Perceived Stigma in Health Care Settings and the Physical and Mental Health of People of Color in the United States

Abstract

Purpose: Addressing perceived and enacted stigma in clinical settings is critical to ensuring delivery of high-quality patient-centered care, reducing health disparities, and improving population health outcomes.Methods: Data from the Behavioral Risk Factor Surveillance System's (2012–2014) Reaction to Race module were analyzed to test the hypothesis that perceived stigma in health care settings would be associated with poorer physical and mental health. Poor health was measured by (1) the number of days the respondent was physically or mentally ill over the past month and (2) depressive disorder diagnosis. Multivariate linear and logistic regression models were employed.Results: Effects of stigma on physical and mental health were significant. Perceived stigma was associated with additional 2.79 poor physical health days (β=2.79, confidence interval [CI]=1.84–3.75) and 2.92 more days of poor mental health (β=2.92, CI=1.97–3.86). Moreover, perceived stigma in health care settings was associated with 61% higher odds of reporting a depressive disorder (adjusted odds ratio=1.61, CI=1.29–2.00). Among other findings, individuals who were married, younger, had higher income, had college degrees, and were employed reported significantly fewer poor physical and mental health days and had lower odds of self-reported depressive disorder.Conclusions: Reducing stigma against people of color in health care settings (environments that should be pro-patient) must be a top priority for population health scholars and clinicians. Reducing perceived stigma in clinical settings may produce better mental and physical health outcomes in minority patients thereby reducing health disparities. In addition, fewer days lost to poor health could positively influence the health care system by decreasing utilization and may improve economic productivity through increasing days of good health.

Creating COVID-19 Stigma by Referencing the Novel Coronavirus as the “Chinese virus” on Twitter: Quantitative Analysis of Social Media Data

“…Stigma is the deleterious, structural force that devalues those who hold undesirable characteristics [1]. Stigma is a social process that occurs between groups; this process can occur in-person and online [2][3][4][5][6]. Regardless of setting, research has consistently found that stigma is associated with negative health outcomes [2,4,[6][7][8][9].…”

Stigma Associated with COVID-19 Among Health Care Workers in Indonesia

“…8,11 Studies suggest that stigma is associated with negative health outcomes. [12][13][14] Stigma and discrimination negatively affect public health efforts in diseases such as mental illness, epilepsy, tuberculosis, leprosy, and HIV/AIDS. 8,12,13 Stigma caused people with HIV to hide their disease, avoid voluntary testing and counseling, and not seek for treatment, pushed the epidemic underground.…”

“…5,8 Furthermore, stigma may lead people to distrust the government, health professionals, and health care system. 6,12,13 In the context of COVID-19 pandemic, public health measurements taken to contain the outbreak such as mask using, quarantine and isolation fueled stigma towards the disease; 15 therefore, it is imperative that people trust their government and health care systems so that they will be cooperative. 6 Stigma against particular disease is very dangerous, in particular if it comes from HCWs, as it may lead to poor health care service even rejection to treat patients.…”

Beyond race: Impacts of non-racial perceived discrimination on health access and outcomes in New York City

“…Previous research has found such discrimination to be one of the factors mediating the relationship between group membership and health outcomes [3][4][5][6][7][8][9]. Given the nature of disparities in health access and outcomes in the United States, where historically African-Americans have shown worse access and outcomes across various indicators, this literature has primarily focused on race/ ethnicity-based discrimination, particularly between whites and African Americans [10][11][12]. In recent years, discrimination research has expanded its scope and found evidence of an association between perceived discrimination and adverse health outcomes among other minority groups also, such as Asian Americans and Hispanic Americans [13,14].…”