9 In this conceptualization, stigma is defined as the co-occurrence of labeling, stereotyping, separation, status loss, and discrimination in a context in which power is exercised. proposed a reconceptualization of the construct from a sociological perspective, which is now widely used in the stigma literature. In response to criticisms regarding variations in the definition of stigma and its excessively individual focus, B. G. L. Such a discussion is both worthwhile and timely, in light of the potential insights a stigma framework can provide the field of population health. 9 The field of population health would greatly benefit from a synthesis of these disparate literatures and from the development of a theoretical framework that provides insights into the processes that generate health inequalities among members of stigmatized groups. In addition, studies have tended to examine single outcomes (e.g., associations between stigma and self-esteem) at 1 level of analysis (typically at the individual level, without attention to structural conditions). For example, we have literatures focused on the health implications of HIV stigma, 3,4 mental illness stigma, 5,6 and sexual orientation stigma, 7,8 which proceed on separate tracks. 2 We argue that stigma is in fact a central driver of morbidity and mortality at a population level.Īlthough the literature on stigma and health has grown dramatically, its full power and significance remain somewhat obscured because bodies of research pertaining to specific stigmatized statuses have generally developed in separate domains. 1 If stigma is a significant source of stress and social disadvantage, one might expect it to have substantial effects on population health, similar to other social determinants, such as socioeconomic status (SES), social relationships (i.e., social support), and racism or discrimination.

Growing evidence shows that the stigma associated with multiple circumstances (e.g., HIV, mental illness, sexual preference) both disadvantages the stigmatized and is a major source of stress in their lives.

Death by Arrogance by Bruce E. Dunn