More Stigma Leads to Worse Physical Health
Scientists have known for some time that prejudice and discrimination can harm people’s health. People who are stigmatized—those who face negative stereotypes, prejudice, or discrimination due to their race, gender, or other personal attributes—experience more stress than other people do. Many of the health discrepancies we see between racial or ethnic groups are not due to differences in biology, but rather result from this stress, which causes health problems.
Many stigmatized characteristics, such as race and gender, can be easily observed by other people. But other characteristics, such as sexual orientation or mental illness, are not so easily observed. We wondered what happens if someone has multiple concealable stigmatized identities. For example, what if someone is gay and has depression, neither of which is easily observed by other people? Will their physical health outcomes be worse than their friend who also has depression but is straight? If so, what are possible reasons for their different health outcomes, given that their stigma is concealable?
To examine this question, my colleagues and I surveyed individuals who had at least one concealable stigmatized identity. We found that people who had more stigmatized attributes had worse physical health than people who had fewer. In addition, the more stigmatized attributes our participants reported, the more they anticipated they would be subject to prejudice and discrimination if other people found out about their concealed identities. The more they expected future prejudice or discrimination, the more they brooded about their concealable stigmatized identity, and the additional brooding seemed to be associated with worse physical health. Overall, people who worried more about their stigma becoming known by others had worse physical health.
Keep in mind that these data were collected from a survey, and the participants were reporting on their own health rather than using doctor’s notes, biomarkers, or other objective indicators. So, we can’t be sure whether participants’ reports of their heath were completely accurate.
In addition, my coauthors and I believe that having a larger number of stigmas causes people to worry more, and that increased worry causes worse health. However, because we collected all of the data at once, rather than over time, so we cannot say for certain that this causal process is responsible for the link between concealed stigmas and health.
Finally, the social structures that maintain prejudice and discrimination can, by themselves, also cause health disparities between groups. Worrying may harm a person’s health, but all the self-help in the world won’t solve structural inequalities. In the meantime, if we can help people to reduce some of their worry, then maybe we can help their physical health, too.
For Further Reading
Reinka, M. A., Pan-Weisz, B., Lawner, E. K., & Quinn, D. M. (2020). Cumulative consequences of stigma: Possessing multiple concealable stigmatized identities is associated with worse quality of life. Journal of Applied Social Psychology, 50(4), 253–261. https://doi.org/10.1111/jasp.12656
Hatzenbuehler, M. L., Nolen-Hoeksema, S., & Dovidio, J. (2009). How does stigma “get under the skin”? The mediating role of emotion regulation. Psychological Science, 20(10), 1282-1289. 10.1111/j.1467-9280.2009.02441.
Hatzenbuehler, M. L., Phelan, J. C., & Link, B. G. (2013). Stigma as a fundamental cause of population health inequalities. American Journal of Public Health, 103(5), 813-821. 10.2105/AJPH.2012.301069
Quinn, D. M., & Chaudoir, S. R. (2009). Living with a concealable stigmatized identity: the impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health. Journal of Personality and Social Psychology, 97(4), 634. 10.1037/a0015815
Mora Reinka recently received her Ph.D. in social psychology from the University of Connecticut and is an incoming Assistant Professor of Health Psychology at Ursinus College.