By Monica Schoch-Spana, PhD, Ann Norwood, MD, Nidhi Bouri, and Kunal Rambhia, April 30, 2009
What is Stigma in the Context of a Disease Outbreak?
Stigma comes from the need to fix blame during an outbreak of contagious disease. People are trying to answer basic questions: “Where did this come from?” and “How is it spreading?” In their desire to understand and avoid illness, people often create a mental distinction between “us” (the uninfected) and “them” (the infected). This may feel like a good first step toward safety. But it is often based on an inaccurate picture of health risk, and it often derives from pre-existing social differences and prejudices. A whole country or group of people may be singled out as the source of the problem—rather than the germ. Right now, Mexico and, more broadly, Spanish-speaking people are seen by some as the “cause” of 2009 H1N1 (“swine flu”).
Why do People Tend to Blame “Outsiders” for Contagion?
Pointing a finger helps turn a mysterious illness into something that feels more familiar and more controllable. “Outsiders” are easy targets. People with a different national, ethnic, or religious background have historically been accused of spreading germs, regardless of what the science says. During the 2003 SARS crisis, 84% of surveyed Chinatown businesses in New York City reported a drop in trade, despite the limited presence of disease. In the early 1980s, Haitians were blamed for AIDS, despite the fact that the disease was spread via particular behaviors and not specific kinds of people. Typhoid Mary was vilified not just for infecting people through her cooking, but also for being a working class Irish immigrant, a detested social group in her day.