Lecture 24 032724 PDF

Language A founda)on of community is language ▪ Language influences how we feel and how we react to things ▪ Biased language - words and phrases that are considered prejudiced, offensive, and hur@ul ▪ Helps to shape our world ▪ Describes and gives meaning to our lives ▪ Persuades and changes minds ▪ C...

Language A founda)on of community is language ▪ Language influences how we feel and how we react to things ▪ Biased language - words and phrases that are considered prejudiced, offensive, and hur@ul ▪ Helps to shape our world ▪ Describes and gives meaning to our lives ▪ Persuades and changes minds ▪ Can destroy or empower Focusing on the use of language – crucial first step in addressing s)gma, social exclusion, and discrimina)on against people with a variety of health condi)ons S)gma Across social sciences – process by which people become socially discredited because they have a characteris)c that society deems as “unacceptable” or “undesirable” Three realms: 1) Social s)gma: S)gma)zing aQtudes and behaviors 2) Experienced s)gma: people’s experience of those aQtudes and behaviors 3) Self-s)gma: people’s internaliza)on of and agreement with these nega)ve judgments ▪ Born out of fear ▪ Complex and pervasive global barrier to health-seeking behavior, care, and adherence to treatment across a wide range of health condi)ons S)gma influences popula)on health outcomes Worsening, undermining, or impeding a variety of processes (i.e., social rela)onships, resource availability, stress, and psychological and behavioral responses, exacerba)ng poor health) Anthropology’s Contribu)on Emphasis on how cultural and sociopoli)cal context shapes social s)gma for the individual and beyond S)gma is regulated within a broader social sphere ▪ Within kin networks ▪ Local moral worlds shape s)gma experience, because they focus people’s aZen)on on condi)ons that threaten “what maZers most” to people (Yang et al. 2014) How Does S)gma Work? ▪ Embedded in cultural norms (i.e., results from individual not mee)ng social expecta)ons), may vary across )me and space ▪ Created and perpetuated by people (not by diseases) ▪ Diseases are o^en feared and s)gma)zed (poor health is cross-culturally a shared concern) ▪ Coping with experienced s)gma is difficult, having a support group can help ▪ Tied with power rela)ons (i.e., who has access to resources and social privileges), can be used to reinforce these power structures ▪ S)gmas tend to co-occur, compounding their consequences ▪ Linked with evolved emo)ons associated with pathogen avoidance (e.g., feelings of disgust or fear associated with visible signs of infec)on) ▪ S)gma is currently an underappreciated global health concern, compromising the wellbeing of those affected and decreasing interven)on program effec)veness Evolu)onary Perspec)ves on S)gma Why might s)gma-associated emo)ons have evolved? Proposed explana)ons include: ▪ Part of our psychology that helps us determine with whom to associate ▪ Caused by “smoke detector” principle: Best to be very sensi)ve to cues of poor health, even if some)mes overreact and avoid individuals with non-infec)ous condi)ons (part of “behavioral immune system”) ▪ Hypothesized that strongest s)gmas should be apparent in areas where threat of infec)on is perceived to be highest Health Costs of S)gma ▪ Can prevent disease diagnosis and treatment (if afraid to seek medical care) ▪ Can lead to the spread of misinforma)on and poor public understanding of disease origins and transmission paZerns ▪ May lead to missed diagnoses and long-term mismanagement of condi)ons Well-Being Effects of S)gma ▪ Experiences of s)gma may be worse than the disease causing the s)gma ▪ May be ostracized by community & lose access to necessary resources ▪ Experience of s)gma may cause stress and addi)onal poor health, exacerba)ng disease pathology ▪ S)gma experienced due to illness - intersects with other forms of discrimina)on (e.g., race/ethnicity, sexual orienta)on, gender, etc.) in ways that further exacerbate stress and wellbeing Socioeconomic Costs of S)gma ▪ May avoid going to work or playing a more ac)ve role in society ▪ May lead to high-risk individuals (e.g., with fewer resources and greater risk of exposure) being less likely to seek diagnosis and treatment, for fear of losing work or social standing ▪ Especially harmful for chronic condi)ons that are hard to hide (e.g., leprosy or elephan)asis), leading to long-term economic and social losses Policy Implica)ons of S)gma ▪ S)gma)zed individuals may distrust healthcare professionals and not follow their advice ▪ Should account for possibility of uninten)onally causing s)gma when designing disease interven)ons ▪ S)gmas can compound – layer with other diseases, race, age, weight HIV & AIDS HIV: Human Immunodeficiency Virus, a virus that aZacks the human immune system AIDS: If untreated, HIV can lead to Acquired ImmunoDeficiency Syndrome (AIDS), the immune system is compromised, and people contract opportunis)c infec)ons (e.g., tuberculosis, Kaposi’s sarcoma, pneumonia) HIV Origins ▪ HIV jumped to humans from nonhuman primates ▪ Likely in the early 1900s, in Africa ▪ Emerged from Simian Immunodeficiency Virus (SIV) ▪ Hypothesized to be linked with hun)ng and wild meat consump)on ▪ HIV was not clinically described un)l the early 1980s HIV and AIDS-Related S)gma ▪ HIV/AIDS-related s)gma refers to prejudice, discoun)ng, discredi)ng, and discrimina)on directed at people perceived to have AIDS or HIV, as well as their partners, friends, families, and communi)es S)gma)zing language is defined as language that: ▪ Perpetuates myths and stereotypes ▪ Uses nouns (labels) to describe people (e.g. HIV-infected woman) ▪ Uses demeaning or outdated words or phrases Two Types of S)gma INTERNAL ▪ Comes from self-judgement and nega)ve self-talk we hear in our heads ▪ It is developed by our life experiences and can be difficult to change ▪ SHAME = I am bad ▪ I am not worthy ▪ Silence ▪ Secrecy ▪ Judgment EXTERNAL ▪ Comes from what we hear from others ▪ Family friends ▪ Healthcare providers ▪ Media HIV-RELATED STIGMA IS EXPERIENCED AT DIFFERENT LEVELS Impact of S)gma on Care and Treatment