Disease stigma can be devastating. People with stigmatized diseases may endure psychological and physiological harms, avoid diagnosis and treatment, lose relationships and jobs, and even face a shortened life expectancy. These harmful effects have inspired theories among sociologists about why stigmas emerge, why some diseases are more stigmatized than others, and whether disease stigma has declined. Yet, the ability of researchers to test these theories has been hampered by a lack of data on how stigma varies across diseases over time.
In their new study, “The Stigma of Diseases: Unequal Burden, Uneven Decline,” appearing in the October 2023 issue of The American Sociological Review, authors Rachel Kahn Best, University of Michigan, and Alina Arseniev-Koehler, Purdue University and University of California-San Diego, use new methods to learn why some diseases are more stigmatized than others and whether disease stigma has declined over time.
The authors measured the stigmatizing meanings linked to 106 diseases by using word embedding methods to analyze 4.7 million news articles from 1980 to 2018. This method revealed patterns that were difficult to detect in studies of single diseases, allowing the authors to test theoretical predictions about how stigmatizing meanings vary across diseases and over time.
The authors found that, while chronic diseases—e.g., cancers or genetic conditions—used to connote negative personality traits, immorality, and disgust, chronic disease stigma has dramatically declined, and these stigmatizing meanings have largely melted away. This cultural change could make the experience of dealing with a chronic illness less discouraging and isolating.
But other stigmatizing meanings have been remarkably stable across the past four decades. Despite advances in treatment and powerful activism, mental illnesses remain strongly linked to judgments about personality and morality. Meanwhile, infectious diseases remain tightly linked to disgust.
In the past four decades, stigma has transformed from a sea of negative connotations surrounding most diseases to two primary conduits of meaning: infectious diseases spark disgust, and behavioral health conditions cue judgment.
Since these stigmatizing meanings are so entrenched, advocates may not be able to dislodge them. Instead, the authors suggest that advocates should prioritize blunting stigma’s effects (e.g., through policies prohibiting discrimination in housing, the workplace, and health-care settings).