Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 May;103(5):813-21.
doi: 10.2105/AJPH.2012.301069. Epub 2013 Mar 14.

Stigma as a fundamental cause of population health inequalities

Mark L Hatzenbuehler  1 , Jo C Phelan, Bruce G Link
Affiliations

Stigma as a fundamental cause of population health inequalities

Mark L Hatzenbuehler et al. Am J Public Health. 2013 May.

Abstract

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.

PubMed Disclaimer

Figures

FIGURE 1—
FIGURE 1—
Multiple mediating mechanisms reproduce disadvantage for stigmatized groups. Note. M = mediating mechanism; SES = socioeconomic status. The thick arrow indicates a strong effect whereas the thin arrow indicates a weak effect. The arrow interrupted with a dash indicates a blocked mechanism.
See this image and copyright information in PMC

Comment in

  • The role of stigma in health disparities.
    Lee B. Lee B. Am J Public Health. 2013 Aug;103(8):e4. doi: 10.2105/AJPH.2013.301406. Epub 2013 Jun 13. Am J Public Health. 2013. PMID: 23763403 Free PMC article. No abstract available.
  • Hatzenbuehler et al. respond.
    Hatzenbuehler ML, Phelan JC, Link BG. Hatzenbuehler ML, et al. Am J Public Health. 2013 Aug;103(8):e4-5. doi: 10.2105/AJPH.2013.301430. Epub 2013 Jun 13. Am J Public Health. 2013. PMID: 23763427 Free PMC article. No abstract available.

References

    1. Major B, O’Brien LT. The social psychology of stigma. Annu Rev Psychol. 2005;56:393–421 - PubMed
    1. Berkman LF, Kawachi I, Social Epidemiology. Oxford, UK: Oxford University Press; 2000
    1. Hatzenbuehler ML, O’Cleirigh C, Mayer KH, Mimiaga MJ, Safren SA. Prospective associations between HIV-related stigma, transmission risk behaviors, and adverse mental health outcomes in men who have sex with men. Ann Behav Med. 2011;42(2):227–234 - PMC - PubMed
    1. Herek GM, Capitanio JP, Widaman KF. HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999. Am J Public Health. 2002;92(3):371–377 - PMC - PubMed
    1. Link BG, Struening EL, Neese-Todd S, Asmussen S, Phelan JC. Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illnesses. Psychiatr Serv. 2001;52(12):1621–1626 - PubMed

Publication types

MeSH terms