Relational stigma as a social determinant of health: "I'm not what you _____see me as"

被引:7
作者
Addison, Michelle [1 ]
Lhussier, Monique [2 ]
Bambra, Clare [3 ]
机构
[1] Univ Durham, Dept Sociol, 32 Old Elvet, Durham DH1 3HN, England
[2] Northumbria Univ, Dept Social Work Educ & Community Wellbeing, Coach Lane Campus West, Newcastle NE7 7XA, England
[3] Newcastle Univ, Fac Med Sci, Populat Hlth Sci Inst, 5th Floor, Ridley 1, Newcastle Upon Tyne NE1 4LP, England
来源
SSM-QUALITATIVE RESEARCH IN HEALTH | 2023年 / 4卷
基金
英国惠康基金;
关键词
Health; Inequality; Drugs; Stigma; Harm; Marginalization; Bourdieu; PERSPECTIVES; GENDER; DRUGS; WOMEN; HARM;
D O I
10.1016/j.ssmqr.2023.100295
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Aim: The aim of the paper is to understand how people who use drugs (PWUD) experience stigma. To examine this issue, this paper draws on Bourdieu's logic of practice to understand how social harm emerges relationally between people via 'mechanisms of stigma'.Methods: This paper draws on 24 qualitative semi-structured interviews with people who use drugs (heroin, crack/ cocaine, amphetamine, ecstasy; 11 men/12 women/1 transgender) living in the northeast of England. Thematic analysis of data was undertaken and coded in Nvivo.Findings: PWUD experienced stigmatisation relationally with family, employers, health workers, Criminal Justice System, and the public for reasons linked to (but not limited to) their drug use, social class position, and their appearance. Stigmatisation shaped how participants saw themselves as a person 'lacking' in a valued or worthy identity. Social relations had detrimental effects on mental and physical health, and how participants accessed health services.Conclusions: Models of Social Determinants of Health (SDoH) currently focus almost entirely on a positivist, material 'reality' in which a person lives (housing, employment, food insecurity, healthcare, education, access to services), overlooking the ways in which social relations and a practical 'mastery' of social space contribute to health and inequalities. Furthermore, relational stigma shapes our experience of a healthy life; as such, stigma should be regarded as a SDoH as it contributes to a widening of health inequalities and unfairly impacts mar-ginalised people in society.
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页数:9
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