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Stigma as a Fundamental Cause of Population Health Inequalities
Open accessAbstract
Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health.
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“According to social status research, when individuals are afforded positive status within their cultural institutions, institutions protect against stress and support health (Demakakos et al., 2008; Hatzenbuehler et al., 2013; Sapolsky, 2004). But when institutions relegate individuals into lower statuses, institutions generate stress and derail health (Adler, 2009; Sapolsky, 2004).”
From Cultural trauma as a fundamental cause of health disparities (2022) · cites this paper as Hatzenbuehler et al., 2013
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“To date, several fundamental causes—e.g., socioeconomic status (SES; Link and Phelan, 1995), stigma (Hatzenbuehler et al., 2013), racism/racial segregation (Phelan and Link, 2015; Williams and Collins, 2016)—have been codified in the literature.”
From Cultural trauma as a fundamental cause of health disparities (2022) · cites this paper as Hatzenbuehler et al., 2013
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“the dominant group may exercise stigma using multiple mechanisms such as anti-immigrant media and messaging (Morey, 2018) and resource-reducing discrimination in employment, housing, and education (Hatzenbuehler et al., 2013) to marginalize minority groups with status loss and negative labels/stereotypes (Link and Phelan, 2001).”
From Cultural trauma as a fundamental cause of health disparities (2022) · cites this paper as Hatzenbuehler et al., 2013
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“Following stigma exposure, individuals may experience minority stress—a stigma-related chronic, additive stress (on top of general life stressors) associated with reduced mental and physical health (Hatzenbuehler et al., 2013; Meyer, 2003) in stigmatized cultural groups such as sexual minorities (Hatzenbuehler, 2009; Operario et al., 2015).”
From Cultural trauma as a fundamental cause of health disparities (2022) · cites this paper as Hatzenbuehler et al., 2013
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“Stigma influences population health outcomes by worsening, undermining, or impeding a number of processes, including social relationships, resource availability, stress, and psychological and behavioral responses, exacerbating poor health [9].”
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“A few general stigma frameworks have also highlighted the influence of social and structural forces on the stigmatization process across socio-ecological levels [6, 9, 36].”
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Metadata
- Authors
- Hatzenbuehler, M. L., Phelan, J. C., & Link, B. G.
- Affiliations
- Columbia University (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2013-05
- Volume
- 103
- Issue
- 5
- Pages
- 813-821
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC3682466
- OpenAlex
- W1976985160
- Cited by
- 2,674
- References
- 120
- Citations by year
- 2026: 196 · 2025: 256 · 2024: 290 · 2023: 243 · 2022: 303 · 2021: 308 · 2020: 276 · 2019: 194 · 2018: 177 · 2017: 145 · 2016: 120 · 2015: 81 · 2014: 62 · 2013: 18
- FWCI
- 105.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- National Institute on Drug Abuse (K01DA032558)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Keywords
- stigma, health disparities, population health, social determinants of health, psychological pathways, interpersonal relationships, coping styles, stigmatized groups
- MeSH terms
- Attitude to Health, Employment, Health Services Accessibility, Humans, Interpersonal Relations, Minority Groups, Obesity, Self Concept, Sexual Behavior, Social Isolation, Sociology, Medical, Stress, Psychological, HIV Infections, Persons with Psychiatric Disorders, Health Status Disparities, Healthcare Disparities, Social Stigma
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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