Stigma as a Cause of Population Health Inequalities
Stigma as a Cause of Population Health Inequalities
Fundamental cause theory proposes that some social factors or circumstances remain persistently associated with health inequalities over time despite dramatic changes in diseases, risk factors, and health interventions. Inequality persists because fundamental causes have certain characteristics. First, a fundamental social cause influences multiple disease outcomes through multiple risk factors among a substantial number of people. Second, a fundamental social cause involves access to resources—knowledge, money, power, prestige, and beneficial social connections— that can be used to avoid risks or minimize the consequences of disease once it occurs. Third, fundamental social causes are robustly related to health inequities across time and place. These enduring relationships occur because the association between the fundamental cause and health is reproduced over time via the creation of new intervening mechanisms.
Policies and interventions must address the social factor itself, rather than the putative mechanisms that link this factor to health. Otherwise, fundamental social causes will continually produce health inequalities through the production of new mechanisms. The theory and research based on these concepts have focused primarily on SES as a fundamental cause of health inequalities. Stigma also meets fundamental cause criteria and deserves consideration as a major and persistent influence on population health.
Stigma as a Fundamental Cause
Fundamental cause theory proposes that some social factors or circumstances remain persistently associated with health inequalities over time despite dramatic changes in diseases, risk factors, and health interventions. Inequality persists because fundamental causes have certain characteristics. First, a fundamental social cause influences multiple disease outcomes through multiple risk factors among a substantial number of people. Second, a fundamental social cause involves access to resources—knowledge, money, power, prestige, and beneficial social connections— that can be used to avoid risks or minimize the consequences of disease once it occurs. Third, fundamental social causes are robustly related to health inequities across time and place. These enduring relationships occur because the association between the fundamental cause and health is reproduced over time via the creation of new intervening mechanisms.
Policies and interventions must address the social factor itself, rather than the putative mechanisms that link this factor to health. Otherwise, fundamental social causes will continually produce health inequalities through the production of new mechanisms. The theory and research based on these concepts have focused primarily on SES as a fundamental cause of health inequalities. Stigma also meets fundamental cause criteria and deserves consideration as a major and persistent influence on population health.
Source...