Communicating about and in the context of stigma: Lessons for health professionals

Health stigma is a widely understood phenomenon that impacts both the wellbeing of recipients of health care and the trajectories of their illness journeys. As stigma is a societal issue that results in largely negative consequences for the individuals who are members of stigmatised groups, solutions and understanding must also be located at a societal level. Of the different types of stigma relevant to health, mental health has received the most coverage by researchers, including those in Hong Kong. However, it is equally necessary to address general health stigma in a time when primary care has risen sharply in prominence, as stigmatising processes and beliefs could have a strongly negative impact on the uptake and likely success of primary care efforts. Problematically, theorising around general health stigma is less well-developed in Asian cultures than is that around mental health stigma and this may ultimately impede the development of practical, local efforts to address stigma and its consequences. In a multicultural and multilingual society such as Hong Kong, it is important to address the cultural bases of stigma and stigmatising beliefs. As well, communication norms will be implicated in these processes. The present paper will present results from several qualitative and quantitative studies that illustrate and contrast the ways in which stigma is enacted and communicated in the health domain, including by health professionals. These studies have been run in Hong Kong and Australia and involve lay people and some health care providers. The results suggest that: a) stigmas in Hong Kong have clearly defined loci (e.g., contagious conditions, mental health, and morally salient conditions); and b) that interpretations of stigma and stigma processes are sharply differentiated between Hong Kong and Western societies. In particular, the focus of morality in the identification of stigma targets and the way in which interpretations are shaped is discussed. The talk will conclude with implications for health care practice in Hong Kong.