Introduction
Stigma, prejudice, discrimination and health

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Introduction

There is a great urgency to understand more fully the linkages between stigma, prejudice, discrimination and health to aide in the development of effective public health strategies. A goal of the US Healthy People 2010 programme is to eliminate health disparities among different segments of the population (DHHS, 2002). Prejudice and discrimination are believed to be important contributors to the production of health disparities (IOM, 2002). It is difficult to pick up a consensus report on mental illness or HIV/AIDS without finding numerous references to the ways the stigmatization of these health conditions undercuts prevention and treatment efforts (Department of Health and Human Services, 2003, USAID, 2000).

For this reason, in September 2006, the Health & Society Scholars Working Group on Stigma, Prejudice, Discrimination and Health convened scholars across the social and health sciences who study the social and psychological processes of stigmatization and prejudice. The objective of this conference was to strengthen collaboration across disciplines, discuss challenging conceptual issues, and identify the most pressing research objectives facing this relatively new line of inquiry. Driving discussions was the budding idea for a Special Issue that would attempt to bridge disparate research traditions in stigma, on the one hand, and in prejudice and discrimination on the other. As editors of the Special Issue, we believe the importance of this endeavor lies in missed opportunities for conceptual coherence and for capitalizing on insights generated from each research tradition and possibly, to an underestimation of the impact of stigma and prejudice on health. Several exciting manuscripts emerged from the conference making up the content of this Special Issue.

The Special Issue breaks from existing volumes in fundamental ways. To date, manuscript collections on stigma and those on prejudice and discrimination are organized around a single disciplinary perspective and focus on either stigma or prejudice but never both. Authors included in the Special Issue write from diverse disciplinary perspectives and represent a starting point of cooperation among scholars interested in these two traditions. The articles develop conceptual and empirical research linking stigma and prejudice; identify under-recognized cultural and policy dynamics that contribute to the formation of stigma and prejudice and may mediate their health impacts; describe pathways through which stigma and prejudice affect health outcomes; and explore the implications of these themes for public health practice. In this commentary, we explain why these themes are important and introduce articles in the Special Issue.

Section snippets

Bridging stigma and prejudice research traditions

Stigma and prejudice research traditions stem from the seminal works of sociologist Goffman (1963) and social psychologist Allport (1958). In their works, stigma and prejudice are each complex concepts that encompass individual experience, the interaction between non-marginalized and marginalized groups, and broader structural and social phenomena such as power relations, historical contingencies, community practices and program/policy design. Goffman defines stigma as “an attribute that links

The formation of stigma and prejudice

At the conference, there was a call for greater attention to the reasons why and methods used by societies to promulgate stigma and prejudice. Stigma researchers in particular are criticized for not paying enough attention to these issues (Corrigan et al., 2004, Link and Phelan, 2001, Parker and Aggleton, 2003). The critique is that stigma researchers tend to describe the adverse effects of stigma on persons labeled with a stigmatized attribute, explaining stigma by examining the social

Linking stigma, prejudice and health

Progress has been made in explicating the pathways through which stigma and prejudice impact health in this young field of inquiry. However, conference participants agreed, much more work is needed to deepen our understanding of the many ways that stigma and prejudice affect marginalized persons leading to psychological, social and biological consequences. In general, stigma and prejudice are believed to adversely impact health through five pathways.

First, studies have documented that

Implications of these themes for public health practice

Nearly all the articles in the Special Issue are suggestive of innovative approaches and points of intervention to either reduce the impact of prejudice and stigma for health or to redress stigmatization and prejudice and their root causes. For example, returning to Dovidio et al.'s contribution, they describe that just because some forms of prejudice can be unconsciously or automatically activated, does not mean that they cannot be changed (Dovidio et al., 2008). He and others have found that

Acknowledgement

We wish to thank Fred Markowitz and Suzanne Ouellette for their thoughtful reviews of manuscript proposals for the Special Issue.

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    Funding for the Stigma, Prejudice, Discrimination and Health Working Group and for the Conference in support of the development of the Special Issue was provided by the Robert Wood Johnson Health and Society Scholarship Program at Columbia University.

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