Stigmatizing the Unhealthy

Abstract

Stigma can lead to poor health outcomes. At the same time, people who are perceived as unhealthy may experience stigma as the result of that perception. As part of a larger project examining discrimination on the basis of health status or “healthism,” we explore the role of stigma in producing disadvantage based on health status. Specifically, we look to the principles of health equality and health justice. An intervention violates health equality when it is driven by animus, which can be the result of stigma. Additionally, laws and policies offend health justice when they worsen health outcomes or they create or deepen health disparities. An intervention that produces stigma — whether intentionally or unintentionally — may offend health justice by making people worse off, in absolute or in comparative terms. Stigma-related health laws and policies can therefore be healthist in at least two ways. We therefore conclude that stigma should neither be the basis, nor the product, of efforts to improve health.

Moral Features of the Therapeutic Relationship with Adults: Dignity, Trust, Autonomy, Vulnerability, and Resilience

“…• Not seeing the individual "as a whole person" 11 • Labeling patients as "difficult" which focuses on patients' deficiencies 13 • Status loss 16 • Lack of empathy 17 community[y]." 19 Care is "the practice of attentiveness and attending to the moral (and mortal) being of others-their welfare, suffering, need, and vulnerability."…”

“…2 Espoused by psychologist Carl Rogers, unconditional positive regard means that the humanist therapist "accepts and loves the person" for who he or she is. 2 Work by prominent aphasiologists such as Byng et al, 3 LaPointe, 4 Sarno, 5,6 Worrall, 7 and others [8][9][10][11][12][13][14][15][16] suggests we might not be living up to these ethical responsibilities. Patients report that by careless words and actions, some clinicians inadvertently devalue and depersonalize them 17 (see Table 1).…”

Optimism and Social Support Predict Healthier Adult Behaviors Despite Socially Disadvantaged Childhoods

“…One implication of this finding, if it reflects a causal association, is that interventions to increase positive psychosocial factors may improve health behaviors among all adults, not just those who experience relatively advantaged childhoods. Alternatively, it is possible that the direction of effect is reversed, such that less healthy behaviors such as smoking or unhealthy diets, which are highly stigmatized [30], could lead to decreased optimism and/or social support by damaging self-esteem or social networks. If this is the case, interventions might instead target the health-related behaviors themselves.…”