Cultural perspectives on health stigma: multilevel evidence from three cultures.

Stigmatization is associated with a large set of negative health behaviors and outcomes. Stigma itself is a multilevel, group-based phenomenon and is most amenable to a research perspective that is correspondingly multimodal. A key deficit of stigma research is the lack of a coherent model of culture. The research that examines health stigma in Asia is almost exclusively focused on mental health. Further, much of the research that does incorporate culture is based on Asian immigrant populations in Western cultures. By contrast, research on the cultural, psychological, and communicative underpinnings of health stigma in Asia is severely lacking. Accordingly, the current mixed methods research project addresses this deficit. Respondents from Hong Kong, the Philippines, and Australia took part in either an interview study (N = 83) in which they freely discussed potentially stigmatizing conditions; or a quantitative, online survey arm (N = 1413) in which perceptions of health conditions (selected based on the interview arm: mental health conditions; obesity; HIV; contagious conditions; autism spectrum disorder [ASD]) were gathered regarding perceived public stigma, personal stigma, and control beliefs. Preliminary analyses compare both Asian cultures to Australia. Highlights included: consistency between qualitative and quantitative components; a specific stigma for ASD in Hong Kong; and a complex but systematic pattern in the construction of stigma-relevant control beliefs across cultures in contrast to traditional, dimensional cultural analyses. Results are discussed in terms of theories of stigma in health communication and directions for future analyses and research will be advanced for discussion.