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Background:
Stigma and discrimination have been associated with different diseases and pandemics, with negative consequences for the people who suffered them and for their communities. Currently, COVID-19 has become a new source of stigmatization.
Aims:
The aim of the present study is to analyze longitudinally the evolution of intersectional perce...
Context in source publication
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Background
To evaluate the current status of emotional exhaustion and peritraumatic distress of healthcare workers (HCWs) in the COVID-19 pandemic, and identify factors associated with their mental health status.
Methods
An online survey involving 1,068 HCWs that included nurses, physicians, and public health officers was conducted. Descriptive st...
Citations
... This is an important finding that adds to the understanding of a collective crisis like the pandemic. Previous studies have pointed out how increased stigma is associated with high case rates and related fear, with predictions of it reducing as the recovery phase sets in Ugidos et al. (2020). Contrastingly, we found that right after an equally severe second wave and without a significant reduction in immediate fears, there was a change in the perception of disease related stigma. ...
The COVID-19 pandemic has been a novel and evolving experience impacting health, livelihoods, well-being, decision-making, and community life. While uncertainty is seen as integral to the pandemic experience, limited literature has examined the consequences of the same, as embodied within individual and collective experiences. From the theoretical lens of Embodied Uncertainty (Sword-Daniels et al. Citation2018), the present study explored meaning making and coping with uncertainty as embodied in the lived experiences of the pandemic, through longitudinal qualitative research (LQR). Participants from a diverse socio demographic pool were interviewed in 2020 (N = 30) and 2021 (N = 14), following the two major phases of Covid-19 outbreak in India. Thematic analysis revealed complex intersections between social identity, stigma and economic strife and how novel coping strategies were being employed as the ongoing nature of the pandemic became a reality. We also found shifts in information seeking and institutional trust, shaped by the lived experiences of people as opposed to policy and state action. The results highlight key areas of vulnerability and coping with uncertainty in collective crises, gaps in state response and its impact, and how social identities shape interpretations of risks.
... Most of the existing literature examining the dimensionality of stigma, in the context of the COVID-19 pandemic, has focused on understanding perceived and enacted stigma at the individual and interpersonal levels (Dopelt et al., 2023;Missel et al., 2022;Ugidos et al., 2022). Stangl et al.'s (2019) Health Stigma and Discrimination Framework underscores the fluid, multifaceted, and intricate interplay between power and vulnerability, and can be applied to understand how stigma shifts over time. ...
Limited attention has been paid to understanding how shifts in COVID-19 stigma are associated with sociohistorical changes, and how these dynamics impact perceived and enacted stigma among those affected by COVID-19. From drivers of fear and scapegoating at the beginning of the pandemic to subsequent health and social impacts on prevention efforts, this study examines how COVID-19 stigma emerged and evolved across the COVID-19 pandemic in Toronto, Canada. Data are derived from 26 cross-sectional, in-depth, semistructured interviews conducted from August to October 2021 as part of a qualitative evaluation of the COVID-19 Ring-Based Prevention Trial With Lopinavir/Ritonavir (CORIPREV-LR) study. Interviews were conducted virtually, transcribed verbatim, and analyzed using an immersion crystallization approach and Dedoose software. Narratives from CORIPREV-LR study participants underscore three central themes detailing temporal dimensions of COVID-19 stigma: (a) dramatic social change: markers of infection-related stigma during early COVID-19; (b) incremental social change: playing “political football” with COVID-19 policy responses; and (c) inertia: vaccine ideologies driving COVID-19 compliance-related stigma. Participants described differing COVID-19 stigma trajectories, shifting from the initial shock of the pandemic, through multilevel changes in guidelines, to subsequent inertia amid vaccine rollout. Despite participants reporting a decrease in COVID-19 infection-related stigma since the onset of the pandemic, COVID-19 compliance-related stigma was shown to increase as the pandemic advanced. Experiences of COVID-19 stigma were also described as being shaped by race, class, migration status, and occupation, highlighting the complex interplay between temporal events and intersectional stigma processes during the pandemic.
... Stigma has different facets. It has been further observed that persons who have been diagnosed with COVID-19 may not only suffer societal discrimination, but they are also at risk of internalizing these beliefs, developing feelings of inferiority and selfanger, eventually applying to themselves and behaving as stigmatized individuals (for instance, thinking that the disease is their responsibility or that because of it, they may be dangerous to others) (2)(3)(4). This internalized stigma can lead to devaluation of self and generate emotions of self-prejudice, guilt, or shame, which would further affect their behavior and lead to adverse mental health consequences such as depression and anxiety (3,4). ...
... It has been further observed that persons who have been diagnosed with COVID-19 may not only suffer societal discrimination, but they are also at risk of internalizing these beliefs, developing feelings of inferiority and selfanger, eventually applying to themselves and behaving as stigmatized individuals (for instance, thinking that the disease is their responsibility or that because of it, they may be dangerous to others) (2)(3)(4). This internalized stigma can lead to devaluation of self and generate emotions of self-prejudice, guilt, or shame, which would further affect their behavior and lead to adverse mental health consequences such as depression and anxiety (3,4). Stigma hampers diagnosis, treatment, prevention, and control of diseases as individuals tend to hide their identity, avoid social interaction, and follow health guidelines and healthy preventive adaptive behaviors. ...
Introduction
The COVID-19 pandemic has led to physical and psychological complications and social consequences in the form of illness-related stigma. This study aimed (1) to assess the sociodemographic and clinical variable, as well as COVID-19 related knowledge and perception of persons admitted for COVID-19/Suspected COVID-19 in Nepal, (2) to determine their levels of COVID-19- related internalized stigma, depression, and anxiety symptoms, and (3) to evaluate the correlates of COVID-19- related internalized stigma.
Materials and methods
It was a cross-sectional exploratory study with a convenience sample of 395 participants (306 confirmed cases, 89 suspected cases) conducted between July–October 2020 in four health facilities in Madhesh and Lumbini provinces of Nepal. We used a semi-structured questionnaire to assess sociodemographic details, clinical information, COVID-19-related knowledge, perception, COVID-19-related internalized stigma, and the Hamilton Anxiety Depression Scale (HADS) in Nepali language. Descriptive statistics, correlation analyses, and linear regression analyses were performed. The level of statistical significance was considered at p < 0.05.
Results
Around 23.3% of the patients had anxiety symptoms, 32.9% had depressive symptoms, and 20.3% had high COVID-19-related internalized stigma (mean ISMI score: 2.51–4.00). Linear regression analyses showed a significant positive association of COVID-19-related internalized stigma total score, with the following eight factors, i.e., no income in the past one month (p = 0.013), below average socioeconomic status (p = 0.004), anxiety symptoms (p = <0.001), depressive symptoms (p = <0.001), recent testing positive for COVID-19 (p = <0.001), involuntary admission (p = <0.001), prior experience of being in isolation and quarantine (p = 0.045), and those who blame others for COVID-19 (p = 0.025).
Conclusion
COVID-19 survivors and suspects are vulnerable to symptoms of depression, anxiety, and COVID-19-related internalized stigma. For the first time from Nepal, our data suggests that COVID-19-related internalized stigma is associated with anxiety and depression symptoms, perceived below-average socioeconomic status, involuntary admission, prior experience of being in isolation and quarantine, recent COVID-19 positive report, self-blame, below-average socioeconomic status and no income in the past one month. Mitigating and preventing internalized stigma associated with a public health crisis such as COVID-19 is imperative by diagnosing and treating such mental health issues early and designing interventions and policies especially targeting vulnerable populations focusing on their economic background and socio-cultural beliefs.
... There was also a tendency to focus on one identity factor, such as 'indigenous' participants, without further differentiating these cases. Table 2 summarizes a range of articles from the 172 reviewed; these included autoethnographic (Ashlee et al., 2017), ethnographic (Sharp, 2021) and narrative accounts (de Regt, 2017), qualitative interview-based studies (Meier, 2020;Peretz, 2017;Thorjussen and Sisjord, 2020), quantitative survey designs (Lord et al., 2019;Rahman et al., 2020) and analysis of secondary data (Earnshaw et al., 2021;Ugidos et al., 2020). Table 2 also identifies the main intersectionality-related findings in the selection of studies, highlighting how each study could be grouped together in different ways around engagement with intersectional methods (Ashlee et al., 2017;de Regt, 2017;Wiens et al., 2020), the use of intersectionality to contribute new insights in a disciplinary field or context of study (Lord et al., 2019;Thorjussen and Sisjord, 2020), to better understand social injustices or inequality (Meier, 2020;Rahman et al., 2020;Ugidos et al., 2020), or to engage in acts of resistance or liberation (Ashlee et al., 2017;Peretz, 2017). ...
... Table 2 summarizes a range of articles from the 172 reviewed; these included autoethnographic (Ashlee et al., 2017), ethnographic (Sharp, 2021) and narrative accounts (de Regt, 2017), qualitative interview-based studies (Meier, 2020;Peretz, 2017;Thorjussen and Sisjord, 2020), quantitative survey designs (Lord et al., 2019;Rahman et al., 2020) and analysis of secondary data (Earnshaw et al., 2021;Ugidos et al., 2020). Table 2 also identifies the main intersectionality-related findings in the selection of studies, highlighting how each study could be grouped together in different ways around engagement with intersectional methods (Ashlee et al., 2017;de Regt, 2017;Wiens et al., 2020), the use of intersectionality to contribute new insights in a disciplinary field or context of study (Lord et al., 2019;Thorjussen and Sisjord, 2020), to better understand social injustices or inequality (Meier, 2020;Rahman et al., 2020;Ugidos et al., 2020), or to engage in acts of resistance or liberation (Ashlee et al., 2017;Peretz, 2017). We explore in greater detail how and why some of these articles adopt additive thinking and articulation relational frames in the next section. ...
Data's increasing role in society and high profile reproduction of inequalities is in tension with traditional methods of using social data for social justice. Alongside this, ‘intersectionality’ has increased in prominence as a critical social theory and praxis to address inequalities. Yet, there is not a comprehensive review of how intersectionality is operationalized in research data practice. In this study, we examined how intersectionality researchers across a range of disciplines conduct intersectional analysis as a means of unpacking how intersectional praxis may advance an intersectional data science agenda. To explore how intersectionality researchers collect and analyze data, we conducted a critical discourse analysis approach in a review of 172 articles that stated using an intersectional approach in some way. We contemplated whether and how Collins’ three frames of relationality were evident in their approach. We found an over-reliance on the additive thinking frame in quantitative research, which poses limits on the potential for this research to address structural inequality. We suggest ways in which intersectional data science could adopt an articulation mindset to improve on this tendency.
... This result was consistent with a previous study indicating that discrimination frequency was lower in 2021 than it was in 2020 10 . Although inconsistent with the results of a study conducted on the general population claiming that discrimination frequency had not decreased after a month duration 22 . Based on the difference in results, it can be inferred that a longer period between the first and second points of measurement would result in a noticeable reduction. ...
The psychological distress experienced by coronavirus disease of 2019 (COVID-19) survivors after recovery from the illness is amplified by discrimination endured because of their infection status. However, the difference in the risk of facing discrimination and risk of experiencing psychological distress in the early and late waves of the COVID-19 pandemic remain unclear. This study aimed to investigate whether the risk of facing discrimination because of infection status was lower in the early or late waves and whether risk of discrimination on psychological distress was more serious in later, rather than earlier waves. We conducted two online surveys to collect data from survivors divided into two groups. The participants with scores of five or more on the Kessler Psychological Distress Scale were identified as having experienced psychological distress. The participants were identified as having experienced discrimination based on infection status if they had endured being blamed, some type of discrimination, or having themselves or their families maligned. The timing of infection was split into infected during early waves of the pandemic for 2021 participants and infected during later waves of the pandemic for 2022 participants. Modified Poisson regression analyses were performed using experiences of discrimination as criteria and timing of infection as predictors. Modified Poisson regression analyses were further performed using the presence of psychological distress as a criteria and experiences of discrimination and timing of infection as the criteria, in addition to interaction effect of these es. The data of 6010 participants who were infected in early waves and 5344 participants who were infected in later waves were analyzed. The risks of being blamed, some forms of discrimination, and participants and their families being maligned were significantly lower in the group who were infected in later waves than those infected in earlier waves. Experiences of discrimination were highly associated with psychological distress in those infected in later waves than those infected in earlier waves, while only being blamed showed a significant association. Risk of discrimination was found to be lower in those infected in later waves, whereas risk of discrimination on psychological distress was shown to be more serious in those infected in later waves. Therefore, we submit that it is more important to support COVID-19 survivors who face discrimination, than it is to attempt to decrease the current discriminatory climate caused by the COVID-19 pandemic.
... Evidence suggested that people infected with COVID-19 not only feel ostracized but also internalize public stigma and thus are reluctant to reconnect with society after the end of their quarantine period (9). Given the ramifications of COVID-19related stigma, a growing number of studies have emerged, assessing its psychosocial correlates, including health literacy about COVID-19, media broadcasts of biased information about COVID-19, fear and anxiety about contracting COVID-19, and quarantine and social-distancing policies (10)(11)(12). Moreover, several demographic factors, including gender, age, education level, and employment status, have been associated with COVID-19related stigma (13). ...
Objective
Infectious diseases including COVID-19 and mental disorders are two of the most common health conditions associated with stigma. However, the comparative stigma of these two conditions has received less attention in research. This study aimed to compare the prevalence of stigmatizing views toward people with COVID-19 and mental disorders and the factors associated with these views, among a large sample of adolescent and young adult students in China.
Methods
A total of 9,749 adolescents and young adults aged 15–24 years completed a survey on stigmatizing attitudes toward COVID-19 and mental disorders, as well as mental health-related factors, including general mental health status and symptoms of depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD). Multivariable linear regression analyses were conducted to identify factors associated with stigmatizing views.
Findings
The prevalence of COVID-19 and mental disorders-related stigma was 17.2% and 40.7%, respectively. COVID-19-related stigma scores were significantly higher among male students (β = 0.025, p < 0.05), those without quarantine experience (β = 0.035, p < 0.001), those with lower educational level (p < 0.001), those with lower family income (p < 0.01), and those with higher PTSD symptoms (β = 0.045, p < 0.05). Mental disorder-related stigma scores were significantly higher among individuals with average and lower-than-average levels of family income (p < 0.01), depression symptoms (β = 0.056, p < 0.001), anxiety symptoms (β = 0.051, p < 0.001), and mental health problems (β = 0.027, p < 0.05).
Conclusion
The stigma of mental disorders is higher in the youth population than the stigma of COVID-19. Factors associated with stigmatizing attitudes toward people with COVID-19 and mental disorders varied across the youth. Stigma-reduction interventions among the youth should be targeted specifically to COVID-19 or mental disorders conditions.
... Es ist daher zu vermuten, dass auch bei einer Infektion mit SARS-CoV-2 Stigma-tisierungsprozesse auftreten können [4,25,26]. In der internationalen Literatur, die im Rahmen der Coronapandemie bisher zu diesem Thema entstanden ist, zeigt sich, dass die mit COVID-19 verbundene Stigmatisierung weit verbreitet, vielfältig und dynamisch ist [27][28][29]. ...
Background:
Self-stigmatization in the context of infectious diseases can be a psychosocial burden and reduce the cooperation with infection control measures. This study investigates for the first time the level of self-stigmatization among individuals with different social and medical vulnerabilities in Germany.
Methods:
Data are derived from an online survey (CAWI: Computer Assisted Web Interview) conducted during the COVID-19 pandemic in winter 2020/21. The quota sample (N = 2536) is representative for the key variables gender, age, education, and place of residence for the German adult population. For operationalizing COVID-19 related self-stigmatization, we developed a new scale. We also collected information on medical and social vulnerabilities as well as trust in institutions. Data analysis was based on descriptive statistics and multiple ordinary least squares (OLS) regression.
Results:
Overall, we find a level of self-stigmatization slightly over the scale mean. While socially vulnerable groups do not have higher levels of self-stigmatization - with the exception of women - individuals with medical vulnerabilities (higher infection risks, poor health status, risk group) show higher levels of self-stigma. Higher trust in institutions is associated with higher levels of self-stigmatization.
Discussion:
Stigmatization should be regularly monitored during pandemics and considered in communication measures. Thus, it is important to pay attention to less stigmatizing formulations and to point out risks without defining risk groups.
... There is also research highlighting socio-spatial precariousness as a result of the oppressive coexistence experienced by many LGBTI people (Ugidos et al., 2020). ...
Objective:
To measure the knowledge and attitudes of Catalan nursing students regarding lesbian, gay, bisexual, trans and intersex (LGBTI) patients, as well as their perception of specific training in this area, according to their internship modalities, sociodemographic circumstances and academic background during the COVID-19 pandemic.
Background:
During the COVID-19 pandemic, the Spanish Government created the "Health-Aid" internship: a paid alternative to curricular internships. There is extensive evidence that paid work environments perpetuate negative attitudes towards LGBTI patients.
Method:
Cross-sectional survey aimed at Catalan nursing students. The "Attitudes Towards and Knowledge About Lesbian, Gay, Bisexual, Trans and Intersex Patients" questionnaire was adapted. Descriptive study and backward regression models were constructed.
Results:
337 students, mean age 23.80 years (SD: 5.17) participated. 85% women and 54 (16%) completing the Health Aid internship modality. More than 50% did not attend specific training on the care of the LGBTI population. Differences between internship modalities showed higher values in the curricular internship group: attitudes (U = 6526.50, p = 0.031) and training perception (U = 5926.50, p = 0.008).
Conclusions:
Nursing students' attitudes towards LGBTI patients and their perception of specific training on care for this population were negatively influenced by the paid Health Aid internship during the pandemic.
Implications for nursing management:
Even under dire circumstances, clinical training must be properly managed to address the specific health needs of vulnerable populations, such as LGTBI patients. Paid internships in emergency scenarios may impede these objectives.
... A recent study from Spain using a survey among the general population could demonstrate that discrimination and internalised stigma increased and decreased with the dynamic of the pandemic. 28 To the best of our knowledge, no study so far assessed COVID-19-related stigma in survivors from high-income countries. Therefore, our objective was to evaluate the level and dimensions of experienced stigma and applied coping strategies in COVID-19 survivors during the early pandemic in a high-income setting. ...
... 12 13 16 25 42 In some studies, stigmatising attitudes were linked to experienced vulnerability, poor education and conflicting information in the media, 17 22 24 44 pointing out the necessity of careful communication and precise information about COVID-19. 28 On the other hand, a strong, solidary social network and sound relationships were valuable resources to cope with stigma. 23 39 43 45 This might work in both directions: For those not infected, COVID-19 is not reduced to a faceless, dangerous virus, but connected to a human being. ...
... Information about COVID-19 in social media is often incorrect 58 or biased 24 and people have difficulties finding reliable sources 11 to distinguish between fake and fact. In line with previous research, 28 we emphasise the need of providing accurate information and exposing misinformation on disease prevention and treatment to end COVID-19-related stigma. ...
Objective
Health-related stigma is considered a social determinant of health equity and a hidden burden of disease. This study aimed to assess the level and dimensions of stigma and respective coping mechanisms in COVID-19 survivors.
Methods
A mixed-methods study with sequential explanatory design was conducted at the University Hospital of Ulm, Germany. Stigma was assessed using the Social Impact Scale (SIS) including adult COVID-19 survivors with mild-to-severe disease. Subsequently, 14 participants were sampled with regard to gender, age and severity of disease for in-depth interviews to understand how stigma was experienced and coping strategies were applied. The questionnaire was analysed using descriptive statistics, t-test and analysis of variance. Content analysis was used for qualitative data.
Results
From 61 participants, 58% were men and mean age was 51 years. The quantitative analysis of the SIS indicated an intermediate level of experienced stigma. Participants experienced stigma mainly as ‘social rejection’ (M=14.22, SD=4.91), followed by ‘social isolation’ (M=10.17, SD=4.16) and ‘internalised shame’ (M=8.39, SD=3.32). There was no significant difference in experienced stigma regarding gender, education, occupational status or residual symptoms. However, participants between 30 and 39 years of age experienced higher levels of stigma than other age groups (p=0.034). The qualitative analysis revealed how stigma seemed to arise from misconceptions creating irrational fear of infection, leading to stereotyping, vilification, discrimination and social exclusion of COVID-19 survivors, leaving them feeling vulnerable. Stigma cut through all social levels, from the individual level at the bottom to the institutional and societal level at the top. Social networks protected from experiencing stigma.
Conclusion
COVID-19-related stigma is a relevant burden in the ongoing pandemic. Providing accurate information and exposing misinformation on disease prevention and treatment seems key to end COVID-19-related stigma.
... Since the coronavirus disease 2019 (COVID-19) outbreak, the stigma associated with COVID-19 has been of broad interest to the public, researchers of multiple disciplines (e.g., psychologists, sociologists), and policymakers concerning social harmony and public mental health. A series of studies have investigated the public's COVID-19 stigma from multiple lenses, including the public's feelings toward people who are stigmatized because of COVID-19 (e.g., Ransing et al., 2020;Ugidos et al., 2020), people being stigmatized during the pandemic (e.g., Baldassarre et al., 2020;Bruns et al., 2020;Earnshaw et al., 2020;He et al., 2020;Muhidin et al., 2020;Jennings et al., 2021), and their thoughts about the harm of COVID-19 stigma to the public's health and the whole society (Das, 2020). In addition, the public not only held negative attitudes toward COVID-19 related people and groups but also to the innocent people who were unassociated with COVID-19, such as people with a religious belief (i.e., Muslims) (Islam et al., 2021). ...
... Existing literature on COVID-19 stigma has explored the public's negative emotions (e.g., fear) toward the COVID-19 patients (Ahorsu et al., 2020;Kumar and Nayar, 2020), avoidance of people residing in the COVID-19 affected regions (Ransing et al., 2020;Xin et al., 2020), and negative attitudes toward people who suffered from COVID-19 (Ugidos et al., 2020). However, most of these studies on COVID-19 stigma assessed only one or two dimensions of COVID-19 stigma and investigated it independently without comparing it with other disease stigmas, which couldn't address the common and different dimensions of COVID-19 stigma other than other stigmas. ...
... Prior studies on the pandemic stigmas have uncovered the public's discriminatory attitudes toward disease-related people and groups (Ahorsu et al., 2020;Kumar and Nayar, 2020;Ransing et al., 2020;Ugidos et al., 2020;Xin et al., 2020;Nguyen et al., 2021). Among previous studies, a few attempts have been made to compare the newly emerging pandemic disease-related stigma with other stigmas. ...
Since the outbreak of COVID-19, the public stigma associated with COVID-19 has emerged. To better understand the COVID-19 stigma, the present research conducted three studies on 1,493 Chinese participants from the outbreak to the recovery period of the COVID-19 pandemic to examine the psychological mechanisms of COVID-19 stigma by comparing it with other disease-related stigmas in terms of their explicit and implicit processes. Study 1 and Study 2 jointly demonstrated that the public endorsed more stigma toward the COVID-19 related people (i.e., the COVID-19 patients) relative to the other disease-related people (i.e., the SARS patients, people with flu) in multiple explicit aspects, including emotional, motivational, cognitive, and social processing. Using the implicit association test (IAT), Study 3 found no significant difference in the implicit measures of the COVID-19 vs. the SARS groups, which further revealed that the pandemic stigmas (i.e., COVID-19 and SARS) were similar at the implicit level. These findings suggest common (implicit level) but distinct (explicit level) psychological processes of the pandemic-related stigmas, which provide reference to policymakers in formulating suitable interventions to deal with COVID-19 stigma and a newly generated potential stigma and provide psychological support for the public in the future.
