July 10, 2008
Exploring stigma and health
By Jean Patterson
School of Social Work
Stigma, Prejudice, Discrimination and Health, a special issue of the journal Social Science & Medicine, is groundbreaking in exploring links among stigma, prejudice, and discrimination and their impact on health, as well as implications for public health practice.
Jennifer Stuber, assistant professor in the UW School of Social Work, is the issue’s lead editor. Stuber, who is a prominent scholar in the field of stigma, especially stigma related to mental health, also co-authored the issue’s introduction and two of its articles. The August 2008 issue is online now at http://www.sciencedirect.com/science/journal/02779536.
The introduction’s co-authors are Columbia University faculty members Ilan Myer, associate professor of clinical sociomedical sciences, and Bruce Link, professor of epidemiology and sociomedical sciences.
Stuber, a former Robert Wood Johnson Health and Society Scholar at Columbia, defines stigma as “the negative labels, pejorative assessments, social distancing, and discrimination that can occur when individuals who lack power deviate from group norms. Stigma is at once a social process of marginalization perpetrated by those who do the stigmatizing and at the same time a condition that stigmatized individuals must navigate.”
The impetus for the special issue, Stuber and her introduction co-authors explain, was “to bridge disparate research traditions in stigma, on the one hand, and in prejudice and discrimination on the other. There is a great urgency to understand more fully the links among stigma, prejudice, and health to enhance the development of effective public health interventions and to reduce health disparities.”
To date, these co-authors reflect, research on the issue of stigma and research on prejudice and discrimination “are organized around a single disciplinary perspective and focus on either stigma or prejudice but never both.”
In this issue the various contributors “write from diverse disciplinary perspectives and represent a starting point of cooperation among scholars interested in these two traditions.”
Articles in the issue, the introduction notes, “develop conceptual and empirical research linking stigma and prejudice, identify under-recognized cultural and policy dynamics that contribute to the formation of stigma and prejudice” (and may mediate their health impacts), “describe pathways through which stigma and prejudice affect health outcomes, and explore the implications of these themes for public health practice.”
The main point, the co-authors conclude, is that when prejudice researchers focus on stressors related to various forms of discrimination to the exclusion of stress related to stigma, they’re likely overlooking important dimensions of other stressors that can lead to poor health outcomes.
The same holds true for those who focus on stigma to the exclusion of interpersonal and structural forms of discrimination.
However, Stuber notes, when researchers from each of these traditions incorporate findings from the other, the health impact of the interaction between discrimination and stigma is brought into sharper focus and the implications for public health policy become clearer.
In one of the articles that she wrote, Stuber focuses on “stigma perceived by current and former smokers, the persons who are stigmatized.”
She cited several major reasons for the stigmatization:
- attribution — stigma produced when a person is believed to be in control of the behavior in violation of group norms,
- fear — especially the fear related to the health hazards of secondhand smoke,
- policy — for example, companies who refuse to hire smokers or who place restrictions on smoking in the workplace,
- power and marginalization — because people in a lower social or economic environment are less likely to perceive smoker-related stigma than people with higher socioeconomic status, and
- social norms — with family and peers usually having a more powerful influence on the expected behaviors of smokers than those in the smoker’s neighborhood or community.
“The determinants of smoker-related stigma are important,” Stuber says, “because stigma might discourage initiation of smoking or strengthen motivation to quit. Thus, it is critical to understand how to harness the powerful effects of stigma and to ensure its ‘benefit’ is realized equally across socioeconomic, racial and ethnic groups.”
David Takeuchi, associate dean for research in the School of Social Work, says, “The research reflected in this special issue of Social Science & Medicine will have a great impact on the ongoing research related to stigmatization and its relationship to discrimination. Jennifer and her colleagues have opened an important dialogue among researchers across various academic disciplines.”
