Stigma: A biocultural proposal for integrating evolutionary and political‐economic approaches

Abstract

ObjectivesStigma—the process by which people become socially discredited because they hold a characteristic that is classified as unacceptable or undesirable—has barely been considered in biocultural analyses. Yet, it provides an acute point of articulation for evolutionary and political‐economic perspectives on human variation, including the biocultural production of health disparities. To explain the theoretical integration of the two perspectives to stigma, we first lay out some operationalizable definitions of stigma, and review feasible methods to capture them in the field. We then test the roles of predictors suggested from evolutionary (respondent's level of disgust, fear of contagion) and political‐economic (respondent's perceived social standing and negative social labeling of those who violate hygiene norms) theories of stigma.MethodsWe used survey, interview, and behavioral report data from a study of hygiene behaviors at four local community sites in Guatemala, Fiji, New Zealand, and the United States (N = 300). We applied a hierarchical GLMM design that treats site as a random effect.ResultsThe independent influences of both variable sets are evident in publicly visible forms of reported hygiene behaviors, specifically the exhibition of clean bodies, clothes, and homes.ConclusionWe propose that the study of stigma provides a productive operationalizable space to engage the promise of the biocultural synthesis to integrate evolutionary and political‐economic models of health and human variation.

Parental misperception of their child's weight status and how weight underestimation is associated with childhood obesity

“…Parents may also avoid labeling their child as “overweight” or “obese” for fear of leading to children's stigmatization (Turner et al, ). In this context, stigma refers to the process by which arbitrary moral judgments (eg, lazy) become attached to body size, leading to social discrediting, rejection, and marginalization (Brewis, ; Brewis & Wutich, ). The stigmatization of obesity, as obesity itself, is an increasing global, cultural, and biological phenomenon that often starts at a young age (Hansson, Karnehed, Tynelius, & Rasmussen, ).…”

Stigma in African genomics research: Gendered blame, polygamy, ancestry and disease causal beliefs impact on the risk of harm

“…The second important insight from our analysis is that where the design or conduct of genomics research intersects with stigma, the stigma tends to be pre-existing: it is not caused by genomics research. Furthermore, the types of stigma encountered cut across different categories ( Brewis and Wutich, 2019 ). Public stigma could play a role when participants are worried that research enrolment could be seen as confirmation that they suffer from a stigmatised trait; it may also be a factor in understanding gendered blame, for instance when women are cast as ‘bad parents’ when they have children with neurodevelopmental conditions.…”

“…Gendered blame ( Berns, 2001 ) occurs when women are systematically blamed for social and economic misfortunes and is a form of public stigma ( Brewis and Wutich, 2019 ). When children are born with congenital abnormalities or illnesses, it is common for women in traditional African settings to be held responsible for their condition, usually because of things the woman is alleged to have done during pregnancy.…”

“…When genomics research is conducted on these conditions, it is imperative that attention be paid to understanding how the conduct of genomics research intersects with the stigma experienced by patients and their family members. At one level, there are questions about how experienced and public stigma ( Brewis and Wutich, 2019 ) impact on recruitment processes. But perhaps more importantly, there are questions about whether conducting genomics research on these conditions may enforce or counter stigmatising narratives that need to be taken seriously in the conduct of genomics research and in research investigating stigma and genetic attribution.…”

“…Yet overwhelmingly, concerns about stigma continue to take a prominent position in African genomics research – most recently in relation to the return of genome summary results ( Tiffin, 2019 ). When it is described as a risk in African genomics research, it is typically treated as a black box with no consideration of the types of stigma ( Brewis and Wutich, 2019 ; Major et al, 2017 ) or the social and political processes that give rise to, entrench and perpetuate it ( Link and Phelan, 2001 ; Tyler and Slater, 2018 ). Furthermore, genomics research is also treated as a black box, with no regard for how different types of genomics research and different stages of the research process may interact with those different types of stigma and the processes that uphold it.…”