Weaver Lesley Jo, Trainer Sarah
University of Alabama, Tuscaloosa, USA.
Obesity Solutions, Arizona State University, West Hall, 1000 South Cady Mall, Tempe, AZ, 85287, USA.
Cult Med Psychiatry. 2017 Sep;41(3):319-340. doi: 10.1007/s11013-016-9518-3.
Stigma is a powerful determinant of physical and mental health around the world, a perennial public health concern that is particularly resistant to change. This article builds from sociologist Erving Goffman's classic conception of stigma as a unitary social phenomenon to explore the stigma attached to two seemingly dissimilar conditions: food insecurity in rural Brazil, and obesity in the urban United Arab Emirates. Our analyses underscore that both conditions are stigmatized because they represent a departure from a deeply-held social norm, and in both cases, self-stigma plays an important role. Furthermore, in both cases, the stigma associated with food insecurity and obesity is likely at least as harmful to personal wellbeing as are the biological consequences of these conditions. Finally, evidence increasingly links obesity and food insecurity causally. Our analyses suggest that these forms of stigma transcend individuals and are largely structural in their origins, and therefore that they are most likely to be improved through structural change.
耻辱感是全球身心健康的一个重要决定因素,是一个长期存在的公共卫生问题,尤其难以改变。本文以社会学家欧文·戈夫曼关于耻辱感是一种单一社会现象的经典概念为基础,探讨与两种看似不同的情况相关的耻辱感:巴西农村的粮食不安全问题和阿联酋城市的肥胖问题。我们的分析强调,这两种情况都受到污名化,因为它们偏离了一种根深蒂固的社会规范,而且在这两种情况下,自我耻辱感都起着重要作用。此外,在这两种情况下,与粮食不安全和肥胖相关的耻辱感对个人幸福的危害可能至少与这些情况的生物学后果一样大。最后,越来越多的证据将肥胖与粮食不安全因果联系起来。我们的分析表明,这些耻辱感形式超越了个体,其根源在很大程度上是结构性的,因此最有可能通过结构性变革得到改善。