Public Health Measures and Stigma

Many public health measures can have a greater impact on certain disadvantage classes or social groups. This may attenuate, at least temporarily, the social inequalities in health as these groups have a higher prevalence of the conditions that public health measures want to address, but it can also stigmatize them, which in turn will exacerbate again health inequities. We describe the concepts of social class, classism and stigma, and analyse different currents of thought that have conceived the role of stigma within public health. It is accepted that in exceptional conditions some public health measures with certain stigmatising effects as an unintended consequence, but never deliberately, as a nuclear or exclusive component of the intervention, can be supported. Finally, we propose several conditions that must be met to avoid or minimize the stigma in public health actions: the participation of the classes and social groups involved in the decision making; independent ethical surveillance; to avoid the individualization of public health problems, which blames the victim, and emphasise that they are predominantly collective problems; sufficient compensation for the individuals and groups harmed; and the effort to confront and correct the deep and structural causes of health inequalities.