Several studies have documented the role of stigma as a barrier to access and use of health and social care services in different settings, most of them offering suggestions on how to minimise the impact on those at risk of stigmatisation. Despite the availability of research and subsequent interventions, such as See Me and Time to Change, stigma remains a constant risk factor for ill-health and wellbeing amongst vulnerable groups, particularly minority ethnic communities in the UK). Most research and subsequent interventions into stigmatisation focus on tackling external stigma, defined here as stigma directed towards individuals by external players, for example, friends, family and members of the community or wider society. This article rather examines the issue of internalised stigma, that is, the individual’s own sense of devaluation and discrimination. It is informed by existing literature and findings from a pilot qualitative research study involving HIV positive immigrant Black African men and their families living in London. The paper concludes with policy and practice suggestions to tackle health issues relating to stigma.
Key messages
- The concept of stigma covers a number of interrelated components, such as stereotyping, labelling, loss of status, power exertion and discrimination. Externalised stigma results from the actions of external players, internalised stigma is an individual’s own sense of devaluation and discrimination.
- Black Africans and other minority ethnic groups in the UK are likely to perceive themselves as outsiders, hence they are likely to experience stigma. This may have knock on effects, such as shunning health and social care services.
- Evidence suggests that HIV positive Black Africans in the UK are likely to conceal their HIV status and to forfeit potential sources of social support because of internalised stigma.
- There is need for research into internalised stigma among minority ethnic groups in the UK to inform current and future campaigns addressing stigma. Such research and subsequent interventions should involve all stakeholders involved in services targeting minority ethnic groups in the UK.
Sections
- The concepts of stigma and the outsider complex
- Black and other minority ethnic groups as outsiders in the UK
- Internalised stigma as a barrier to accessing social support by HIV positive African immigrants
in London, UK - Implications for policy and practice
Author(s): John O A Owuor; Jane N Nake;
Briefing series: Better Health Briefing Paper 36
Publisher: Race Equality Foundation
Publication date: April 2015
