Dangerous infectious disease stigmas often formed by misguided health messages

A message can say more than is actually written, especially in the realm of healthcare, a new study finds.

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According to researcher Rachel Smith, associate professor of communication arts and sciences and investigator with Penn State University’s Center for Infectious Disease Dynamics, and her team, the drafting of public health messages can significantly affect how the public will react to a given infectious disease. The syntax and presentation of a health bulletin can form stigmas that, in turn, influence the likelihood of public endorsement for authoritative interventions — like isolating infected persons, mandating they receive treatment and mapping their location.

“Stigma-related processes have been a concern for some time,” Smith noted. “This research shows that we’re building strong theories to understand why and how our communication about infectious diseases can shape stigma-related processes: how people think, feel, and react to it. With theories, we can anticipate when communication about infectious diseases can trigger stigmas and stigmatization, and have a means by which to revise our communications so as to avoid them.”

To measure public reaction probabilities, Smith cultivated a hypothetical disease — carried by rodents — and developed 16 various health alerts summarizing the fictitious ailment and those inflicted. According to a press release: “The alerts, based on an existing alert developed by the Centers for Disease Control, indicated whether or not infected people were labeled by the disease. The alerts also indicated the disease was transmissible or not transmissible between humans; had visible symptoms (open sores on arms and a wet, loud cough) or no visible symptoms; and was fatal, painful and caused paranoid delusions, or was mild and easy to cure.”

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From the results, Smith was able form the Model of Stigma Communication, comprised of four content cues: disease symptoms, labels associated with infected persons, perceptions of dangerousness, and responsibility.

"These content cues can elicit responses such as disgust and anger," Smith said in the news release. "They can also shape the development of stigma and influence the likelihood that people will share a stigma message with others or endorse isolating and removing stigmatized people from community."

Smith found that people were more apt to share stigmas in a health alert if visual symptoms were present.

"The visible symptom might suggest that infected persons are different," she said, "and this could facilitate social bonding among people spreading the rumor, even if infected persons are not considered a group in and of themselves."

The model and the strength of the results were particularly shocking, Smith told PhysBizTech: “The model for stigma communication, tested in this experiment, predicted over half of the variance in participants’ support for rather dramatic actions, such as forcing infected persons to receive wanted treatment, to register infected persons, and have publically accessible maps of infected persons’ locations. In social science research, it is usual to predict so much and to see such variance: Participants’ responses, depending on the version of the health alert they read, varied from strong disagreement to strong agreement with such actions.”

Those establishing and perpetuating health messages are encouraged to pay particular attention to the ways in which a disease and those patients battling it are labeled.

“This experiment’s results provide some insight into how health alerts can inform the public about infectious diseases without stigma-related outcomes,” Smith said. “Communication focusing on the condition (its affects and how to respond) instead of on infected persons can convey concerns about the infectious disease without triggering stigma-related processes. We’re trying to avoid framing the person as the illness. This is just the beginning; there is more work to be done. Completing this work in transdisciplinary teams is challenging, but provides us the opportunity for real breakthroughs in theory development, clinical interactions and intervention designs. Together we can thoughtfully design and carefully evaluate how well our health communication strategies are encouraging intended health outcomes, without encouraging unintended ones.”

The results will be published in a forthcoming issue of Communication Monographs and are available online now. [See also: Virus update: West Nile still out for blood]

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