Week 5 Flashcards
(21 cards)
What is stigma dictionary definition
A mark or spot on skin
A mark of disgrace or infamy (e.g. branding or marking of a slave or criminal)
Visible sign/ characteristic of a disease
What is stigma Goffman 1963
An attribute that is ‘deeply discrediting’
Reduces the bearer ‘from a whole and usual person to a tainted, discounted one’
Stigma, stereotype and prejudice
Stigma- social interaction (sociology), focus on individual and society, visible or known difference, negative
Prejudice- social cognition (psychology), focus on group or individual, attitudes and emotions, negative
Stereotype- social cognition (psychology), focus on group, social expectations, positive, negative or neutral
Development of stigma as a sociological concept
Impact of what is happening in whole society rather than particular ‘groups’ e.g. values, fears
Social interaction between the stigmatising and the stigmatised
Social impact on the individual who is stigmatised
Social causes/ effects of stigma
People distinguish and label human differences; some are seen as undesirable
What is undesirable is decided by society, differences between times/cultures
Impact of powerful people and institutions as effect of labelling will spread faster
People can experience emotional reactions to labelled people- fear, repulsion, disgust
Labelled persons may feel shame, humiliation
Labelled persons experience status loss and discrimination as consequence
Why is this important for health/care
Important element in the experience of illness
Special care needs for people with a visible health condition
Potentially delay in help seeking
Stigma and prejudice can influence health practitioners and policies
Stigmatised health conditions
Visible differences
Mental health
Infectious diseases
Feared conditions e.g.cancer
Stigma of cancer
‘Incurable’ disease can lead people to avoid even saying word
Unclear causes makes its more frightening
Can lead to visible difference
Potentially embarrassing outcomes (impotence/colostomy bag)
Blaming patients might make others feel safer
However positive impact of better prognosis for many, awareness raising, charity activities
Three types of stigma (Goffman)
‘Abominations of the body’- physical disfigurement/ deviations from a social norm
‘Blemishes of character’- a known record e.g. alcoholism, long term unemployment, seen as character flaw
‘Tribal identities’- negative evaluation of people due to association with a particular group most often via family e.g. class, ethnicity, religion
Physical stigma
Long history of identifying and classifying physical deformities
-fear and disgust but also fascination
-living/ dead bodies were displayed
Appearance a common focus of teasing in childhood
Visible differences can lead to others staring, avoidance, inappropriate questions
Impact of physical stigma
Heightened social anxiety
Embarrassment
Depression
Low self esteem
Social withdrawal
Isolation
Stigmatised activities/experiences
Drug/alcohol addiction
Time spent in prison
Long term unemployment
Prostitution
Mental illness
‘Alternative’ sexualities
Tribal identities
A person visibly belongs to a particular group
-religious groups (clothing, symbols)
-‘racial’ groups (physique, skin colour)
-ethnic groups (all of above)
-chosen ‘tribes’ (clothing, symbols)
Stigma expresses wider social power structures
‘Courtesy stigma’- stigma rubs off on people close to stigmatised person
Impact of stigma (Goffman)
Stigma changes the social identity of a person (both to themselves and others)
A person becomes ‘discredited’ when they have a sign of a stigmatising condition which cannot be disguised; they’re forced to deal with their stigma in almost all interactions
Also labelled as ‘discrediting’ stigma
A person becomes ‘discreditable’ when its possible for them to conceal a sign of a stigmatising condition
Effects of being discreditable vs discredited
Where an individual is discredited: enacted stigma (people stare, avoid, express disgust), effects on employment and earning potential, isolation (people may avoid contact in anticipation of a negative response)-felt stigma
Where a individual is discreditable: concealment strategies which may not work, passing as ‘normal’, evaluating whether or not to reveal condition
People can move between the two (e.g. with relapsing-remitting conditions)
Managing a ‘spoiled’ identity
A ‘spoiled identity’ implies that an individuals social identity is dominated by the stigmatised illness/attribute
People may respond to this by: passing as normal, information control (deciding who to trust), avoiding all social contact, trying to avoid blame, refusing to be ashamed
How is stigma different from stereotype
Stereotype focuses on group identity
Stigma focuses on the stigmatised individual and the effect on them
Stigma also includes wider society, power dynamics
How is stigma different from prejudice
Prejudice is similar to stereotype but more about attitude/negative emotions towards particular groups and individuals
Focuses more on the person holding the prejudice who may never be in contact with the person they’re prejudiced against
Can lead to discrimination/scapegoating
It may explain why HCP may treat people differently personally (being rude) and medically (not offering treatment)
Impact on outcomes/ health inequalities?
Ongoing debate on whether prejudice in healthcare contributes to inequality in outcomes
Disadvantaged groups have worse outcomes
Reasons for this are complex: environment, behaviour, experiencing discrimination
Negative attitudes discourage people from seeking help
What is medicalisation
Process by which human conditions and problems come to be defined and treated as medical conditions and thus become subject of medical study, diagnosis, prevention and treatment
Examples are childbirth, menopause, alcoholism
This can be as a basis of encroachment by the medical profession or could be sought by groups in society
Conrad states ‘describes a process by which non-medical problems become defined and treated as medical problems, usually in terms of illness and disorders’
What are the three levels of medicalisation according to Conrad and Schneider
The conceptual- medical vocabulary used to describe an issue that could be described through other means, not necessarily within a medical encounter or leading to treatment, e.g. bad/antisocial behaviour
The institutional - organisations use a medical approach to manage problems in which organisation specialises (reduce people to their medical conditions).e.g. absenteeism; physicians being managers of hospitals
The interactional- patient actively seeks involvement of HCP, face to face contact, a social problem is defined as medical, diagnosis . E.g. prescribing anti-depressant medication for an unhappy family life
