Cultural variation in health stigmatization and stigma-relevant judgements

Stigma is a multilevel, group-based phenomenon entailing the rejection of individuals who carry a stigmatizing mark. Many early examples of stigma in the social sciences (e.g., Goffman, 1963) were relevant to health domains (e.g., amputation and skin blemishes). Although Oaten, Stevenson, Occhipinti, Tapp, and Case (2022) recently provided support for an evolutionary model of stigma first advanced by Kurzban and Leary (2001), few stigma studies have explicitly addressed cultural factors as potential drivers of stigma. In the domain of health, although a large amount of work addresses mental health stigma, including work sensitive to culture, few researchers have addressed the impact of culture on stigma-relevant judgements. Informed by communication accommodation theory (CAT), the present study examined across 3 cultures how people perceive and stigmatize people with different health conditions. Participants from Australia (N = 449), Hong Kong SAR (N= 631), and the Philippines (N = 333; total N= 1,413) completed an online survey assessing moralisation of the health condition, perceived family blame, perceived disease risk and prevalence, controllability (including avoidance), and sociodemographic and identity variables. Judgements were made in the context of: mental health conditions, obesity, HIV/AIDS, contagious conditions, and autism-spectrum disorder (ASD). These conditions were chosen via interviews in an initial qualitative component of the research. Mean differences in judgements were assessed with 5 (health condition) X 3 (culture) ANOVAs. The prediction of perceived public stigma by the focal variables was assessed with within-culture OLS regressions. Results indicated broad agreement across cultures in stigmatizing judgements with some distinct exceptions (e.g., more stigmatisation of ASD in Hong Kong; more controllability beliefs but less public stigma in Australia). Regressions suggested that judgements in Australia and the Philippines were more similar to each other than to those in Hong Kong. Results are discussed in terms of cultural systems.