Stress, Stigma, & Minority Health
Friday, May 22, 2020
Posted by: Karen Hardin
This article is part of the "Did You Know" article series presented by OPA's Committee on Social Responsibility.
Written by: Amy Kerr, MEd, Clinical Psychology Graduate Student, Miami University
As psychologists, we have a responsibility to advocate for health equity, as the health disparities that currently exist in the United States directly affect our clients and communities. These disparities exist for people belonging to various minority populations, including racial and ethnic minority groups, members of the LGBTQ+ community, people with disabilities, and people of low socioeconomic status. Though health outcomes and disparities differ among populations, people from minority populations are generally at higher risk for a variety of health problems such as heart disease, obesity, and pre-term infant birth (National Academies of Science, Engineering, and Medicine, 2017). These disparities have generally persisted despite efforts to increase health equity and improve health outcomes for people from minority groups.
While a wide variety of factors impact health outcomes, evidence suggests that the stigma and stress of minority status may be driving these disparities. Stigma can be defined in sociological terms as concurrent labeling, stereotyping, separation, loss of status, and discrimination in a context involving power dynamics, and is related to a variety of factors that influence health outcomes, such as access to housing and healthcare, educational and employment opportunities, and level of social support (Hatzenbuehler, Phelan, & Link, 2013). Limited access to resources and supports leads to added stress for individuals in many minority populations. Additional stressors experienced by people holding minority identities include facing discrimination, macroaggressions, and internalized prejudice (e.g., internalized racism or homophobia) that influences their sense of self (Hatzenbuehler et al., 2013; American Psychological Association [APA], 2017).
High levels of stress have been linked to a variety of negative health outcomes, including those listed above. Additionally, stress may lead to sleep difficulties, increases in maladaptive coping behaviors such as substance use, and difficulty self-regulating and recovering from stress, as well as exacerbating other mental health problems (APA, 2017). The serious consequences of stigma and related stress on the health of minority communities points to the need for psychologists to promote greater health equity for their clients and communities.
Psychologists are already doing a great deal to help people from minorities cope with the stigma and additional stressors they face and to reduce health disparities for minority populations. These efforts range from providing culturally adapted cognitive behavioral stress management interventions at the individual level to public policy advocacy and efforts to increase access to healthcare and other resources at the community level (APA, 2017). In addition to these efforts, psychologists must advocate for broad social change in order to help reduce the stigmas that are a fundamental cause of health disparities (Hatzenbuehler et al., 2013). See below for a list of suggestions on how you can continue these efforts.
What can psychologists do?
- Conduct further research on how prejudice and discrimination influence health outcomes. Employ research methods that allow for members of minority populations to share their perspectives and serve as collaborators, such as community based participatory research.
- Advocate for legislation and policies that promote health for minority populations, including policies aimed at increasing access to health and mental health care as well as those aimed at reducing discrimination.
- Clinicians and trainees should continue to seek education and build cultural competence in working with individuals holding various minority identities.
- Connect with local organizations and advocacy groups that aim to combat prejudice and discrimination.
American Psychological Association, APA Working Group on Stress and Health Disparities.
(2017). Stress and health disparities: Contexts, mechanisms, and interventions among
racial/ethnic minority and low-socioeconomic status populations. Retrieved from
Hatzenbuehler, M. L., Phelan, J. C, & Link, B. G. (2013). Stigma as a fundamental cause of
population health inequalities. American Journal of Public Health, 1(3), 813-821.
National Academies of Sciences, Engineering, and Medicine. 2017. Communities in action:
Pathways to health equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/24624