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A Novel Method for Measuring Stigma in Health: Evidence from Adolescents During COVID-19

37 Pages Posted: 14 Feb 2022

See all articles by Elisa Cavatorta

Elisa Cavatorta

King’s College London

Ihab Shukri

Palestinian Ministry of Education

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Abstract

Background: Health-related stigma carries a heavy burden on the individual and on society. This study illustrates a novel method to reveal stigmatisation that overcomes limitations of existing methods. 

Methods: The method is based on a conjoint experimental design. It is illustrated in the context of stigmatisation due to SARS-CoV-2 exposure in a sample of 5,757 secondary-school children from a developing country. The general method is framed as a realistic decision for this study’s target population: choosing a classmate as desk-mate on the first day of school. The experimental design allows to causally measure discriminatory intent due to specific classmate characteristics. Discrimination is calculated by comparing the probability of a classmate recovered from SARS-CoV-2 exposure being chosen to that of a classmate not exposed but otherwise identical. How discrimination varies when the classmate is from a marginalised community (‘multiple stigma’) and by members within and outside the marginalised community is also assessed. 

Findings: Classmates recovered from COVID-19 are chosen 25% less frequently (Odd Ratio=0.75). The rate is similar across genders, age groups and parental education. Discrimination due to COVID-19 is larger when the affected classmate is from a different community: out-group classmates affected by COVID-19 are chosen 35% less frequently by one community and 57% less by the other (OR=0.65;0.43). Direct familiarity with COVID-19 eliminates discrimination (OR statistically identical to 1); indirect familiarity reduces discrimination from 30% to 17%. Knowledge of COVID-19 is not correlated with discrimination. 

Interpretation: The findings reveal a significant peer-to-peer discrimination due to COVID19 among school-aged children, and double stigma against people originating from marginalised communities. The method offers an alternative to existing measures when assessing multiple stigmatised conditions and cross-cultural comparability on a common metric is desirable.

Funding Information: None.

Declaration of Interests: We declare no conflict of interest.

Ethics Approval Statement: The Ethical Review Board of King’s College London approved the study and informed consent was collected from all participants.

Keywords: Stigma, discrimination, adolescents, measurement

Suggested Citation

Cavatorta, Elisa and Shukri, Ihab, A Novel Method for Measuring Stigma in Health: Evidence from Adolescents During COVID-19. Available at SSRN: https://ssrn.com/abstract=4034483 or http://dx.doi.org/10.2139/ssrn.4034483

Elisa Cavatorta (Contact Author)

King’s College London ( email )

Strand
London, England WC2R 2LS
United Kingdom

Ihab Shukri

Palestinian Ministry of Education ( email )

Palestine

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