Stigmatizations Effect on Health Discussion

Stigmatizations Effect on Health Discussion ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Stigmatizations Effect on Health Discussion Hello, I need help with my public health discussion post and discussion response. They are due Wednesday night. The assignment is straight forward, read the articles that I have attached and summarize them. I have attached the article and the assignment guidelines in the pdfs. I have also attached the discussion post that you will respond too. Stigmatizations Effect on Health Discussion screen_shot_2020_11_24_at_5.39.03_pm.png screen_shot_2020_11_24_at_5.40.29_pm.png screen_shot_2020_11_24_at_5.40.43_pm.png link_bg_and_jc_phelan_2001_conceptualizing_stigma.pdf hatzenbuehler_2013_stigma_as_fundamental_cause.pdf Conceptualizing Stigma Author(s): Bruce G. Link and Jo C. Phelan Source: Annual Review of Sociology, Vol. 27 (2001), pp. 363-385 Published by: Annual Reviews Stable URL: http://www.jstor.org/stable/2678626 Accessed: 30-06-2017 13:44 UTC JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at http://about.jstor.org/terms Annual Reviews is collaborating with JSTOR to digitize, preserve and extend access to Annual Review of Sociology This content downloaded from 156.145.113.140 on Fri, 30 Jun 2017 13:44:36 UTC All use subject to http://about.jstor.org/terms Annu. Rev. Sociol. 2001. 27:363-85 Copyright (? 2001 by Annual Reviews. All rights reserved CONCEPTUALIZING STIGMA Bruce G. Link1 and Jo C. Phelan2 ‘Columbia University and New York State Psychiatric Institute, New York, NY 10032; e-mail: BGLl@Columbia.edu 2Department of Sociology, Columbia University, New York, NY 10021; e-mail: JCP13@Columbia.edu Key Words labeling, stereotype, discrimination, exclusion, deviance * Abstract Social science research on stigma has grown dramatically over the past two decades, particularly in social psychology, where researchers have elucidated the ways in which people construct cognitive categories and link those categories to stereo- typed beliefs. In the midst of this growth, the stigma concept has been criticized as being too vaguely defined and individually focused. In response to these criticisms, we define stigma as the co-occurrence of its components-labeling, stereotyping, sep- aration, status loss, and discrimination-and further indicate that for stigmatization to occur, power must be exercised. The stigma concept we construct has implications for understanding several core issues in stigma research, ranging from the definition of the concept to the reasons stigma sometimes represents a very persistent predicament in the lives of persons affected by it. Finally, because there are so many stigmatized circumstances and because stigmatizing processes can affect multiple domains of people’s lives, stigmatization probably has a dramatic bearing on the distribution of life chances in such areas as earnings, housing, criminal involvement, health, and life itself. It follows that social scientists who are interested in understanding the distribution of such life chances should also be interested in stigma. INTRODUCTION Erving Goffman’s (1963) book Stigma: Notes on the Management of Spoiled Identity inspired a profusion of research on the nature, sources, and consequences of stigma. Both PsychInfo and Medline show dramatic increases in the number of articles mentioning the word stigma in their titles or abstracts from 1980 (PsychInfo 14, Medline 19) to 1990 (PsychInfo 81, Medline 48) to 1999 (PsychInfo 161, Medline 114). Research since Goffman’s seminal essay has been incredibly productive, leading to elaborations, conceptual refinements, and repeated demonstrations of the negative impact of stigma on the lives of the stigmatized. The stigma concept is applied to literally scores of circumstances ranging from urinary incontinence (Sheldon & Caldwell 1994) to exotic dancing (Lewis 1998) to leprosy (Opala & 0360-0572/01/0811-0363$14.00 This content downloaded from 156.145.113.140 on Fri, 30 Jun 2017 13:44:36 UTC All use subject to http://about.jstor.org/terms 363 364 LINK * PHELAN Boillot 1996), cancer (Fife & Wright 2000), and mental illness (Angermeyer & Matschinger 1994, Corrigan & Penn 1999, Phelan et al 2000). Stigmatizations Effect on Health Discussion It is used to explain some of the social vagaries of being unemployed (Walsgrove 1987), to show how welfare stigma can lead to the perpetuation of welfare use (Page 1984), and to provide an understanding of situations faced by wheelchair users (Cahill & Eggleston 1995), stepparents (Coleman et al 1996), debtors (Davis 1998), and mothers who are lesbian (Causey & Duran-Aydintug 1997). A substantial portion of the productive research on stigma has been contributed by social psychologists who have used the insights of the social cognitive approach to understand how people construct categories and link these categories to stereotyped beliefs. This line of research represents a major advance in the understanding of stigma processes, and sociologists would do well to attend to it thoroughly (for a comprehensive review, see Crocker et al 1998). Given these advances in the social psychology of stigma and given the accumulated scientific impact of research on stigma more generally, we propose a return to the stigma concept from a distinctly sociological perspective. We engage our sociological perspective by attending to several core criticisms of the stigma concept and its application. The first of these criticisms is directed toward the clarity of the concept and follows from the observation that stigma is defined in different ways by different investigators. The second is a set of criticisms regarding the way in which the stigma concept has been applied by some researchers. We use these criticisms both as a stimulus to return to the stigma concept and as a critical analytic lens in constructing a revised conceptualization. We follow our explication of the stigma concept with a more detailed discussion of each of its component parts. We end by applying our conceptualization to several core issues in the stigma literature with an eye to assessing whether our conceptualization is helpful in understanding those issues. In doing so, we attend more to the nature and consequences of stigma than to its sources. (For a review of some ideas about the origins of stigma see Crocker & Lutsky 1986.) VARIATIONS IN THE DEFINITION OF STIGMA One of the curious features of literature concerning stigma is the vari exists in the definition of the concept (Stafford & Scott 1986). In many circum- stances investigators provide no explicit definition and seem to refer to something like the dictionary definition (“a mark of disgrace”) or to some related aspect like stereotyping or rejection (e.g., a social distance scale). When stigma is explicitly defined, many authors quote Goffman’s definition of stigma as an “attribute that is deeply discrediting” and that reduces the bearer “from a whole and usual person to a tainted, discounted one” (Goffman 1963, p. 3). Since Goffman, alternative or elaborated definitions have varied considerably. For example, Stafford & Scott (1986, p. 80) propose that stigma “is a characteristic of persons that is contrary to a norm of a social unit” where a “norm” is defined as This content downloaded from 156.145.113.140 on Fri, 30 Jun 2017 13:44:36 UTC All use subject to http://about.jstor.org/terms CONCEPTUALIZING STIGMA 365 a “shared belief that a person ought to behave in a certain way at a certain time” (p. 81). Crocker et al (1998, p. 505) indicate that “stigmatized individuals possess (or are believed to possess) some attribute, or characteristic, that conveys a social identity that is devalued in a particular social context.” Stigmatizations Effect on Health Discussion An especially influential definition is that of Jones et al (1984), who use Goffman’s (1963, p.4) observation that stigma can be seen as a relationship between an “attribute and a stereotype” to produce a definition of stigma as a “mark” (attribute) that links a person to undesirable characteristics (stereotypes). In our own reviews of stigma and mental illness (e.g., Link & Phelan 1999), we have added the component of discrimination to the Jones et al (1984) definition. Of the many reasons that definitions of stigma vary, two seem particularly prominent. First, as indicated above, the stigma concept has been applied to an enormous array of circumstances. Each one of these is unique, and each one is likely to lead investigators to conceptualize stigma in a somewhat different way. Second, research on stigma is clearly multidisciplinary, including contributions by psychologists, sociologists, anthropologists, political scientists, and social geographers. Although there is a great deal of overlap in interests across these disciplines, there are nevertheless some differences in emphasis. Even within disciplines, people approach the stigma concept from different theoretical orientations that pro- duce somewhat different visions of what should be included in the concept. Thus, different frames of reference have led to different conceptualizations. Because of the complexity of the stigma phenomenon, it seems wise to continue to allow variation in definition so long as investigators are clear as to what is meant by stigma when the term is used. Having said this, we shall also attempt to move matters ahead by specifying a conceptualization of stigma that includes many of the concerns that people working in this area of research share. Before proceeding, however, it is important to note that the use of the stigma concept has been challenged by some social scientists who have focused on the perspective of persons who are stigmatized (Schneider 1988, Fine & Asch 1988, Sayce 1998; Kleinman et al 1995). Understanding these challenges is important for the further development of research on stigma, particularly from a sociological perspective. CHALLENGES TO THE STIGMA CONCEPT There are two main challenges to the stigma concept. The first is that m scientists who do not belong to stigmatized groups, and who study stigm from the vantage point of theories that are uninformed by the lived experience of the people they study (Kleinman et al 1995, Schneider 1988). For example, in writing about the experience of disability, Schneider (1988) asserts that “most ablebodied experts” give priority “to their scientific theories and research techniques rather than to the words and perceptions of the people they study.” The result is a misunderstanding of the experience of the people who are stigmatized and the perpetuation of unsubstantiated assumptions. Writing about disability, Fine & Asch This content downloaded from 156.145.113.140 on Fri, 30 Jun 2017 13:44:36 UTC All use subject to http://about.jstor.org/terms 366 LINK * PHELAN (1988) identify five assumptions: (a) that disability is located solely in biology, (b) that the problems of the disabled are due to disability-produced impairment, (c) that the disabled person is a “victim,” (d) that disability is central to the disabled person’s self-concept, self-definition, social comparisons, and reference groups, and (e) that having a disability is synonymous with needing help and social support. Stigmatizations Effect on Health Discussion The second challenge is that research on stigma has had a decidedly individualistic focus. For example, according to Oliver (1992), the central thrust of stigma research has been focused on the perceptions of individuals and the consequences of such perceptions for micro-level interactions. According to Oliver (1992), research examining the sources and consequences of pervasive, socially shaped exclusion from social and economic life are far less common. Interestingly, this criticism is echoed by at least one renowned student of stereotyping, prejudice, and discrimination. In her review of these topics, Susan Fiske (1998) concludes that (at least within social psychology) the literature on discrimination is far less extensive than that on stereotyping and that more attention needs to be addressed to structural issues. In another vein, even though Goffman (1963, p. 3) initially advised that we really needed “a language of relationships, not attributes,” subsequent practice has often transformed stigmas or marks into attributes of persons (Fine & Asch 1988). The stigma or mark is seen as something in the person rather than a designation or tag that others affix to the person. In this respect the term stigma directs our attention differently than a term like “discrimination.” In contrast to “stigma,” “discrimination” focuses the attention of research on the producers of rejection and exclusion-those who do the discriminating-rather than on the people who are the recipients of these behaviors (Sayce 1998). Thus, the terms we use could lead to “different understandings of where responsibility lies for the ‘problem’ and as a consequence to different prescriptions for action” (Sayce 1998). Researchers on stigma could respond to these challenges by disputing their validity or pointing to exceptions in the now voluminous literature on stigma. We find these critiques to provide a useful stimulus for a reassessment of the conceptualization of stigma and related concepts. One way in which some of the issues raised by the critiques can be addressed is to propose that stigma be described with reference to the relationships between a set of interrelated concepts. DEFINING STIGMA IN THE RELATIONSHIP OF INTERRELATED COMPONENTS An important precedent to locating the meaning of stigma in the relation betw concepts is available in Goffman’s observation that stigma can be seen as the relationship between an “attribute and a stereotype.” We expand the nexus of relationships somewhat with the intent of capturing a fuller set of meanings for This content downloaded from 156.145.113.140 on Fri, 30 Jun 2017 13:44:36 UTC All use subject to http://about.jstor.org/terms CONCEPTUALIZING STIGMA 367 the term by doing so. We state our conceptualization as concisely as we can and then elaborate the components it contains. In our conceptualization, stigma exists when the following interrelated components converge. In the first component, people distinguish and label human differences. In the second, dominant cultural beliefs link labeled persons to undesirable characteristics-to negative stereotypes. In the third, labeled persons are placed in distinct categories so as to accomplish some degree of separation of “us” from “them.” In the fourth, labeled persons experience status loss and discrimination that lead to unequal outcomes. Finally, stigmatization is entirely contingent on access to social, economic, and political power that allows the identification of differentness, the construction of stereotypes, the separation of labeled persons into distinct categories, and the full execution of disapproval, rejection, exclusion, and discrimination.Stigmatizations Effect on Health Discussion Thus, we apply the term stigma when elements of labeling, stereotyping, separation, status loss, and discrimination co-occur in a power situation that allows the components of stigma to unfold. With this brief explication of the stigma concept as background, we turn to a more detailed examination of each component we identified. COMPONENT 1-ON DISTINGUISHING AND LABELING DIFFERENCES The vast majority of human differences are ignored and are therefore socially irrelevant. Some of these-such as the color of one’s car, the last three digits of one’s social security number, or whether one has hairy ears-are routinely (but not always) overlooked. Many others such as one’s food preferences or eye color are relevant in relatively few situations and are therefore typically inconsequential in the large scheme of things. But other differences, such as one’s skin color, IQ, sexual preferences, or gender are highly salient in the United States at this time. The point is that there is a social selection of human differences when it comes to identifying differences that will matter socially. The full weight of this observation is often overlooked because once differences are identified and labeled, they are typically taken for granted as being just the way things are-there are black people and white people, blind people and sighted people, people who are handicapped and people who are not. The taken-for-granted nature of these categorizations is one of the reasons that designations like these carry such weight. There are, however, some observations we can make that bring to light just how social this social selection of human differences is. First, substantial oversimplification is required to create groups. One example is the assignment of individuals to categories of “black” or “white” when there is enormous variability within the resulting categories and no clear demarcation between categories on almost any criterion one can think of, even attributes like skin color, parentage, or facial characteristics that are believed to define the categories This content downloaded from 156.145.113.140 on Fri, 30 Jun 2017 13:44:36 UTC All use subject to http://about.jstor.org/terms 368 LINK * PHELAN (Fullilove 1998). The same can be said for other categorizations like gay or straight, blind or sighted, handicapped or not. Second, the central role of the social selection of human differences is revealed by noting that the attributes deemed salient differ dramatically according to time and place. For example, in the late nineteenth century, human physical characteristics such as small foreheads and large faces were particularly salient-these characteristics were thought to be ape-like-and were believed to reveal the criminal nature of the people possessing them (Gould 1981). And, of course, cultures vary extensively in characteristics deemed socially significant. Stigmatizations Effect on Health Discussion For example, ancient Mayan culture gave unusual significance to being cross-eyed and sought to create this desirable characteristic in children through devices that encouraged babies to focus on objects in ways that forced their eyes to cross. Sociological studies of social construction and medicalization are also good examples (Conrad 1992). Hyperactivity is much more salient now, as an indicator of a disorder, than it used to be, and the medical term ADHD (attention deficit hyperactivity disorder) is part of common parlance. Because human differences are socially selected for salience, we have chosen to use the word “label” rather than “attribute,” “condition” or “mark.” Each of these latter terms locates the thing that is being referred to in the stigmatized person and risks obscuring that its identification and election for social significance is the product of social processes. In contrast, a label is something that is affixed. Moreover in the absence of qualifications, terms like “attribute,” “condition,” or “mark” imply that the designation has validity. In contrast the word “label” leaves the validity of the designation an open question-an option that has great utility as, for example, when one wishes to discuss the stigma some women experienced as a consequence of being labeled witches. With regard to this aspect of the stigma process, the critical sociological issue is to determine how culturally created categories arise and how they are sustained. Why is it that some human differences are singled out and deemed salient by human groups while others are ignored? What are the social, economic, and cultural forces that maintain the focus on a particular human difference? COMPONENT 2-ON ASSOCIATING HUMAN DIFFERENCES WITH NEGATIVE ATTRIBUTES The second component of stigma occurs when labeled differences are linked to stereotypes. This aspect of stigma was highlighted in Goffman’s (1963) work and has been central to the conceptualization of stigma ever since. It is the aspect of stigma that has been most salient in the psychological literature about stigma, perhaps because it poses critical questions of a psychological nature about the thought processes that facilitate connections between labels and stereotypes. Con- sistent with this emphasis in psychology is the centrality of this dimension in psychologists’ definitions of stigma. For example, Crocker and colleagues (1998) This content downloaded from 156.145.113.140 on Fri, 30 Jun 2017 13:44:36 UTC All use … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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