Abstract
BackgroundIllness-related stigma has been identified as an important public health concern. Past research suggests there is a disproportionate risk of mental-health stigma in the military, but this same finding has not yet been established for physical-health stigma. The current study aimed to assess the independent contribution of mental and physical health on both enacted stigma (discriminatory behaviour) and felt stigma (feelings of embarrassment) and to determine whether these associations were stronger for military personnel than civilians.MethodsData were obtained from the 2002 Canadian Community Health Survey - Mental Health and Well-being and its corresponding Canadian Forces Supplement. Logistic regressions were used to examine a potential interaction between population (military [N = 1900] versus civilian [N = 2960]), mental health, and physical health in predicting both enacted and felt stigma, with adjustments made for socio-demographic information, mental health characteristics, and disability.ResultsMental health did not predict enacted or felt stigma as a main effect nor in an interaction. There was a strong link between physical health and enacted and felt stigma, where worse physical health was associated with an increased likelihood of experiencing both facets of stigma. The link between physical health and enacted stigma was significantly stronger for military personnel than for civilians.ConclusionsPhysical health stigma appears to be present for both civilians and military personnel, but more so for military personnel. Elements of military culture (e.g., the way care is sought, culture of toughness, strict fitness requirements) as well as the physical demands of the job could be potential predictors of group differences.
Highlights
Illness-related stigma has been identified as an important public health concern
The military sub-sample had a higher prevalence of males than the civilian sub-sample, as well as a higher prevelance of middle aged, white, and married individuals
Military personnel were more likely to report experiencing enacted stigma with 16.34% (95% C.I. [14.44; 18.24]) indicating they had experienced discimination over the past 12 months compared to 6.50% of civilians (95% C.I. [5.39; 7.61])
Summary
Illness-related stigma has been identified as an important public health concern. Illness-related stigma has been identified as an important public health concern [1, 2], with many documented negative effects including anxiety [3], stress [4], depression [5], reduced self-esteem/self-efficacy [6], reduced or delayed care-seeking [7, 8], and lowered adherence to treatment [9]. In the workplace health-related stigma is associated with a lack of career advancement, poor quality of work, as well as diminished employability, and increased likelihood of being unemployed or under-employed [23, 24]
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