Patient stigma, medical interactions, and health care disparities: A selective review

Healthcare disparities represent differences in the quality of healthcare received by different racial/ ethnic or social groups that are the result of inequitable economic, political, social, and psychological processes. This chapter examines enacted stigma (negative feelings, thoughts, and actions) among health care providers and felt stigma among their patients (awareness of the biases and discrimination directed toward them because of their stigmatized condition), each of which can produce disparities in healthcare for stigmatized patients. These processes are considered for individuals from four stigmatized groups: Racial minority group members, people who have above average weight or are considered obese, individuals living with HIV, and people with certain cancers. Stronger enacted stigma and felt stigma make communication in interactions with healthcare providers less productive, informative, and positive for members of all four groups. Ultimately, poorer quality communication can contribute to poorer outcomes from these interactions, and thus disparities in health status.