A new health policy brief from Health Affairs, with support from the Robert Wood Johnson Foundation, is titled “Structural Stigma In Law: Implications And Opportunities For Health And Health Equity.” It was written by Sarah Hemeida, Lina Brou, and Daniel Goldberg, all of whom are affiliated with the University of Colorado Anschutz Medical Campus, and Hallie Conyers-Tucker, a JD candidate at Seattle University School of Law. The brief joins Health Affairs’ ongoing series of policy briefs on the social determinants of health.

As the brief states, stigma, defined as a stain on a person’s reputation, operates both as a process and an outcome. It is a pervasive experience for its targets and can go unnoticed by those who are unaffected. When stigma is promoted through the organizations and systems that govern daily life, it is called structural stigma. A powerful social determinant of health, the stigmatization process has been demonstrated to worsen physical health outcomes and social well-being.

The brief illustrates how laws and policies mediate structural stigma through the example of people with substance use disorder (SUD); explores potential mechanisms linking structural stigma in law to negative health outcomes, and therefore to health inequities for populations that are already marginalized; and recommends an approach for revision of laws and policies that can reduce structural stigma for targeted communities.

The authors completed a pilot study for the state of...

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