Biennial conference press release, June 22, 2012 – Public health practitioners know all too well about the difficulties of helping people find the health services they need. However, some members of the population are living with large and systematic levels of exposure to health risk which goes widely unrecognized. Individuals with concealable health needs or characteristics such as mental illness, HIV/AIDS, and sexual minorities are more likely to have health problems and are significantly more likely to go undetected by health services.

These findings were presented today at the 9th Biennial Conference of The Psychological Study of Social Issues (SPSSI) in Charlotte, North Carolina, and are being published in the journal of Basic and Applied Social Psychology next year. The review by Stephenie Chaudoir from the College of the Holy Cross and colleagues Valerie A. Earnshaw, Yale University, and Stephanie Andel, University of South Florida, suggests that social stigma can “get under the skin” for vulnerable populations such as HIV/AIDS sufferers and sexual minorities. Their health problems which are often undetected due to stigma may be permanently undercutting the access and quality of health services.

Psychologists have long understood how visible characteristics of individuals can lead to stigmatization with a whole range of negative social and health consequences. But they have been uncertain of the extent to which stigma affects individuals when the characteristics are not easily observed in daily life.
 
“On one hand, stigmatized individuals can derive a number of self-esteem benefits from their group membership to the extent that they feel that they are part of a larger group. On the other hand, belonging to a larger disadvantaged group may block individuals’ access to information, social opportunities, and resources that benefit their health,” says Chaudoir, the lead author of the study.

The new research shows that these experiences are more acute for individuals with concealable stigma. While individuals with visible characteristics of stigma must deal with the conspicuousness of the stigma in every day interactions, they also benefit from the social and psychological support from others who share that characteristic. This benefit is less frequently available if characteristics are not visible. “Concealable stigma is often experienced as social rejection waiting to happen”, says Chaudoir.

This experience brings with it a range of problems that increase the exposure to health risks. Individuals with concealable stigma do not often have adequate support networks, may actively resist healthcare which heightens their risk of experiencing health problems, and are more likely to have difficulty in obtaining the right care from formal health networks and employers.

Mental illness, HIV/AIDS, and sexual minority status represent a large segment of the population which faces gaps in healthcare services where training and resources do not provide adequate access and quality of treatment. Chaudoir and co-authors of the study, Valerie A. Earnshaw of Yale University and Stephanie Andel of the University of South Florida say that further efforts are necessary to collect data to analyze the affects of concealable stigma on healthcare access and quality.