Neural and Cardiovascular Pathways from Stigma to Suboptimal Health

Abstract

This chapter reviews research from the emerging field of social neuroscience to examine the underlying mechanisms that explain why stigma and discrimination lead to suboptimal health outcomes. The review is structured around three pathways through which stigmatization has negative effects on physical health, and it discusses neural and cardiovascular processes associated with (1) the stress that being a target of discrimination elicits, (2) impaired self-regulation of health behavior among targets of discrimination, and (3) how intergroup dynamics during interactions between health care provider and patient can result in suboptimal health care for stigmatized individuals. The insights offered by the neuroscience perspective provide crucial information on how to interrupt the downward stigma–health spiral and can inform policy to reduce the impact of stigma and discrimination on the physical health of its targets.