Stigmatization

Ostracism

One perspective on stigmas is that they all follow one basic rule: as Steven Neuberg and colleagues explain, humans stigmatize those whose characteristics or choices interfere with group living. For example, infectious diseases threaten a community's ability to survive and succeed by limiting members' ability to perform their duties or by causing death and disability. Further, infectious diseases inherently capitalize on the social nature of groups by spreading from member to member through their interactions. Before modern medicine, limited treatments existed; history is replete with examples of infectious diseases destroying communities and societies. People who created and communicated infectious [Page 1331]disease stigmas protected uninfected members by identifying infected persons and limiting their interactions with uninfected members. Multiple species, such as bees and lobsters, ostracize members with symptoms of diseases. Further, in species who depended on each other for survival, being ostracized meant certain and speedy death from infection, lack of access to resources (e.g., food), or predators. Ostracism, then, eliminated further spread but also created a reservoir of the disease.

In the pharmaceutical age, stigmatization still includes socialization, recognition, and regulation, but stigmatizing has a different effect than it did before modern medicine. Rather than eliminating contact with all uninfected people, ostracism is likely to shift contact to other people with the same health conditions or to those who are unaware. Further, infected persons are unlikely to perish before interacting with others, and medical options are not perfectly effective or distributed. Even through intense vaccination programs and quarantine measures, very few infectious diseases have been entirely eliminated. Through diagnostic procedures people may learn that they have a stigmatized condition before they show stigmatizing symptoms; in order to avoid the pain of stigmatization, persons may hide their health conditions. Even if they can enact enough prevention behaviors to promote their own quality of life, the stress of secrecy and anticipated stigmatization can engage biological stress responses (e.g., elevated cortisol), which can depress the immune system. Others may avoid testing altogether in order to avoid potential stigmatization, thus eliminating their ability to access medical assistance.

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