HEALTH Disease, Stigma And The Repercussions (NAPSA)—Thesocial aspects of certain diseases can be almost as challenging as the physical symptoms of the illness itself. That’s particularly true of diseases such as HIV/AIDS, incontinence, sexually transmitted dis- eases, mental and neurological conditions and others that are said to carry a stigma. Stigma is defined as “an attribute that is deeply discredit- ing and causes others to distance themselves.” The stigmas that surroundcertain diseases are now seen as factors that can influence a person’s decisions about seeking health care and taking the appropriate medicine. Even today, in both developed and developing countries, people with some illnesses—such as syphilis, tuberculosis or leprosy— can be shunned, isolated and even subject to violence. “In many ways, people with a stigmatized illness face problems on two fronts: the disease itself and the shame andprejudice that come with the diagnosis,” observed Byron J. Good, Ph.D., of Harvard Medical School. Said Good, “Some conditions— epilepsy, mental illness and sexu- ally transmitted diseases, for example—have tremendoussocial significance.” Concealing and denying symptoms For example, researchers have found that obese patients may cancel physician appointments because of weight concerns, with cancellations increasing as weight increases. In another study, stigma was What Determines Why Some Diseases Carry A Stigma? |s the disease or conditionvisible? Are thesignsof it disfiguring and upsetting? Does the condition interfere with social interaction? e Whatis the potential for dangerto others,infection or death? Howlikely are these consequences? @ identified as a factor that influ- enced sexually active teens not to seek care for sexually transmitted diseases and to perceive negative reactions of providers to questions about those infections. Stigma andself-esteem Sometimes to protect selfesteem, a person with a stigmatized disease will deny that a problem exists. According to Dr. Sandra M. Lowe, M.D. of the New York Uni- versity Medical Center, some people with a stigmatized condition use cognitive strategies, denial or minimization, others try to blend in unnoticed. Lowe says others avoid social encounters or use anger to respond to shame or use humor to respond to rejection. Stigma and healthcare providers Even health care professionals who are aware of the struggle faced by people with stigmatized illnesses can contribute to the problem. Said Dr. Alexandre Kalache of the World Health Organization, “Physicians and other professionals are not immune to society’s stigmatization of certain illnesses and their attitudes often reflect the attitudes of society.” As an example, Kalachecites the term GOMER, an acronym for “Get Out Of My Emergency Room” that is sometimes applied to older people with chronic dis- eases who frequently visit the ER. In another case, researchers at Yale University found a bias among health professionals against people whoare overweight. While the study found the bias among medical professionals was not as strong in the general population, researchers felt that the fact that it shows up among those dedicated to helping people with obesity at all shows just how strong the biasis. Changing perceptions about stigma Fortunately, some media have helped to combat stigma. For example, popular movies such as “Philadelphia,” “As Good As It Gets” and “A Beautiful Mind,” and television shows such as “Sesame Street,” have addressed the issue of stigma and the need for more understanding on the part of the public and professionals. The Pfizer Journal presents facts, opinions and commentary from thought leaders on issues concerning health and the future of medical care. It helps readers gain a deeper understanding of issues related to existing medical treatments, tomorrow’s therapies and behavior and environmentalissues that influence our health and well-being. The Health Repercussions Of Stigma edition of the Pfizer Journal can be found at www.thepfizerjournal.com.
