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date: 19 January 2020

Abstract and Keywords

Accumulating evidence shows that stigma has health-harming consequences that build health disparities between those who are stigmatized and those who are not. However, most research has considered one stigmatized status at a time as it affects (generally) one outcome at a time. Moving from this singular focus to consider all forms of stigma as they affect multiple outcomes suggests a large and pervasive effect of stigma on life chances. This chapter considers whether stigma should be classified as a “fundamental cause”—an especially pernicious social factor that remains persistently associated with health inequalities over time. The chapter concludes by observing that if the stigma-as-a-fundamental-cause idea is supported, it follows that reductive efforts to address disparities via biomedical interventions will fail. Stigma stands as a factor that needs to be addressed in its own right if health inequalities are to be addressed and population health improved.

Keywords: fundamental causes, health disparities, stigma, stigma motives, social determinants of health, racism and health

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