Healthcare systems across the world are attempting to shift towards a more preventative approach whereby the key is to ensure people remain healthy rather than fixing us when we become sick. Such a shift in focus would be considerable, but research from the Kellogg School reminds us that it’s not always easy to get us to make the right choices.
The researchers wanted to explore the role our self-image plays in the health decisions we make, especially if the health problems we’re addressing were linked to stigmatized behaviors. For instance, regular screening for cervical cancer is widely believed to be a good practice to get into, but the high number of sexual partners often linked with cervical cancer is stigmatized.
Keeping healthy
The researchers found that social stigma can play a crucial role in our health choices. For instance, risks such as smoking or being obese are often stigmatized, so if we perceive ourselves as a good person, we are likely to make choices to rectify matters.
Similarly, if health messaging mentions a stigmatized risk factor, it results in the healthy behavior being tainted, which in turn makes people less likely to engage in it, even if it’s beneficial to them. Across five experiments, the researchers found that when people were primed to think of a moral sense of self, they would be far more likely to undergo cancer screening if they weren’t also reminded of stigma from issues such as smoking.
What’s more, this sense of moral identity also changed our perceived risk of lung cancer as well, with those people in the high-stigma condition perceiving their risk to be about 20% lower when they were primed with moral identity. In other words, when we tell ourselves that we’re a good person, we believe that we’re not the kind of person who gets diseases we view as the preserve of bad people. As a result, we then reduce the amount of time we spend protecting ourselves from such diseases.
Of course, this can have the opposite impact if we perceive something as being morally just, such as getting vaccinated against a fictitious disease.
“Someone who cares about being a good person wants to take care of themselves, because being healthy is virtuous,” the authors explain. “Being healthy is virtuous from a self-control perspective, because it means you can resist things that are not good for you. But healthiness is also virtuous from a public-health perspective. Historically, healthy people reduced spread of diseases and created better-functioning, more-productive societies.”
Overcoming stigma
This can change when stigma is taken into account, however, as our sense of morality can strip away the virtuosity of certain health behaviors.
As such, the researchers believe that it’s vital that and policymakers have to be aware that when developing health messaging that stigmatized risk factors might diminish our motivation to choose what is ostensibly the healthier option. For instance, when discussing cancer screening, it might pay to avoid mentioning cancer, or when discussing diabetes interventions to avoid mentioning obesity.
This has been evident during the pandemic, as for conservatives, the use of masks and vaccines has become stigmatized, so adherence to Covid protection measures could threaten the view conservatives have of themselves as a good person.
So, just as health messaging would do well to avoid associations with stigmatized risk factors, so would public health organizations do well to avoid messaging that draws attention to ideology.
