It’s safe to say that shame and stigma have run rampant throughout the coronavirus pandemic.
People are judged for their choices, whether it’s playing it too safe or engaging in social behaviors. Those associated with COVID-19 are more frequently being hit with a painful stigma: There have been anecdotes about being ghosted by friends after getting sick, hate crimes and racist rhetoric directed toward Asian Americans and some reports about people losing their jobs after contracting the virus.
Shaming isn’t unique to COVID-19. We’ve seen this play out before with other epidemics — mainly with HIV ― but also with more common health issues like smoking, substance use and obesity.
And even though shaming might at times feel like a productive way to alter someone’s behavior, it’s actually not. In fact, shaming usually backfires and makes people who feel the brunt of the blame less likely to engage with public health efforts like testing and contact tracing. In other words: It can lead to dangerous consequences.
Why We Shame Certain Health Issues
The first question worth asking here is, why do people shame others for health issues at all? Obviously, no one wants to get COVID-19. No one wants to give the infection to their grandmother or pass it on to someone who could develop a life-threatening complication and wind up in the intensive care unit.
We see stigma and shaming most often with conditions that are misunderstood and feared (think mental illness and substance use). This viewpoint is common with conditions that people falsely think are preventable ― like obesity, sexually transmitted illnesses, complications from smoking and now COVID-19. The thought here is that if a person’s actions contributed to them developing the condition, then they are responsible and can be blamed (and shamed). Of course, this pattern of thinking fails to address all the factors that contributed to the conditions.
According to Bruce Link, a professor of sociology and public policy at University of California, Riverside, casting shame and stigma creates an “us versus them” mentality, which allows people to find comfort in their own choices and feel distanced and separated from people who behave in a way they disagree with.
As one study put it, “us versus them” provides people with a false, misguided sense of security in the idea that “good things happen to to people who have been good, and bad things happen to people who have been bad.”
“People try to use stigma to control other people’s behavior.”
Shaming might also give the shamer a sense of control when they otherwise feel like they have no say in the matter (like a pandemic, for instance).
“In life and in public health, sometimes there is a stigmatization of behaviors that people want to control. People try to use stigma to control other people’s behavior,” said Link, who has researched shaming’s impact on public health.
How Shaming Impacts Public Health
According to Julia Marcus, an infectious disease epidemiologist and associate professor in the department of population medicine at Harvard Medical School, shaming ultimately winds up doing way more harm than good, particularly when it comes to slowing disease transmission.
“Shaming, from a public health perspective, doesn’t generally work as a strategy for changing people’s health behaviors, and actually it can do the opposite,” Marcus said.
Just take a look at the lessons we’ve learned years of research on HIV prevention. Though HIV and COVID-19 are two distinctly different infections, both are subject to major shaming — with HIV, the stigma falls on sexual pleasure, and with COVID-19, it’s social pleasure.
When these behaviors — both of which are important for our health — are stigmatized, the “message becomes, ‘You are a bad person if you do this thing,’” Marcus said. That stigma then creates a huge barrier to productive public health efforts.
According to past research on HIV, shaming can prevent people from disclosing their behaviors to doctors. It can also impact their willingness to receive treatment or care. It makes people less likely to get tested, even if they think they have a disease, and causes them to feel uncomfortable sharing their exposures with close friends and family. People want to protect themselves from being judged or looked down upon, even with relatives, Link said.
“What ends up happening is, rather than engaging with public health, people want to hide from it. Instead of deterring risky behavior, we end up deterring disclosure,” Marcus added.
“What ends up happening is, rather than engaging with public health, people want to hide from it. Instead of deterring risky behavior, we end up deterring disclosure.”
Public health efforts like testing and contact tracing are important tools that help us get a handle on disease transmission, but if people feel too burdened by shame and stigma to engage with these strategies, our entire public health system can be undercut.
Here’s What We Can Do Instead
Rather than shaming a person for their actions, try taking an empathetic approach. Acknowledge that no one sets out to contract or spread COVID-19, and that most often these things happen because people’s needs aren’t being met.
In some cases, this may be a financial need, causing someone to go to work where they are exposed to the coronavirus and unknowingly bring the infection home to their families. Human beings are also social creatures, and the pandemic restrictions have emphasized our need to interact and connect with loved ones. Some people don’t have access to the latest data regarding transmission or their risk.