COVID-19 – Facts, Cultural Considerations, and Risk of Stigmatization
By Debra Pettit Bruns, PhD, MSN, MSPH, Nina Vanessa Kraguljac, MD, and Thomas R. Bruns, MSHF
The novel Coronavirus 2019 (COVID-19) was first recognized and reported in Wuhan, Hubei Province, China on December 31, 2019. On January 30, 2020, the World Health Organization announced COVID-19 as the sixth public health emergency requiring worldwide attention (World Health Organization, 2020). There are seven types of corona virus which can infect humans, and infections are not uncommon around the globe. As this pandemic continues, we recognize how culture may affect risk of infection and risk of stigmatization.
The impact of culture on health is widely known and accepted. When considering new diseases, epidemics, and pandemics we must consider culture perceptions and ways they may impact how symptoms are recognized, access to care and treatment are provided, and how fear of stigmatization may affect illness reporting and outcomes. Our interventions should assess cultural beliefs and assumptions, while mitigating stigma against individuals, families, and communities. Interventions need to be implemented locally with culturally appropriate education and community participation. It is important to assess the role of culture and avoid correlating disease with questionable cultural causations. This may lead to blaming specific populations for their high prevalence rate or stigmatizing of certain groups (Sovran, 2013).
Stigmatization is real and can negatively affect populations of people in seeking and accessing care and also in general public response. Individuals who perceive they are stigmatized against may delay seeking care, others become afraid of those believed to be sick or exposed, entire populations may be prejudiced against, and in some cases stigmatization has led to violence against individuals and groups.
Stigma has been a major theme throughout the literature on infectious disease outbreaks and specifically surrounding quarantine measures. Quarantined individuals are more likely to report stigmatization and social rejection including avoidance, withdrawing social invitations, and making critical comments, suggesting stigma may specifically be surrounding people who are quarantined (Brooks, 2020).
Data on COVID-19 has shown us that mortality increases significantly with age and those with underlying comorbidities. Targeted social distancing for vulnerable groups may be an effective way to reduce morbidity and mortality but could also inadvertently increase stigma towards them. As health care providers we must be aware of the potential for stigmatization of populations affected by COVID-19 as well as the potential psychological consequences of prolonged quarantine on all populations. Furthermore, it is important to consider the real economic impact related to lost workdays due to quarantine and social isolation efforts as well as travel restrictions that may negatively impact access to care and ability to pay for care.
Efforts geared towards general education regarding COVID-19 and the rationale for social distancing and quarantine provided to the general public can reduce stigmatization. Media reporting is a powerful tool to influence public opinion and can assist in preventing stigmatization. As stated by the Center for Disease Control (2020) this situation is constantly changing as we are continuing to learn more about the virus, disease pathology, and tertiary effects. The cases of COVID-19 will continue to rise and the virus will be sustainable for future infections. Timely and appropriate public health interventions along with proper screening, treatment, and follow-up for affected individuals and close contacts can reduce the number of infections, illness severity, and deaths. For successful management of the epidemic, effective screening, and treatment of COVID-19 we should focus public health efforts at culturally appropriate methods of education, prevention, treatment, and follow up.
Article Details
COVID-19: Facts, Cultural Considerations, and Risk of Stigmatization
Debra Pettit Bruns, PhD, MSN, MSPH, Nina Vanessa Kraguljac, MD, and Thomas R. Bruns, MSHF
First Published April 21, 2020 Research Article
DOI: 10.1177/1043659620917724
Journal of Transcultural Nursing
About the Authors
