The scar that takes time to heal: A systematic review of COVID-19-related stigma targets, antecedents, and outcomes

Abstract

COVID-19, as a crucial public health crisis, has affected our lives in nearly every aspect. Besides its major health threats, COVID-19 brings severe secondary impacts, one of which is the rise of social stigma. Although numerous studies have examined the antecedents and outcomes of COVID-19-related stigma, we still lack a systematic understanding of who is being stigmatized during the COVID-19 pandemic, what exacerbates COVID-19-related stigma, and what impacts COVID-19-related stigma has on victims. Therefore, this review aims to provide a systematic overview of COVID-19-related stigma. With 93 papers conducted with 126,371 individuals in more than 150 countries and territories spanning five continents, we identify three targets that have received the most research: Chinese/Asian people, (suspected) patients and survivors, and healthcare workers. Furthermore, we find that for each stigma target, characteristics of the stigmatized, stigmatizer, and context contribute to COVID-19-related stigma and that this stigma negatively influences victims' health and non-health outcomes. We call for future research to provide a more integrative, balanced, and rigorous picture of COVID-19-related stigma via conducting research on neglected topics (e.g., contextual factors that contribute to stigma toward HCWs) and stigma interventions and using a longitudinal design. In practice, we urge governments and institutions (e.g., ministries of public health, hospitals) to pay close attention to stigma issues and to promote safe and inclusive societies.

COVID-19 Linked Social Stigma Among Arab Survivors: A Cross-Sectional Experiences from the Active Phase of the Pandemic

“…Findings from this study confirmed the previous systematic review 45 but also went beyond that to provide a comprehensive picture of challenges experienced by participants during COVID-19. Participants expressed how social media had shaped negative mental pictures and social attitudes against them and how the COVID-19 news outbreak, misconceptions, rumors, and misinformation impede response efforts by fostering stigma and discrimination.…”

Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA

“…Stigma and misunderstanding about Long COVID are prevalent, as evidenced by a qualitative study showing many participants encountering discrimination in healthcare settings 22. This lack of understanding and the resultant stigma or dismissive attitudes can be particularly distressing for those suffering from Long COVID 33. Finally, the unpredictable nature of Long COVID, including uncertainty about recovery, potential long-term impacts and possible effective treatments, can lead to significant anxiety and stress 34…”

“…22 This lack of understanding and the resultant stigma or dismissive attitudes can be particularly distressing for those suffering from Long COVID. 33 Finally, the unpredictable nature of Long COVID, including uncertainty about recovery, potential long-term impacts and possible effective treatments, can lead to significant anxiety and stress. 34 The findings of the current study have great public health and clinical implications.…”

Adaption and validation of scales to measure COVID-19 stigma attitudes and perceptions.

“…The authors also found that characteristics of the stigmatized, stigmatizer, and the context contribute to COVID-19 stigma, which negatively influence victims’ health and nonhealth outcomes. In some settings, specific survey measures have been developed to measure COVID-19 stigma and examine associations with attitudes and behavior (Zhou et al, 2022). Much of this measure development has been conducted in Asia, where health care workers and other persons presumed to be exposed to COVID faced significant stigma and discrimination (Huang et al, 2023; Nair et al, 2022).…”