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
. 2024 Dec 30;24(1):3614.
doi: 10.1186/s12889-024-21171-8.

The use and operationalization of "structural stigma" in health-related research: A scoping review

Evan L Eschliman  1   2 , Edwina P Kisanga  3 , Long Jie Huang  4 , Ohemaa B Poku  5 , Becky L Genberg  6 , Danielle German  3 , Sarah M Murray  7 , Lawrence H Yang  8   9 , Michelle R Kaufman  3   10
Affiliations

The use and operationalization of "structural stigma" in health-related research: A scoping review

Evan L Eschliman et al. BMC Public Health. .

Abstract

Background: Research that investigates the negative health effects of stigma beyond the individual and interpersonal levels is increasingly using the concept of "structural stigma." This scoping review investigates how the concept of "structural stigma" has been used and operationalized in health-related literature to date in order to characterize its usage and inform future operationalizations.

Methods: A systematic search and screening process identified peer-reviewed, English-language research articles that used the term "structural stigma" available prior to January 1, 2024 in five databases (i.e., PubMed, PsycINFO, Embase, Web of Science, CINAHL).

Results: Of the 298 articles identified, over half (53%) were published from 2021 onward. Articles most commonly were set in the United States (n = 163, 55%), investigated stigma toward sexual minority people (n = 163, 55%), and cited the introduction of a special issue of Social Science & Medicine as their source of the concept (n = 84, 28%). Most articles (64%) used at least one additional conceptual framework, most commonly minority stress theory (n = 107, 36%). Quantitative operationalizations (n = 102) engaged most in the conceptual domain of laws and government-level policies, while qualitative operationalizations (n = 68) engaged most with institutional (i.e., non-government-level) policies, practices, and procedures.

Conclusions: As the use of "structural stigma" is increasing, operationalizations can better leverage the concept's breadth and account for individuals' intersectional lived experiences. This will necessitate bridging across methodologies and bodies of research on related negative social processes.

Keywords: Discrimination; Qualitative; Quantitative; Scoping review; Stigma; Structural factors.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
Number of articles that contain “structural stigma” by year published and by operationalization type
Fig. 3
Fig. 3
Operationalizations of structural stigma in identified articles by conceptual structural domain(s) engaged
See this image and copyright information in PMC

References

    1. Du Bois WEB. The Philadelphia Negro: a social study. Reprint edition. Philadelphia: University of Pennsylvania; 1996.
    1. White Hughto JM, Reisner SL, Pachankis JE. Transgender stigma and health: a critical review of stigma determinants, mechanisms, and interventions. Soc Sci Med. 2015;147:222–31. - PMC - PubMed
    1. Krieger N. Methods for the Scientific Study of Discrimination and Health: an Ecosocial Approach. Am J Public Health. 2012;102:936–44. - PMC - PubMed
    1. Diez Roux AV. Ecological variables, ecological studies, and multilevel studies in public health research. In: Detels R, Gulliford M, Abdool Karim Q, Tan CC, editors. Oxford textbook of global public health. Sixth edition. Oxford: Oxford University Press; 2017.
    1. Clouston SAP, Link BG. A Retrospective on Fundamental cause theory: state of the literature and goals for the future. Annu Rev Sociol. 2021;47:131–56. - PMC - PubMed

Publication types

LinkOut - more resources