@article{a9e5684d4f014617a2298e60910aca15,
title = "Challenges and opportunities in examining and addressing intersectional stigma and health",
abstract = "Background: 'Intersectional stigma' is a concept that has emerged to characterize the convergence of multiple stigmatized identities within a person or group, and to address their joint effects on health and wellbeing. While enquiry into the intersections of race, class, and gender serves as the historical and theoretical basis for intersectional stigma, there is little consensus on how best to characterize and analyze intersectional stigma, or on how to design interventions to address this complex phenomenon. The purpose of this paper is to highlight existing intersectional stigma literature, identify gaps in our methods for studying and addressing intersectional stigma, provide examples illustrating promising analytical approaches, and elucidate priorities for future health research. Discussion: Evidence from the existing scientific literature, as well as the examples presented here, suggest that people in diverse settings experience intersecting forms of stigma that influence their mental and physical health and corresponding health behaviors. As different stigmas are often correlated and interrelated, the health impact of intersectional stigma is complex, generating a broad range of vulnerabilities and risks. Qualitative, quantitative, and mixed methods approaches are required to reduce the significant knowledge gaps that remain in our understanding of intersectional stigma, shared identity, and their effects on health. Conclusions: Stigmatized identities, while often analyzed in isolation, do not exist in a vacuum. Intersecting forms of stigma are a common reality, yet they remain poorly understood. The development of instruments and methods to better characterize the mechanisms and effects of intersectional stigma in relation to various health conditions around the globe is vital. Only then will healthcare providers, public health officials, and advocates be able to design health interventions that capitalize on the positive aspects of shared identity, while reducing the burden of stigma.",
keywords = "Layered stigma, discrimination, double stigma, intersectional, measurement, multiple stigma, overlapping stigma, prejudice",
author = "Turan, {Janet M.} and Elafros, {Melissa A.} and Logie, {Carmen H.} and Swagata Banik and Bulent Turan and Crockett, {Kaylee B.} and Bernice Pescosolido and Murray, {Sarah M.}",
note = "Funding Information: Funding for the examples in boxes were provided by NIH R01 TW006374 (Box 1); NIH 1R21 DA033719 and the Indian Council of Medical Research (ICMR) (Box 2); the UAB Center for AIDS Research (Box 3); and the Canadian Institutes of Health Research (CIHR) (Box 4). JMT and BT are supported by the National Institute of Mental Health (R01MH104114) and University of Alabama at Birmingham Center for AIDS Research (CFAR), a National Institutes of Health-funded program (P30 AI027767) that was made possible by the following institutes: NIAID, NCI, NICHD, NHLBI, NIDA, NIA, NIDDK, NIGMS, and OAR. CL is supported by an Ontario Ministry of Research & Innovation Early Researcher Award, the Canada Research Chairs Program, and the research was funded by the Canadian Institutes of Health Research. KBC is supported by a Health Services, Outcomes, and Effectiveness Research Training grant (Agency for Healthcare Research and Quality [AHRQ] T32HS013852). The content is the responsibility of the authors and does not represent the views of the National Institutes of Health, Fogarty International Center, or associated funders. Funding Information: This article is part of a collection that draws upon a 2017 workshop on stigma research andglobal health, which was organized by the Fogarty International Center, National Institute of Health,United States. The article was supported by a generous contribution by the Fogarty International Center. SB thanks the research team at Humsafar Trust, Mumbai, and MGM Medical College for their collaboration on Box 2. CL thanks the research team at Jamaica AIDS Support for Life in Kingston, Montego Bay, and Ocho Rios, Jamaica, for their collaboration (including Kandasi Levermore, Nicolette Jones, Tyrone Ellis), Dr. Annecka Marshall at the University of the West Indies, and PhD candidate Ying Wang at the Factor-Inwentash Faculty of Social Work, University of Toronto, for her data analysis included in Box 4. Funding for the examples in boxes were provided by NIH R01 TW006374 (Box 1); NIH 1R21 DA033719 and the Indian Council of Medical Research (ICMR) (Box 2); the UAB Center for AIDS Research (Box 3); and the Canadian Institutes of Health Research (CIHR) (Box 4). JMT and BT are supported by the National Institute of Mental Health (R01MH104114) and University of Alabama at Birmingham Center for AIDS Research (CFAR), a National Institutes of Health-funded program (P30 AI027767) that was made possible by the following institutes: NIAID, NCI, NICHD, NHLBI, NIDA, NIA, NIDDK, NIGMS, and OAR. CL is supported by an Ontario Ministry of Research & Innovation Early Researcher Award, the Canada Research Chairs Program, and the research was funded by the Canadian Institutes of Health Research. KBC is supported by a Health Services, Outcomes, and Effectiveness Research Training grant (Agency for Healthcare Research and Quality [AHRQ] T32HS013852). Funding Information: This article is part of a collection that draws upon a 2017 workshop on stigma research andglobal health, which was organized by the Fogarty International Center, National Institute of Health,United States. The article was supported by a generous contribution by the Fogarty InternationalCenter. SB thanks the research team at Humsafar Trust, Mumbai, and MGM Medical College for their collaboration on Box 2. CL thanks the research team at Jamaica AIDS Support for Life in Kingston, Montego Bay, and Ocho Rios, Jamaica, for their collaboration (including Kandasi Levermore, Nicolette Jones, Tyrone Ellis), Dr. Annecka Marshall at the University of the West Indies, and PhD candidate Ying Wang at the Factor-Inwentash Faculty of Social Work, University of Toronto, for her data analysis included in Box 4. Publisher Copyright: {\textcopyright} 2019 The Author(s).",
year = "2019",
month = feb,
day = "15",
doi = "10.1186/s12916-018-1246-9",
language = "English (US)",
volume = "17",
journal = "BMC Medicine",
issn = "1741-7015",
publisher = "BioMed Central",
number = "1",
}