Separating disability stigma from health stigma: implications for health and rehabilitation research and practice.

Abstract

Disability stigma is a key under-addressed driver of health inequalities among persons with disabilities, including barriers to accessing rehabilitation. Many studies conflate disability stigma and health stigma despite the International Classification of Functioning, Disability and Health (ICF) distinguishing between the concepts of "disability" and a "health condition." This paper applies the ICF to identify the conceptual boundaries between disability stigma and health stigma. This paper comprises a conceptual review of the disability and health stigma literature. The ICF is used as a framework to analyse the boundaries between these constructs. Analysis identifies a clear conceptual distinction between the two constructs. Health stigma arises from adverse judgements about health conditions. Conversely, disability stigma arises from adverse judgements about impairment(s), activity limitation(s), and/or health-related participation restriction(s) which may relate to health conditions but can also occur independently of them. The revised definition of disability stigma identified by this research better aligns with the ICF and separates it analytically from health stigma. It enables more precise, including intersectional, analysis of disability stigma and provides a basis for clearer measurement. This will support targeted interventions and policies to address disability-related health inequalities, including barriers to accessing rehabilitation.