Conceptualizing Stigma.pdf

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Conceptualizing StigmaAuthor(s): Bruce G. Link and Jo C. PhelanSource: Annual Review of Sociology, Vol. 27 (2001), pp. 363-385Published by: Annual ReviewsStable URL: http://www.jstor.org/stable/2678626 .

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Annu.Rev.Sociol. 2001. 27:363-85Copyright? 2001 by Annual eviews.All rights eserved

CONCEPTUALIZINGSTIGMA

BruceG. Link1 nd Jo C.Phelan2'ColumbiaUniversitynd New York tate sychiatric nstitute, ewYork, Y10032;e-mail: [email protected] ociology, olumbia University, ewYork, Y 10021;e-mail:[email protected]

Key Words labeling, tereotype,iscrimination,xclusion, eviance* Abstract Social cience esearch n tigma as grown ramatically ver he asttwo ecades, articularlyn ocialpsychology, here esearchersave lucidatedheways n which eople onstruct ognitiveategoriesnd ink hose ategories o tereo-typed eliefs. n the midst f this rowth, he tigma oncept asbeen riticized sbeing oovaguely efined nd ndividuallyocused.n response o these riticisms,we define tigma s the o-occurrence f ts omponents-labeling,tereotyping,ep-aration, tatus oss, nddiscrimination-andurtherndicate hat or tigmatizationo

occur, ower must eexercised.he tigma oncept e construct as mplicationsorunderstandingeveral ore ssues n stigma esearch,anging rom he definition fthe oncept othe easons tigma ometimesepresentsvery ersistent redicamentin the ives f persons ffected y t.Finally, ecause here re omany tigmatizedcircumstancesndbecause tigmatizingrocessesan ffect ultiple omains fpeo-ple's ives, tigmatization robably asa dramatic earing n the distributionf ifechancesn uch reas s earnings, ousing,riminalnvolvement,ealth,nd ife tself.It follows hat ocial cientists ho re nterestednunderstandinghe istribution fsuch ife hances hould lso be nterestednstigma.

INTRODUCTION

Erving Goffman's 1963) book Stigma: Notes on the Management of SpoiledIdentity nspired profusion f research n the nature, ources, nd onsequencesof tigma. othPsychInfo ndMedline how ramatic ncreasesn the number farticles entioningheword tigman heir itles r bstracts rom 980 PsychInfo14, Medline19) to 1990 (PsychInfo 1, Medline 8) to 1999 (PsychInfo 61,

Medline 14).Research inceGoffman's eminal ssayhas been ncredibly roductive,ead-ing to elaborations, onceptual efinements,nd repeated emonstrationsf thenegative mpact f stigma n the ivesof the stigmatized. he stigma onceptis applied o iterally cores f circumstances anging rom rinary ncontinence(Sheldon& Caldwell1994)to exotic ancing Lewis 1998)to eprosy Opala&

0360-0572/01/0811-0363$14.00 363

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364 LINK * PHELAN

Boillot1996),cancer Fife & Wright 000), and mental llness AngermeyerMatschinger 994,Corrigan Penn1999,Phelan t al2000). t s used oexplainsome f the ocial vagaries f being nemployedWalsgrove 987), o showhowwelfare tigma an ead to the erpetuationfwelfare se Page1984), nd o pro-vide n understanding f ituations aced y wheelchair sers Cahill & Eggleston1995), tepparentsColeman t al 1996), debtors Davis 1998), nd mothers hoare esbian Causey& Duran-Aydintug997).

A substantial ortion f he roductive esearch n stigma asbeen ontributedby ocial psychologists hohave sed he nsights f he ocial ognitive pproachtounderstand owpeople onstruct ategories nd ink hese ategories ostereo-typed eliefs. his ine f research epresents major dvance n he nderstandingof tigma rocesses, nd ociologists ould o well o ttend o t horoughlyforcomprehensiveeview,eeCrocker t al 1998).Given hese dvances n the ocialpsychology f stigma ndgiven he ccumulated cientificmpact f research nstigmamore enerally, epropose return othe tigma oncept rom distinctlysociological erspective. eengage ur ociological erspective y attending oseveral ore riticisms f the tigma oncept nd ts pplication. he first f hesecriticisms s directed oward he larity f the oncept nd follows rom he ob-servation hat tigma s defined n different aysby different nvestigators. hesecond s a set of criticisms egarding heway n which he tigma oncept asbeenappliedby someresearchers. e use these riticisms oth s a stimulus oreturn othe tigma oncept nd s acritical nalytic ens nconstructing revisedconceptualization. e follow ur xplication f the tigma oncept with moredetailed iscussion f eachof ts component arts.We end by applying ur on-ceptualizationo everal ore ssues n the tigma iterature ith neye o ssessingwhether ur onceptualizations helpful n understandinghose ssues. n doingso,we attendmore o the nature nd consequences f stigma han o ts sources.(Fora review f some deas about he origins f stigma ee Crocker Lutsky1986.)

VARIATIONSN THE DEFINITION OF STIGMA

One of the urious eatures f iterature oncerning tigma s the variability hatexists n the definition f the oncept Stafford Scott 1986). n many ircum-stances nvestigatorsrovide oexplicit efinitionnd eem orefer osomethinglike he dictionary efinition a mark f disgrace ) r to somerelated spect ikestereotyping r rejection e.g., a socialdistance cale).When tigma s explicitlydefined, any uthors uoteGoffman's efinition f tigma s an attribute hat sdeeply iscrediting nd that educes hebearer from whole nd usualpersonto a tainted, iscounted ne Goffman 963,p. 3).

SinceGoffman, lternative r elaborated efinitions avevaried onsiderably.For xample, tafford Scott 1986,p. 80) propose hat tigma is a characteristicofpersons hat scontrary oanorm f social unit where norm sdefined s








CONCEPTUALIZINGSTIGMA 365

a shared elief hat person ught obehave n a certain ay at a certain ime(p. 81). Crocker t al (1998, p. 505) indicate hat stigmatizedndividuals ossess(orarebelieved opossess) ome ttribute, r characteristic,hat onveys socialidentity hat s devalued n a particular ocial context. n especially nfluentialdefinitions that fJones t al (1984),whouse Goffman's 1963,p.4) observationthat tigma an be seen as a relationship etween n attribute nd a stereotypeto produce definition f stigma s a mark attribute) hat inks person oundesirable haracteristicsstereotypes).n our wn eviews f tigma nd mentalillness e.g., Link& Phelan 999),we have dded he omponent fdiscriminationto theJones t al (1984)definition.

Of the many easons hat efinitions f stigma ary, wo seem particularlyprominent. irst, s indicated bove, he tigma oncept as been applied oanenormous rray f circumstances. ach one of these s unique, nd each one islikely o ead investigators oconceptualize tigma n a somewhat ifferent ay.Second, esearch nstigma sclearlymultidisciplinary,ncluding ontributions ypsychologists,ociologists,nthropologists,olitical cientists, nd ocial geogra-phers. lthough heresa great eal of overlapn nterests cross hese isciplines,there re neverthelessomedifferencesnemphasis. ven within isciplines, eo-ple approach he tigma oncept rom ifferent heoretical rientations hat ro-duce somewhat ifferent isions f what hould eincluded nthe oncept. hus,different rames f reference ave edto different onceptualizations.

Becauseof he omplexity f he tigma henomenon, t eems wise ocontinueto allow variation n definition o long as investigators re clear as to what smeant y stigma when he erm s used. Having aidthis,we shall lso attemptto movematters headby specifying conceptualizationf stigma hat ncludesmany f the oncerns hat eopleworking n this rea of research hare. eforeproceeding, owever,t s important o note hat he se of the tigma oncept asbeenchallenged y some social scientists ho have focused n the perspectiveofpersonswho re tigmatizedSchneider 988,Fine& Asch1988, ayce 1998;Kleinman t al 1995).Understandinghese hallengess important or he urtherdevelopment f research n stigma, articularly rom sociological erspective.

CHALLENGESTO THE STIGMACONCEPT

There re twomain hallenges othe tigma oncept. he first s that many ocialscientists hodo not belong ostigmatized roups, nd who study tigma, o so

from hevantage oint f theories hat re uninformed ythe ived

xperienceof thepeople hey tudy Kleinman t al 1995,Schneider 988).Forexample, nwriting bout he xperience fdisability, chneider1988)asserts hat most ble-bodied xperts ive priority to their cientific heories ndresearch echniquesrather han o the words nd perceptions f the peoplethey tudy. he result sa misunderstandingf the xperience f the peoplewhoare stigmatized nd theperpetuationfunsubstantiatedssumptions. riting bout isability, ine&Asch








366 LINK * PHELAN

(1988) identify ive ssumptions: a) that isability s located olely n biology,(b) that heproblems f the disabled re due to disability-producedmpairment,(c) that he disabled person s a victim, d) that disability s central o thedisabled erson's elf-concept, elf-definition,ocialcomparisons,ndreferencegroups, nd e)that aving disabilityssynonymous ith eeding elp nd ocialsupport.

The second hallenge s that esearch n stigma ashada decidedly ndividu-alistic ocus. or xample, ccording oOliver 1992), the entral hrust f tigmaresearch as been focused n the erceptions f ndividuals nd he onsequencesof suchperceptions ormicro-levelnteractions. ccording oOliver 1992),re-search xamining he sources nd consequences f pervasive, ocially hapedexclusion rom ocial and economic ife re far ess common. nterestingly, hiscriticism sechoed y t east nerenowned tudent f tereotyping, rejudice, nddiscrimination.n her review f these opics, usan Fiske 1998)concludes hat(at eastwithin ocialpsychology) he iterature n discrimination s far ess ex-tensive han hat n stereotyping nd that more ttention eedsto be addressedto structural ssues. n another ein, venthough offman 1963, p. 3) initiallyadvised hatwereally eeded a language f relationships, ot ttributes, ubse-quent ractice as often ransformed tigmas r marks nto ttributes f persons(Fine & Asch 1988).The stigma r mark s seen as something n the personrather han designation r tag that thers ffix o the person. n this espect heterm tigma irects ur attention ifferently han term ike discrimination.In contrast o stigma, discrimination ocuses he ttention f research n theproducers f rejection nd exclusion-those who do the discriminating-ratherthan n the peoplewho re the ecipients f these ehaviors Sayce 1998).Thus,the erms we use could eadto different nderstandingsf where esponsibilitylies for he problem' nd as a consequence odifferent rescriptions or ction(Sayce 1998).

Researchers n stigma ouldrespond o these hallenges y disputing heirvalidity r pointing oexceptions n the now voluminous iterature n stigma.We find hese ritiques oprovide useful timulus or reassessment f theconceptualizationf stigma ndrelated oncepts. ne way n which omeof theissues aised y he ritiques anbe addressed s to propose hat tigma e describedwith eference o the elationshipsetween setof nterrelated oncepts.

DEFININGSTIGMA N THERELATIONSHIPOF INTERRELATEDOMPONENTS

An mportant recedent o ocating hemeaning f tigma n the elation etweenconcepts s available n Goffman's bservation hat tigma an be seen as therelationship etween n attribute nd a stereotype. e expand he nexus ofrelationships omewhat ith he ntent f capturing fuller et of meanings or








CONCEPTUALIZING STIGMA 367

the erm ydoing o. We state ur onceptualizations concisely s we can andthen laborate he omponentst contains.

In our conceptualization,tigma xists when he following nterrelated om-ponents onverge. n the first omponent, eople distinguish nd label humandifferences.n the econd, ominant ultural eliefs ink abeled ersons o unde-sirable haracteristics-to egative tereotypes.n the hird, abeledpersons replaced n distinct ategories o as to accomplish omedegree f eparation f usfrom them. n the ourth, abeled ersons xperience tatus ossanddiscrimina-tion hat ead to unequal utcomes. inally, tigmatization s entirely ontingenton access to social, conomic, nd political ower hat llows the dentificationofdifferentness,he onstruction f tereotypes,he eparation f abeled personsinto istinct ategories, nd he ull xecution f disapproval,ejection,xclusion,anddiscrimination. hus,we apply he erm tigmawhen lements f abeling,stereotyping,eparation, tatus oss, nddiscriminationo-occur n a power itu-ation hat llows he omponents f stigma ounfold.With his rief xplicationof the tigma oncept s background, e turn o a more etailed xamination feachcomponent e identified.

COMPONENT 1-ONDISTINGUISHINGAND LABELINGDIFFERENCES

The vast majority f human ifferences re ignored nd are therefore ociallyirrelevant. ome of these-such as the olorof one's car, he ast three igits fone's social security umber, r whether ne has hairy ars-are routinely butnot lways) verlooked. any thers uch s one's food preferences r eyecolorarerelevantnrelatively ew ituations nd re herefore ypicallynconsequentialin the arge cheme f things. ut other ifferences,uch s one's skin olor, Q,

sexualpreferences, r gender re highly alient n the United tates t this ime.Thepoint s that here s a social election f human ifferences hen t comes oidentifying ifferences hatwillmatter ocially.

Thefullweight f his bservation soften verlooked ecause ncedifferencesare dentified nd abeled, hey re typically aken orgranted s being ust theway hings re-there reblack eople ndwhite eople, lind eople nd ightedpeople, eoplewho re handicappedndpeoplewho re not. hetaken-for-grantednature f these ategorizationss one of the reasons hat esignations ikethesecarry uchweight. here re,however, ome bservations e can make hat ringto ight ust how ocial this ocial election f human ifferences s.

First, ubstantial versimplifications required o create roups. ne exampleis the ssignment f ndividuals ocategories f black or white when hereis enormous ariability ithin he resulting ategories nd no cleardemarcationbetween ategories n lmost ny riterion ne an hink f, ven ttributesike kincolor, arentage, r facial haracteristics hat re believed o define he ategories








368 LINK * PHELAN

(Fullilove 998).The ame anbe saidfor ther ategorizationsikegay r traight,blind r sighted, andicapped r not.

Second, he entral oleof he ocial election f human ifferences srevealedby noting hat he ttributes eemed alient iffer ramaticallyccording o timeand place. For example, n the ate nineteenth entury, uman hysical harac-teristics uch s small foreheads nd arge aces wereparticularly alient-thesecharacteristics ere hought obe ape-like-and were elieved o reveal he rim-inalnature f thepeoplepossessing hem Gould 1981). And, f course, ulturesvary xtensively n characteristics eemed ocially ignificant. or example, n-cientMayan ulture aveunusual ignificanceo being ross-eyed nd sought ocreate his esirable haracteristic n children hrough evices hat ncouraged a-bies ofocus nobjects nways hat orced heir yes ocross. ociological tudiesof ocial constructionndmedicalizationre alsogoodexamples Conrad 992).Hyperactivitys muchmore alient ow, s an ndicator f a disorder, han tusedtobe, nd he medical erm DHD (attentioneficit yperactivity isorder)spartof common arlance.

Becausehuman ifferencesre ocially elected or alience, e have hosen ouse the word label rather han attribute, condition r mark. ach of theselatter erms ocates he hing hat s beingreferred o in the tigmatized ersonand risks bscuring hat ts dentificationnd election or ocial significancesthe product f social processes. n contrast, label s something hat s affixed.Moreovern the bsence f qualifications,erms ike attribute, condition, rmark mply hat he esignation asvalidity. n contrast heword label eaves

the validity f the designation n openquestion-an option hat as great tilityas, for xample, hen ne wishes o discuss he tigma omewomen xperiencedas a consequence f being abeledwitches.

With egard o this spect f the tigma rocess, he ritical ociologicalssueis to determine ow ulturally reated ategories rise nd how hey re ustained.Why s t hat ome human ifferencesre ingled ut nd deemed alient yhumangroups hile thers re gnored?What re he ocial, conomic, nd ultural orcesthatmaintain he ocus n a particular uman ifference?

COMPONENT2-ON ASSOCIATINGHUMANDIFFERENCESWITH NEGATIVEATTRIBUTES

The second omponent f stigma ccurswhen abeled differences re inked ostereotypes. his spect f tigma ashighlightedn Goffman's 1963)work ndhas been central o the conceptualizationf stigma ver ince. t is the aspectof stigma hat asbeenmost alient n the psychologicaliterature bout tigma,perhaps ecause t posescritical uestions f a psychological ature bout hethought rocesses hat acilitate onnections etweenabels nd tereotypes. on-sistent ith his mphasis n psychology s the centrality f this dimension npsychologists' efinitions f tigma. or xample, rocker nd colleagues 1998)









define tigma, snoted bove, san attribute r haracteristic hat onveys socialidentity hat s devalued n a particular ontext.

Inour erms, his spect f tigma nvolves label nd stereotype, ith he abellinking person oa set f undesirable haracteristicshat orm he tereotype. nexample f this omponents evident n a vignette xperiment onducted yLinket al (1987).The study xperimentally anipulatedabeling, agging randomhalf f he ignettes former ental atients nd he ther alf former ack-painpatients. t also included measure f the xtent o which espondents elievedthatmental atients n general were dangerous. When hevignette escribedformer ack-pain atient, eliefs bout hedangerousness f peoplewithmentalillnessplayedno part n rejecting esponses oward he vignette ubject.Whenthe ignette escribed former ental atient, owever, hese eliefswere otentpredictors f rejecting esponses: espondents hobelievedmental atients eredangerous eacted egatively o the person escribed s a former ental atientin the vignette. pparently, ormany eople, he mental atient abel linkedthe described erson o stereotyped eliefs bout he dangerousness f peoplewithmental llness,which n turn ed them o desire or ocial distance rom heperson.

As indicated bove, his onnection etween abels nd stereotypes asbeenmajor spect f thepsychological tudy f stigma n recent ears, ollowinghesocialcognitive pproach Fiske1998). This ntriguing ndvery ruitful ody fresearch eeks o lucidate he ognitive rocesses nderlying he se of ategoriesandthe inking f those ategories ostereotypesCrocker t al 1998).Wefocusbriefly n some elected spects f this xtensive ody f research.

According o this iterature, ategories nd stereotypes re often automaticand facilitate cognitive fficiency. he automatic ature s revealed n experi-ments hat ndicate hat ategories nd tereotypesreused n making plit-secondjudgments ndthus ppear obeoperating reconsciously. or xample, aertner&McLaughlin1983)conducted nexperimentn which ne group f white ub-jects was primed y the word whites nd another y the word blacks, ndthen oth roupswere ested s to the peedwithwhich heywere ble to dentifywhether wo strings f letters ere both words.Bothhigh- nd ow-prejudicedsubjects espondedmore apidly opositive ords ike smart, ambitious, ndclean when rimed y heword whites han when rimed y heword blacks.

In addition ooperatingn preconcious,utomatic ay, ome tudies uggest hatcategory sepreserves ognitive esources. hus, or xample, f ubjects repro-videdwith abels ikedoctor, rtist, kinhead, r real estate gentwhen sked o

form n impression f a vignette, hey re better bleto

simultaneously erformanother ask ike turning ff beeping omputer han re subjectswho are notprovided hese abels Macrae t al 1994).Thus, rom psychologicaltandpoint,culturally iven ategories re present ven at a preconcious evel and providepeoplewith means of making horthand ecisions hat ree hem o attend oothermatters. t the ame time, ther esearch n social psychology eveals on-siderableatitude n the ognitive rocesses hat ranspire uch hat ery ifferent








370 LINK * PHELAN

outcomesmay ccur epending n the nature f he ognitions eople mploy ndthe ontexts nwhich eople reembeddedCrocker t al 1998).

COMPONENT3-ON SEPARATINGUS FROM THEM

A third eature f the tigma rocess ccurs when ocial abels connote sep-aration f us from them Morone1997,Devineet al 1999). United tateshistory ndpolitics ffermany xamples s established ld-order mericans e-fined frican-American laves,Americanndians, nd uccessivewaves f mmi-grants s outgroups-the them whowerevery ifferent rom us. Few groups

were ntirely pared. or xample,Morone 1997) provides uotes rom enjaminFranklin's bservations f the mpact f Dutch mmigrants them ) n the En-glish olonists us ). Already he nglish egin oquit articular eighborhoods,surrounded y heDutch, eingmadeuneasy y he isagreeablenessfdissonantmanners.. Besides, he Dutch nder-live,nd re hereby nabled o under-workand under-sell heEnglishwho are thereby xtremely ncommoded nd conse-quently isgusted Franklin 752).Andofcourse,while hegroups epresentingus and them ave hanged, his eparationsstill rominent oday. They re

a menace o us because hey re mmoral, azy, ndpredatory Morone1997).

Thus, ther omponents f the tigma rocess-the inking f abelsto undesir-ableattributes-become he ationale or elieving hat egatively abeled ersonsare fundamentally ifferent rom hose whodon't hare he abel-different ypesof people.At the ame time,when abeledpersons re believed o be distinctlydifferent, tereotypingan be smoothly ccomplished ecause here s little armin attributing llmanner f bad characteristics o them. n the xtreme, he tig-matized erson s thought o be so different rom us as to be not eally uman.And again, n the xtreme, ll manner f horrific reatment f them ecomespossible.

Evidence f efforts oseparate s from hem re sometimes irectly vailablein the very nature f the abels conferred. ncumbents re thought o be thething hey re abeled Estroff 989).Forexample, omepeople peak f personsas being epileptics r schizophrenics ather han escribing hem s havingepilepsy r schizophrenia. hispractice s revealing egardinghis omponent fstigma ecause t s different or ther iseases.Aperson ascancer, eart isease,or the lu-such a person soneof us, personwho usthappens o be beset ya serious llness. ut a person sa schizophrenic.

COMPONENT4-STATUS LOSS ANDDISCRIMINATION

In this omponent f he tigma rocess, he abeled erson xperiences tatus ossanddiscrimination. ostdefinitions f tigma o not nclude his omponent, utas we shall ee,the erm tigma annot old he meaning ecommonly ssign oit when his spect s left ut. n our easoning, hen eople re abeled, et part,









and inked o undesirable haracteristics, rationale s constructed or evaluing,rejecting, nd excluding hem. hus, people are stigmatized hen he fact hat

they re abeled, et part, nd inked oundesirable haracteristicseadsthem oexperience tatus ossanddiscrimination.Consistent ith his, tigmatized roups re disadvantaged hen t comes o a

general rofile f ife hances ike ncome, ducation, sychological ell-being,housing tatus, medical reatment, ndhealth e.g. Druss t al 2000,Link 1987).While ome groups scape he xperience f ome disadvantagedutcomes ome-times e.g., African mericans egarding elf-esteem-see rocker 999), whenone considers he profile f all possible utcomes, he general rinciple learlyholdsformost tigmatized roups. ow does this happen?

Status LossAn lmost mmediateonsequencef uccessful egativeabeling nd tereotypingis a general ownward lacement f a person n a status ierarchy. heperson sconnected oundesirable haracteristicshat educehis or her tatus n the yesof the stigmatizer. he fact hat human eings reatehierarchies s, of course,evident norganizationalharts, ho its where nmeetings, ho defers o whomin conversational urn-taking,nd so on. One strand f sociological esearch nsocialhierarchies,he o-called xpectation-statesradition,sparticularly elevantto the study f stigma nd status oss (Cohen 1982,Driskell& Mullen 1990).Based on finding reliable endency f evenunacquaintedndivdiuals o formfairly table tatus ierarchies hen laced ngroup ituations, esearcherset utto understand heprocesses hat roduced his tate f affairs.What hey avefound s relevant oresearch n stigma n manyways, wo of whichwe shallemphasize ere.First, hisresearch hows hat xternal tatuses, ike race andgender, hape tatus ierarchies ithin mall roups funacquainted ersons venthough heexternal tatus as no bearing n proficiency t a task he group saskedto perform. en and whites re more ikely hanwomen nd blacks toattain ositions fpower ndprestige-they alkmore requently, ave heir deasmore eadily ccepted y others, nd are more ikely o be voted group eader(Mullen t al 1989).Thesefindings re mportant oresearch n stigma ecausethey howhowhaving status hat s devalued n the wider ociety an lead tovery oncrete orms f nequalitynthe ontext f ocial nteractions ithin mallgroups. econd, lthough nequalitiesn status-related utcomes efinitely ccurinthe roups, hey o not esult rom orms fdiscriminationhatwould ereadily

apparent oa casualobserver. nstead roupmembers seexternal tatuses likerace nd gender) ocreate erformancexpectationshat hen eadto labyrinth fdetails hat nvolve aking he loor, eeping he loor, eferringo he ontributionsof others, eadnodding, nterrupting, nd the ike. This s important oresearchonstigma ecause t hows hat ubstantial ifferencesnoutcome an occur venwhen t is difficult orparticipants o specify single vent hat roduced heunequal utcome.








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DiscriminationINDIVIDUAL

DISCRIMINATION The standard ayof conceptualizinghe onnec-tion between abeling, tereotyping, nd discriminationn the stigma iteraturefollows relatively implistic ormulation. n this pproach, he mportance fattitudes ndbeliefs re thought o ie in whether ersonA's labeling nd stereo-typing f personB leads personA to engage n some obvious forms f overtdiscrimination irected t person , such s rejecting job application, efusingto rent n apartment, nd so on.There s no doubt hat his ather traightforwardprocess ccurswith onsiderable egularity, lthough omesocial psychologistswith nterestsn tigma ave ecently emoaned he act hat ocumentingiscrim-

inatory ehavior asnotbeen heir trong uit Fiske 1998).Connecting ttitudesto behaviors s, therefore, onceptualizeds something hearea of research nstigma nd stereotyping eeds Fiske 1998).In this egardAjzen& Fishbein's(1980) theory freasoned ction as been uccessfully pplied o the redictionofmany ehaviorsndmight lso be useful npredicting iscriminatoryehaviors.Theapproach hey ropose s effective ecause t asks us to narrow ur focus oa very pecific ehavior nd to be attentive othe ntricacies f the beliefs ndattitudes oward erforminghe pecific ct n question. ut he rea of tigma e-search eeds o expand ts onception f he rocesses hrough hich abeling nd

stereotypingead to social nequalitiesn ife ircumstances. y tself he tandardmodel hat sks what-makes-person-A-discriminate-against-person-Bs inade-quate for xplaining hefull onsequences f stigma rocesses. n fact, ettingtangled p in the narrow ntricacies f explaining specific ct from nowledgeof a specific et of attitudes nd beliefs ould cloud rather han lluminate urunderstandingf why tigmatized roups xperience omany isadvantages.

STRUCTURALDISCRIMINATION The oncept f nstitutional acism ensitizes s to

the act hat ll manner f disadvantageanresult utside f model nwhich neperson oessomething ad to another. nstitutional acism efers oaccumulatedinstitutional ractices hatwork o the isadvantagefracialminority roups venin the bsence f ndividual rejudice r discriminationHamilton Carmichael1967).For example, mployers more ftenwhite) ely n the personal ecom-mendations f colleagues r acquaintancesmore ftenwhite nd more ikely oknow nd recommend hite ob candidates) orhiring ecisions. he samekindof tructural iscriminations,of ourse, resent or ther tigmatized roups. orexample, isabled ersonsmay be limited n their bility oworknot o much

becauseof their nherent imitations utbecause hey re exposed o what Hahn(1983)calls a disabling nvironment reated ythe arriers oparticipationhatreside n architecture e humans ave constructed Fine & Asch 1988). Con-sider ome possible xamples f tructural iscriminationor mental llness ikeschizophrenia.uppose hat ecause he llness sstigmatized,essfunding sded-icated o research bout t than or ther llnesses nd less money s allocatedto adequate are nd management. oreover, onsider hat, ecauseofhistorical









processes nfluenced y stigma, reatment acilities end obe either solated nsettings wayfrom ther eople Rothman 971) orconfined o someof themost

disadvantaged eighborhoodsn urban ettings n communities hat o not haveenough lout oexclude his tigmatized roup rom heir midst Dear& Lewis1986).At the same time, he most uccessful nd accomplishedmental ealthpersonnel end o accruemore tatus nd money y treating ess serious llnessesin private ffices n affluent reas, eaving he areof peoplewith chizophreniato a generally essaccomplished roup Link 1983).Tothe xtent hat he tigmaof schizophrenia as created uch situation, personwhodevelops his isorderwill be the recipient f structural iscrimination hether r not nyone appensto treat im or her n a discriminatory aybecause of some stereotype boutschizophrenia. tigmahas affected he tructure round heperson, eading heperson o be exposed o a host f untoward ircumstances.

STATUS LOSS AS A SOURCE OFDISCRIMINATION In keepingwith bservationsabout he role of stigma n the oss of status, t is important o note hat owerplacement n a status ierarchy anbegin o have ffects f ts ownon a person'slife hances. t snotnecessary orevisit he abeling nd tereotypinghat nitiallyledto he ower tatus, ecause he ower tatus tself ecomes he asis ofdiscrim-ination. or example, ow status mightmake person ess attractive o socializewith, o nvolve n community ctivities, r to nclude n a business enture hatrequires artners hohavepolitical nfluence ith ocal politicians.n this way,a lower osition n the tatus ierarchy an have cascade of negative ffects nallmanner f opportunities. ecausethediscriminationhat ccurs s one step e-moved rom he abeling nd tereotyping,t s easy omiss he more istal ffectsof these actorsn any ccounting f the ffects f these tigma omponents.

SOCIAL PSYCHOLOGICAL PROCESSES OPERATING THROUGHTHE STIGMATIZEDPERSON Oncethe cultural tereotype s in place, t can affect abeledpersonsin mportant ays hat o not nvolve bvious orms fdiscriminatoryehavior nthe art fpeople nthe mmediate resence f he tigmatized erson. or xam-ple , according o a modifiedabeling heory bout he ffects f tigma npeoplewithmental llnesses Link1982,Link t al 1989),peopledevelop onceptions fmental llness arly n ife s part f socializationnto ur ulture AngermeyerMatschinger 996, cheff 966,Wahl1995).Once nplace,people's onceptionsbecome lay theory boutwhat t means o have a mental llness Angermeyer& Matschinger 994,Furnham Bower1992). Peopleform xpectations s to

whether ost eoplewillreject n ndividual ith mental llness s a friend, m-ployee, eighbor, r ntimate artner ndwhether ost eoplewilldevalue personwithmental llness s less trustworthy,ntelligent, nd competent. hesebeliefshave n especially oignant elevance or personwhodevelops seriousmentalillness, ecause he ossibility fdevaluationnddiscriminationecomes erson-ally elevant.f onebelieves hat thers illdevalue nd reject eople withmentalillnesses, nemust ow fear hat his ejectionpplies ersonally. hepersonmay








374 LINK * PHELAN

wonder, Will others ook down on me, rejectme, simply ecause have beenidentified s having mental llness? hen o the xtent hat t becomes part

of person'sworld iew, hat erception anhave erious egative onsequences.Expecting nd fearing ejection, eople who havebeenhospitalized ormentalillnessesmay ct ess confidentlyndmore efensively, r theymay imply voida potentially hreateningontact ltogether. he result maybe strained nd un-comfortable ocial interactions ith potential tigmatizersFarina t al 1968),more onstricted ocial networks Link et al 1989),a compromised uality flife Rosenfield 997), ow self-esteem Wright t al 2000),depressive ymptoms(Link t al 1997),unemploymentnd ncome oss Link 1982, 1987).While histheory as been most horoughlyxaminedwith espect o mental llnesses, heprocess s probablymuchmore general. n keepingwith his possibility, inel(1999) hasrecently alled he xpectation f stereotypingstigma onsciousnessandhasproposed ts pplication oother tigmatized tatuses.

A related ut lightly ifferent pproach ounderstandinghe ffect f stereo-types sSteele& Aronson's1995) concept f stereotypehreat. ccording o hisidea,peopleknow bout he tereotypes hatmight e applied othem-AfricanAmericans now hey re taggedwith ttributes f violence nd ntellectualnfe-riority, aymenknow hey re seen as flamboyantndpromiscuous, ndpeoplewithmental llnesses now hat hey rebelieved o be unpredictablenddanger-ous. The insight hat teele & Aronson rovide s that he tereotype ecomesthreat r challenge ither ecause onemight e evaluated n accordance ith hestereotype r because ne might onfirm he tereotype hrough ne'sbehavior.nkeepingwith his dea,Steele& Aronson ave hown hat, ontrolling or nitialdifferences n SATscores,African-Americantudents erform orse han whitestudents n a testwhen tudy articipants re ed to believe hat he est measuresintellectualbility. n contrast, hen he ame est s not abeled sbeing iagnos-tic f bility, frican mericans core s well s whites. his research ells s thatthe xistence f a stereotype ndthe dministration f a test f ability an eadto an nvalid ssessment f the cademic otential f African-Americantudentsandthereby o discrimination gainst uch tudents n the basis of a seeminglyobjective est.

Note hat nboth hemodifiedabeling heory nd heorybout tereotypehreat,no one n the mmediate ontext f theperson eeds o have engaged n obviousforms f discrimination. ather, hediscriminationiesanterior o the mmediatesituation ndrests nstead n the ormationnd sustenance f stereotypes nd aytheories. till he onsequences re ometimes evere ndundoubtedly ontributegreatly o differences n the ife hances f people n stigmatized roups.

INTERCHANGEABLEMECHANISMS Theproblem f stigma as been described sa predicament r a dilemma y Goffman nd others Ainlay t al 1986,Crockeret al 1998).One reason or his s brought olight y the ociological bserva-tion hat mechanisms ike the ones we have described re both nterchangeableandmutually einforcingn achieving nds that iscrimnate gainst tigmatized









groups Lieberson 985). f powerful roups remotivated odiscriminategainsta stigmatized them, here re many ways n which uch discriminationan be

achieved. f stigmatized ersons annot e persuaded ovoluntarily ccept heirlower tatus nd inferior ewards, irect iscrimination an be used to accom-plish he ame outcome. f direct iscrimination ecomes deologically ifficult,sophisticated orms f tructural iscrimination-such s tests hat nduce tereo-type hreat-can chieve ome of the ameends.The mechanisms re mutuallyreinforcing s well. To the extent hat tigmatized roups ccept hedominantviewof their ower tatus, hey re less likely o challenge tructural orms fdiscriminationhat lock pportunities hey esire. urther, irect iscriminationreinforces hebelief mong tigmatized roups hat hey willbe treated n accor-dancewith tereotypes ndtherefore einforces rocessesike hose xplicatednthe ontext f modified abeling heory nd the tereotype-threat oncept. romthis vantage oint, tigma s a predicament n the following ense-as long asdominant roups ustain heir iewof stigmatized ersons, ecreasing heuse ofonemechanism hrough hich isadvantage an be accomplished imultaneouslycreates he mpetus o ncrease he seof nother. his atter bservation rings sto thefinal spect f our tigma oncept-its dependence n power ifferences.

THE DEPENDENCE OF STIGMAON POWER

Stigma s entirely ependent n social, conomic, nd political ower-it takespower ostigmatize. n some nstances he role of power s obvious.However,the role of power n stigma s frequently verlooked ecause n many nstancespower ifferencesre o taken or ranted s to seemunproblematic. hen eoplethink f mental llness, besity, eafness, ndhaving ne eg nstead f wo, hereis a tendency ofocus on the attributes ssociatedwith hese onditions ather

than n power ifferences etween eoplewhohave hem ndpeoplewhodo not.But power, ven n these ircumstances,s essential o the ocial production fstigma.

In order oreason bout he role of power n stigma, irst onsider nstancesin which t is clear that ocial power s important. o begin, akethe exampleprovided arlier n which ighteenth entury nglish olonists agged heDutchwith ttributes fdisagreeablenessnd ow-living. long he ame ines, eople fIrish ackground ere tereotyped s temperamental, angerous, uarrelsome,idle and reckless y old-order mericans n the nineteenth entury. he Irish

at the ime were ikened oapesand were portrayed s such n cartoons f theday Feagin & Feagin1996). n the ight f current ircumstances,t s clear hatEnglish olonists f the ighteenth entury nd the old-order mericans f thenineteenth entury ere ble to stigmatize heDutch nd rish becauseof theirpositions fpower ver hese roups t the ime.And, f course, t was the owerof theNazis that llowed heir horoughnddevastating tigmatizationf Jewishpeople.








376 LINK * PHELAN

Buthow an wethink f the ole fpower ncircumstancesikemental llness,obesity, eafness, nd one eggedness? ne way s to recognize hat tigmatized

groups ften ngage nthe ame kinds f tigma-relatedrocessesntheir hinkingabout ndividuals ho are not n their tigmatized roup. onsider or xamplepatients n a treatment rogram or eoplewith erious mental llness. atients nsuch setting re ikely o dentify nd abelhuman ifferences n staff embers.For nstance, heymight ag ome linicians ith he abel pill pusher nd pplystereotypes onnected ith he abels they reate uch as that ill pushers recold,paternalistic,nd arrogant. inally hey might reat hepeople hey dentifyas pill pushers ifferently n accordancewith he conclusions hey avedrawnabout hem y avoiding r minimizing ommunication ith hem, xchangingderogatory omments nd okesabout hem, nd o on. Thus lthough he atientsmight ngage n every omponent f stigmawe identified, he staff ould notend up being stigmatized roup. hepatients imply onotpossess he ocial,cultural, conomic, nd political ower o mbue heir ognitions bout taff ithserious iscriminatory onsequences.

Consider urther hat cenarios imilar o the one ust described xist for llsorts fother ircumstancesnwhich elativelyowerless roups reate abels ndstereotypesboutmore owerful roups ndtreatmembers f themore owerfulgroup n accordance ith hose tereotypes. uch a realization larifies hy hedefinition f stigmamust nvolve eference opower ifferences. ithout uchreference, tigma ecomes very ifferent ndmuch roader oncept hatmightbe applied o awyers, oliticians, allStreet nvestors, ndwhite eople. tigmais dependent npower.

Becauseof the mportance f power n stigmatization,t s critical o ask thefollowing et of questions: o the peoplewhomight tigmatize ave the powerto ensure hat hehuman ifference hey ecognize nd abel s broadly dentifiedin the ulture? o the peoplewhomight onfer tigma ave hepower oensurethat he ulture ecognizesnddeeply ccepts he tereotypes hey onnect o thelabeled ifferences? o the eoplewhomight tigmatize ave he ower o eparateus from them nd to have the designation tick?And do those who might

confer tigma ontrol ccess to major ife domains ikeeducationalnstitutions,-jobs,housing, nd health are n order o put really onsequential eeth nto hedistinctionshey raw? o the xtent hatwe can answer es othese uestions, ecanexpect tigma oresult. o the xtent hatwe answer o, ome f he ognitivecomponents f stigmamight e in place,but whatwe generally eanby stigmawouldnot xist.

IMPLICATIONSOF THESTIGMACONCEPT

Thestigma oncept ehave rticulated as mplications or ow ne might easonabout everal ersistent uestionsncluding:a) the efinition f tigma,b)stigmaas a matter f degree, c) the rigins f stigma, d) the mage f the tigmatized








CONCEPTUALIZINGTIGMA 377

person s a passive victim ersus n active hallenger, e) the consequences fstigma, f) stigma s a persistent ilemma,g)whatweshould o to hange tigmaprocesses, nd h) the mportance f stigma n understanding hedistribution flife hances.

The Definition f StigmaOur explication f the tigma oncept s revealing ith egard owhy o manydefinitions f stigma re extant n the iterature-there re several omponents,each one of which has been described s stigma.We chose to define tigma nthe onvergencef nterrelatedomponents. hus, tigma xists when lements f

labeling, tereotyping,eparation, tatus oss, nd discriminationccur ogether napower ituation hat llows hem. his s a definition hatwe derived, ot ne thatexists n some ndependent xistential ay.As such, ts valuerests n ts utility.Onereason t s helpful s that he erm tigma s nverywideuse, nd ome degreeof larity illhelpus communicate bout he oncept. econd, here rewords hataptly escribe ach of the omponentsike abel ormark r status), tereotyping,exclusion, tatus oss, and discrimination o that he use of the word tigma odescribe nyparticular spect s not necessary. hird, hedefinition ohereswiththe urrent sageof the erm s it s applied o groups hat re commonly eferred

to as stigmatized roups. ecallthat f weonly sedthe ognitive omponents flabeling nd stereotyping odefine tigma, roups ike awyers, oliticians, ndwhite eoplewouldhave o be considered tigmatized roups. ur ncorporationof power, tatus oss,, nd discriminationllows heformal efinition e derivedto cohere with urrent nderstandingsf what stigmatized roup s.Fourth, ebelieve hat he definition elpsus envision nd thereby orefully nderstandseveral mportantssues n the tigma iterature s described elow.

Stigma s a Matter fDegreeOur conceptualizationeads to the conclusion hat tigma xists s a matter fdegree. he abeling f human ifferences anbemore r ess prominent. labelcanconnect person omany tereotypes, o ust few r o none t ll.Moreover,the trength f the onnection etween abels and undesirable ttributes an berelatively trong r relatively eak.Thedegree f separationnto roups f usand them an be more r ess complete, ndfinally he xtent f status oss anddiscriminationanvary. his means hat ome groups re more tigmatized hanothers nd hat ome f he omponents e havedescribed anbe used nalytically

to hink boutwhy ifferencesnthe xtent f tigma xperienced ary rom roupto group.

TheOrigins f StigmaOurpaperhasbeenfocused n the nature nd consequences f tigma ather hanits sources. Nevertheless ur conceptualizationrovides ome deas about how








378 LINK* PHELAN

to think bout he rigins f stigma. s we indicated t the outset f this aper,a great eal of attention n the iterature n stigma as been directed oward he

cognitive rocessing f stigma-relevantnformation. s crucial s theknowledgegainedfrom his iterature s, it is not a sufficient asis for understanding heorigins f stigma. s we have pointed ut, groups othwith nd without owerlabel nd form tereotypesbout he ther roup-members f eachgroup ngagein thekinds f cognitive rocesses hat re studied n the nowvoluminous ocialpsychological iterature. ut what matters s whose cognitions revail-whosecognitions arry ufficient lout n social, ultural, conomic, ndpolitical pheresto ead to mportant onsequences or hegroup hat as been abeled s different.Here swhere he ociological tudy f tigma sbadly eeded-for while ognitiveprocessesmay be necessary auses for he production f stigma, hey re notsufficient auses. We need to further nderstand he ocialprocesses hat llowone group's iews odominate o as to produce eal nd mportant onsequencesfor he ther roup.

PassiveVictim ersus ctive hallengerOneof the most roublesomessues n the tudy f stigma merges when ocialscientists eek to articulate hereal constraints hat tigma reates n people's

lives, nd n doing o they nd up portraying embers f the tigmatized roupas helpless ictims Fine & Asch 1988). ronically, hisproducesmore ines nthe ist of undesirable ttributes hat orm he stereotype bout he stigmatizedgroup-they re additionally passive, helpless, r acquiescent. ecause ofthis, here refrom ime o ime rticles hat emind sthat eople rtfully odge rconstructivelyhallenge tigmatizing rocesses e.g.Reissman 000).Thesearevery mportant eminders,nd themessage hey eliver eeds obe incorporatedinto ur nderstandingf tigma. t he ame ime, he imple act hat hese ormsofresistance xist uggests here ssomething ut here o avoid nd hat here re

powerful onstraining orces t work. ow can wereason bout hese ontrastingimages ndportray onstraint ndresistance nresearch bout tigma? ere, uremphasis n the mportance f power ifferencesn stigma nd our observationthat tigma s a matter f degree re helpful. pecifically, hese llow us to seeissues of constraint nd resistance n the context f a power truggle.We canseethat eople n stigmatized roups ctively seavailable esourceso resist hestigmatizingendenciesf hemore owerful roup nd hat, o he xtent hat heydo, t s inappropriateoportray hem s passive ecipients f tigma. t the ametime, othe xtent hat ower ifferences xist, esistence annot ully vercome

constraint. he mount f tigma hat eople xperience ill beprofoundlyhapedby the elative ower f the tigmatized ndthe tigmatizer.

TheOutcomes f StigmaOur conceptualizationf stigma emands he ssessment f multiple utcomes,not ust one or two.Wecannot ssessthe xtent f tigmatization henwe assess








CONCEPTUALIZINGTIGMA 379

just one outcome, hether hat ingle utcome e self-esteem, ousing tatus, raccessto medical are. From ne vantage oint, his s an odd stricture o mposeonthe tudy f tigma. fwe adopt narrow onceptualizationf tigma, or xam-ple as a label inked o a stereotype, emight xpect pecificity n the utcomes.We might dentify heelements f the stereotype nd then, ased on what hestereotype ntails, redict hich utcomes might e affected. f the tereotype smath ncompetence,henwemight xpect he erson o be excluded rom ndeav-ors where math ompetence s required. s important s this kind f theorizingmight e for nderstanding ome spects f tigma, t will loud ourvision f thefull onsequencesf t s the nly pproach eemploy.

Among hereasons ur conceptualizationf stigma alls for he scrutiny fmany utcomes re three we consider ere.First, tigma nvolves tatus oss-a downward lacement n the status ierarchy. o the extent hat his occurs,we can expect members f stigmatized roups o accrue ll manner f untowardoutcomes ssociated with ower lacement n a status ierarchy, anging rom heselection f sexual partners olongevity. econd, tructural iscriminationanproduce egative utcomes hat ave ittle o do with he tereotyped eliefs hatinitially otivatedhe tructural iscrimination.or xample, heNot n MyBackYard NIMBY) phenomenonesultedntreatment acilities or eoplewithmentalillness eing ocated n relatively oor ndpowerless reas f he ity hat ere lsocrime idden nd dangerousDear & Lewis1986).Asa consequence, eoplewithmental llness re much more ikely o be victimized han ther eople. Third,people'sefforts ocopewith tigmamay have untoward onsequences hat reseemingly nrelated o the tereotypeJames t al 1984, mart Wegner 999).For example, ocialepidemiologist herman ames utsforward he oncept fwhat e calls John enryism -the endencyor ome African mericans oworkextremely ard ndwith reat ressure odisprove he tereotype f aziness ndinability. ccording oJames t l 1984),under ome onditions his oping ffortbears osts n the form f hypertension.n short, comprehensive xploration fthe tigma oncept makes t clear hat tigma an nvolvemany utcomes nd hatanyfull ssessment ust ookto a broad ange f such utcomes.

Stigma s a Persistent redicamentAs previously entioned, he iterature akes eference ostigma s a predica-ment r dilemma. ur conceptualization raws ttention o one way n whichstigma s a persistent redicament-why henegative onsequences f tigma reso difficult oeradicate.Whenpowerful roups orcefully abeland extensivelystereotype less powerful roup, herange of mechanisms or chieving is-criminatory utcomes s both lexible ndextensive.We mentioned hree enerictypes f mechanisms-individual iscrimination,tructural iscrimination,nddiscriminationhat perates hrough he tigmatized erson's eliefs nd behav-iors. But lying elowthese broad-band esignations re a whole multitude fspecificmechanisms-there re manyways o achieve tructural iscrimination,








380 LINK * PHELAN

manyways o directly iscriminate,ndmanyways n which tigmatized ersonscanbe encouraged obelieve hat hey hould ot njoy ull nd qual participation

in ocial nd conomic ife.Moreover,f hemechanismshat re urrently nplaceareblocked r become mbarrassing ouse,newonescan always e created. hisis the main eason hat tigma s such persistent redicament. hen people na stigmatized roup ake ction o avoid negative onsequence, hey requentlydo so bycounteractinge.g. confronting r avoiding) he pecificmechanism hatleadsto the ndesirable utcome hey eek oescape.Butwhen he ange f pos-siblemechanismss broad, hebenefit s only emporary ecause hemechanismthat as been blocked r avoided anbe easily eplaced y another.

A second ndrelated eason hat tigma sapersistent redicaments that here

are a multitude f associated utcomes. ne can exert reat ffort o avoidonestigma-relatedutcome, ikediscriminationnmedical nsurance r njury o self-esteem, ut oing o cancarry osts. or nstance, he oping ffort anbe stressful,asinthe ase of John enryism ndhypertensionevels mong frican mericans(James t al 1984). In that xample, he effort o eliminate ne bad outcomeironically roduces train hat eadsto another. lso, focusing articular ttentionon one outcomemeans hat ess attention s available o deal with ther spects flife.As a result, hile enefits ay ccrue n onedomain, oncomitant armsmayresult n others. t is the xistence f multiple tigma mechanisms nd multiple

stigma utcomes hat elps xplain why tigma sapersistent redicament-why,onaverage,members f tigmatized roups re disadvantagedna broad ange flife domains e.g. employment, ocial relationships, ousing, nd psychologicalwell-being).

We end our discussion f stigma s a persistent redicament ith point fclarification. irst, o say that tigma s a persistent redicaments not to saythat very ndividualn a group uffers he ame outcome. ndividual ifferencesin personal, ocial, nd economic esources lso shape he ife ircumstances fpersons nstigmatized roups, hereby roducing ubstantial ariation ithin tig-matized roups n any utcome nemight onsider. hus,no one s fully rappedin a uniform isadvantaged osition. ll of the other haracteristics f personsinfluence n outcome n the amewaythey nfluence utcomes or ersonswhoarenotmembers f he tigmatized roup nquestion. hepersistent redicamentrefers oa general attern f disadvantagehat sconnected ostigma rocesses flabeling, tereotyping, tatus oss, nddiscrimination.

Changing tigma

If stigma s a persistent redicament, owcan it be changed?One approach sto focus n a particular ehavior n a particular roup. or example, ne mighttarget iring ractices ith he im of ncreasing he mployment hances orstigmatized roup uch as peoplewith mental llnesses.One could then ry ochange mployers' eliefs bout nd attitudes oward iring ersons with uchillnesses. his approach s very ppealing ecause t breaks own he morass finterconnectingtigma-facetsnto more ractable roblem.fonewere o develop









an ntervention, ne could target he ntervention o the pecific eliefs, ttitudes,and behaviors f employers, hereby ncreasing he ikelihood f an apparently

successful utcome or he ntervention esearch tudy. ut what s appealingabout this pproach s also what makes t such an inadequate esponse o thebroader roblem f stigma. he intense ocuson one specific ehavior n onespecific roup eaves the broader ontext ntouched nd as a consequence venthe very ositive utcomes f an unusually uccessful rogram ill erodewithtime. his will occur or easons we have tated: here xists flexible ackageof mutually einforcing echanismsinking he ttitudes ndbeliefs f dominantgroups o an array f untoward utcomes or tigmatized ersons.

Ourconceptualizationeadsus to focus n two principles n considering ow

to really hange tigma. he first s that ny pproachmust e multifaceted ndmultilevel. t needs o be multifaceted o address hemanymechanisms hat anlead to disadvantaged utcomes, nd t needs o be multilevel o address ssuesofboth ndividual nd tructural iscrimination. ut econd, nd most mportant, napproach o changemust ltimately ddress hefundamental auseof stigma-itmust ither hange hedeeplyheldattitudes nd beliefs f powerful roups hatlead to labeling, tereotyping, etting part, evaluing, nd discriminating, r tmust hange ircumstances o as to imit he power f suchgroups omake heircognitions hedominant nes. n the bsence f fundamental hanges, nterven-

tions argeted t only ne mechanism t a time willultimately ail, ecause heireffectiveness illbeundermined ycontextual actors hat re eft ntouched ysuch narrowly onceivedntervention. hus, n considering multifaceted ul-tilevel esponse ostigma, ne should hoose nterventions hat ither roducefundamental hanges n attitudes nd beliefs r change hepower elations hatunderlie he bility f dominant roups o act on their ttitudes ndbeliefs.

Understanding he nfluence f Stigma rocesseson the Distribution fLifeChances

A core concern f sociology s to understand he distribution f life chances,whether hose efer ocareers, arnings, ocial ies, ousing, riminalnvolvement,health, r ife tself.Webelieve hat tigma rocesses ave dramatic ndprobablya highly nderestimatedmpact n such ife hances. Mostresearch roceeds yexamining hestigma ssociatedwith ne circumstance t a time e.g. AIDS,obesity, ental llness,minority acial tatus, emale ender, omosexuality,tc),and most lso assesses only one outcome t a time e.g. earnings, elf-esteem,housing, ocial nteractions, tc.).When his ccurs, esearchersften ind omelevel f ffect or particular tigmatized roup n a particular utcome. owever,it s alsousually rue hat many actors ther han he tigma rocesses nquestioninfluence heoutcome, eaving tigma s just one factor mongmany. his canleadto the onclusion hat tigmamatters ut hat ts effect s relatively odestcompared o other actors. his accounting s misguided or woreasons. irst,in seeking o understand he mpact f stigma or particular ircumstance, nemust eep n mind hat t can affect many ife hances, ot ust one.Thus, full








382 LINK * PHELAN

accounting ust onsider he verall ffect n a multitude f outcomes. econd,there re host f tigmatizingircumstanceshat eed obe considered n tudying

a particular utcome. full ssessment f he mpact f tigma n such n outcomemust ecognizehatmany tigmatizing ircumstances ontribute othat utcomeand not ust the one selected or heparticular tudy n question.Whenviewedbroadly, tigma rocesses ikely lay a major role n life chances nd deservescrutiny ot ust by nvestigators hohappen o be interested n stigma ut by avariety f social scientists hoare nterested n the distribution f ife chancesmore enerally.

CONCLUSIONAlmost orty ears fter he ublication fGoffman's ook n stigma, e revisitedthe oncept n ight f research hat as been undertakenn the nterim. ttendingto criticisms f the oncept nd ts application y researchers romGoffman othe present, e constructed revised onceptualization f the erm. n our def-inition, tigma xistswhen lements f abeling, tereotyping, eparating, tatusloss, nd discriminationo-occur n a power ituation hat llows hese rocessestounfold. fter evelopinghis efinition nd xplicatingts omponent arts, efound tuseful nproviding substantially ifferent erspective n several rucialissues n the iterature n stigma.Moreover, ur conceptualizationuggests hatstigma s likely o be a key determinant f many f the ife chances hat oci-ologists tudy, rom sychological ell-being o employment, ousing, nd ifeitself.A propitious venuefor future esearch would nvolve he ncorporationof stigma oncepts nd measures n community-basedurvey esearch hat eeksto understand he ocial determinants f a broad rray f ife chances. uch anundertaking ould reatly dvance esearch nstigma ecause t would ssess helinkage etween tigma ndoutcomes hat learlymatter npeople's ives, herebyovercominghe riticism e alluded o earlier egardinghe veremphasisn mi-crolevel nteractions n stigma esearch. t the ame time, he ncorporation fstigma oncepts ndmeasures n research ocused n ife hances wouldprovideinvestigatorsn many reasof sociological esearch ith dditional ossibilitiesfor nderstandinghe ocial distributions f the particular utcomes hat re thefocus f their ttention. ost mportantly, owever, uch n endeavor ould ellus much more hanwe already now bout he onditions nderwhich tigma srelated ountoward utcomes nreal ife ituations. nowledge f his ort houldform he asis for hekinds f multifaceted ultilevelnterventionshat epresentourbesthopefor roducing eal hange n stigma-relatedrocesses.

ACKNOWLEDGMENTS

We thank atrick orrigan, ruceDohrenwend, avidPenn, ndElmer trueningfor aluable omments n an earlier ersion f this aper.









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