Health Stigma and the Human Impulse for Denial

Health stigma presents a difficult problem because it prompts competing human impulses of cruelty and denial. Together, these impulses get in the way of better health. Attach stigma to a disease or a health condition and the people who have it begin to feel socially undesirable and isolated. So understandably, they may hide the condition, avoid the label of it, and even avoid thinking about it.

The Stigma of Cancer

For a long time, the word cancer has carried potent stigma. Because good options for treatment were scarce, it was an ominous diagnosis. Jimmie Holland and Jane Gooen-Piels explain:

“The stigma that cancer equals death, which has been attached to the disease for centuries, led to the long-respected dictum that doctors should not tell patients that they had cancer. To do so was considered cruel and would take away patients’ hope (Table 70-1). For centuries, indeed, there was no treatment, and both doctors and patients had a fatalistic attitude as they awaited the inevitable outcome.”

The emergence of better science for understanding and treating cancer has brought down, but not eliminated, the stigma attached to this condition. A recent literature review found that it remains higher in developing countries. But in England, for example, a recent study found cancer stigma to be generally low, though still present. It seems that a substantial portion (16-31%) of the public thinks financial discrimination against persons with a cancer diagnosis is acceptable, doesn’t believe they deserve the best possible care (10-17%), feels awkward around them (10-17%), or holds them personally responsible for their condition (8-11%).

Thus the stigma of cancer serves to promote denial about the condition and erode a person’s prospects for health. People are less likely to have cancer screening when cancer stigma is higher. They are more likely to conceal the diagnosis and delay treatment.

Similarities and Differences with Obesity

Clearly, obesity presents a different case of health stigma. For one thing, the stigma attached to obesity is so strong that some fat activists seek to deny it is a real medical condition. Some even treat the word as an epithet, spelling it as ob*sity.

This expression of a human impulse for denial of a condition linked to so much stigma should not surprise us. The real problem here is ignorance about the condition, a history of poor options for treatment, and the stigma that results.

There is good news for us on this subject, though. Scientific understanding of the disease is improving. Options for treatment are making big leaps forward. And most reasonable people agree that weight bias and obesity stigma are important problems we cannot neglect to solve.

So better days lie ahead.

Click here, here, here, and here for further perspective on the stigma of cancer. For further perspective on the stigma of obesity, click here.

Oak Fractured by Lightning, allegory on the death of the artist’s wife, painting by Maxim Vorobiev / WikiArt

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June 11, 2023