important, but it is only one piece of a much bigger picture. Where people live, the quality of their housing, access to education, employment opportunities, transport, income, discrimination, public policy and the environments around them all influence health. These factors interact throughout a person’s life, shaping opportunities and outcomes long before someone enters a hospital or visits their GP. Although this is something many occupational therapists instinctively understand, studying the evidence behind these ideas gave me a much deeper appreciation of how structural inequalities shape people’s everyday lives.
I had come across the concept of intersectionality before beginning this module through both my professional work and my involvement with AbleOTUK. However, studying it in greater depth significantly strengthened my understanding.
Previously, I tended to think about intersectionality as recognising that people have multiple aspects of identity. While that is true, the module challenged me to think beyond identities themselves and consider the systems of power that shape people’s lives. It is not simply about someone being disabled, from a minoritised ethnic background or living in poverty. It is about how ableism, racism, sexism, classism and other structural inequalities interact to influence opportunities, experiences and health outcomes.
This shift in thinking has encouraged me to move away from asking which characteristic explains an inequality and instead ask how different systems combine to create unequal experiences. I now have a much greater appreciation that health inequalities cannot be understood through a single lens. They are created through the interaction of multiple factors that influence people’s everyday lives.
Viewing health through an occupational lens
As an occupational therapist, I wanted my assignment to reflect the unique contribution our profession can make to discussions about health inequalities. Rather than viewing health purely through medicine or public health, I explored how occupational therapy concepts such as occupational justice, occupational deprivation and occupational alienation help explain how inequalities are experienced in everyday life. Health inequalities are not simply measured through mortality rates or disease prevalence.
They are experienced when someone cannot access education, employment, transport, leisure, relationships or opportunities to participate in meaningful occupations because of barriers within society.
Occupation is where health is lived.
Writing the assignment reminded me that occupational therapists have an important contribution to make, not only in supporting individuals but also in understanding the wider systems that influence participation and well-being.
One aspect of the assignment that I particularly enjoyed was critically exploring intersectionality. It is an incredibly valuable framework for understanding health inequalities, but I also found myself questioning whether recognising complexity is always enough to create meaningful change. Policy increasingly acknowledges inequality, yet many systems continue to operate in ways that reinforce disadvantage. This made me reflect on the gap that can exist between understanding inequality and addressing it.
As occupational therapists, we often work within systems that focus on adapting individuals to fit existing services. This module challenged me to think more about how we might also influence the systems themselves. Completing this module has strengthened my academic skills, but more importantly, it has changed how I think about practice.
It has reinforced that reducing health inequalities is not solely about providing better healthcare. It requires us to understand the wider structural, political and social factors that shape people’s opportunities to participate in everyday life. As I continue my work as a Lead Occupational Therapist, alongside my involvement with AbleOTUK and my wider writing on ableism and health inequalities, I know this learning will continue to influence my thinking.
The module reminded me that occupational therapists are uniquely placed to bridge individual experience and wider societal issues. We see how policy, environments and systems affect people’s occupations every day. Understanding health inequalities is not just an academic exercise. It is fundamental to delivering truly person-centred, equitable and occupation-focused practice.
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