Health-related stigma: Rethinking concepts and interventions 1

Abstract

As a feature of many chronic health problems, stigma contributes to a hidden burden of illness. Health-related stigma is typically characterized by social disqualification of individuals and populations who are identified with particular health problems. Another aspect is characterized by social disqualification targeting other features of a person's identity-such as ethnicity, sexual preferences or socio-economic status-which through limited access to services and other social disadvantages result in adverse effects on health. Health professionals therefore have substantial interests in recognizing and mitigating the impact of stigma as both a feature and a cause of many health problems. Rendering historical concepts of stigma as a discrediting physical attribute obsolete, two generations of Goffman-inspired sociological studies have redefined stigma as a socially discrediting situation of individuals. Based on that formulation and to specify health research interests, a working definition of health-related stigma is proposed. It emphasizes the particular features of target health problems and the role of particular social, cultural and economic settings in developing countries. As a practical matter, it relates to various strategies for intervention, which may focus on controlling or treating target health problems with informed health and social policies, countering the disposition of perpetrators to stigmatize, and supporting those who are stigmatized to limit their vulnerability and strengthen their resilience. Our suggestions for health studies of stigma highlight needs for disease- and culture-specific research that serves the interests of international health.

Notorious Places: Image, Reputation, Stigma. The Role of Newspapers in Area Reputations for Social Housing Estates

“…Much of the recent work on stigma lies in the public health field since stigma can add to the burden of illness and affect access to treatment and control of diseases (Weiss et al, 2006), most notably in relation to HIV/AIDS in recent decades (Nyblade, 2006). As Wassenberg (2004) noted, stigma is wholly negative, whereas image and reputation can be positive or negative.…”

“…Interpretations of stigma in the health field build upon Goffman's early work on the issue in sociology wherein social disqualification-being 'disqualified from full social acceptance ' (1963, p. 9)-occurs as a result of a 'spoiled identity'. Weiss et al (2006) updated Goffman's definitions (concerned with 'physical abominations', 'tribal identities' and 'blemishes of character'), and, paraphrasing their definition, we can understand that stigma is a social process by which a person or group experiences, perceives or anticipates an adverse social judgement that results in discrimination, exclusion, rejection, blame or devaluation as a result of 'an enduring feature of identity' (p. 280). There is a link here to Lynch's (1960) idea of 'imageability' in the city, whereby physical elements and appearance are key components of people's experience of urban space.…”

Analysis of the effect of Individual, Familial and Environmental Factors on Family Stigma of Leprosy in Jombang regency, East Java Indonesia

“…Assessment of an environmental factor is a result of the stigma of pengkajina health workers and social stigma against families was done by individual measurements using a questionnaire regarding the internalized stigma of mental illness (Seismic) scale [8]. Measurement instruments of stigma were family-based kosep stigma [9], the concept component of stigma and social stigma [6], [7], and the concept of family stigma [2] and modified by the use of explanatory Model Interview catalog (EMIC) stigma scale for community [8] , [10] - [12]. The stigma question was about the family stigma towards a family whose members have leprosy.…”

Intervening Negative Impact of Stigma on Employability of a Person with Schizophrenia Through Social Case Work

“…Stigma is a social process or related experience characterized by exclusion, rejection, blame or devaluation that results from an adverse social judgment about a person or group [23] based on attribute, trait or disorder that makes an individual as being unacceptably different from the normal people with whom he or she routinely interacts. Wide range medical conditions are stigmatized e.g.…”