Separating Disability Stigma from Health Stigma: Implications for Health Research and Policy

A key but under-addressed driver of the health inequalities facing persons with disabilities is disability stigma. However, disability stigma remains poorly conceptualised and consequently inconsistently measured and addressed within health research. Many studies treat disability stigma and health stigma as interchangeable. However, the International Classification of Functioning, Disability and Health (ICF) as the globally accepted framework for conceptualising disability clearly distinguishes between the concepts of “disability” and a “health condition”. This paper applies the ICF to show that disability stigma and health stigma have overlapping components but are conceptually distinct. Specifically, while health stigma is recognised to arise from adverse judgements about health conditions, this paper argues that disability stigma arises from adverse judgements about impairment(s), activity limitation(s), and/or health-related participation restriction(s) that may or may not relate to an individual’s health condition. This paper also explains why this distinction matters. First, it aligns the study of disability stigma with modern definitions of disability and the lived experiences persons with disabilities have of stigma. Second, it enables intersectional analysis of the impact of distinct stigmas arising from judgements about health condition(s) and disability status. Third, it contributes to better ways to measure disability stigma and consequently address it within interventions and policies. Fourth, it contributes to an improved classification of stigma within the ICF itself, which can be used to more comprehensively study health inequalities affecting persons with disabilities.