Safety first: How stigma may impact health: Theory suggests that lack of perceived safety may impact the health of people in marginalized communities more than exposure to discriminatory events

Where do you feel safe? And with whom? Where are the spaces in your life where you can truly relax, let your guard down, and not feel like a threat might be lurking?

Over the course of human history, such safety is relatively rare. And for people in marginalized communities, it can be very hard to find. That lack of safety, according to a new theory by University of Utah psychology professor Lisa Diamond and recent doctoral graduate Jenna Alley published in Neuroscience and Biobehavioral Reviews, may have a direct impact on the health of people in marginalized communities, particularly the LGBTQ community. The theory challenges decades of thinking that health disparities in the LGBTQ community are primarily due to encounters with stressful and discriminatory events, a concept called “minority stress.”

“If we want to promote the health of stigmatized populations, it’s not going to be enough to simply remove discriminatory laws,” Diamond says. “If you are still experiencing social disconnection and social rejection, the body is living in a state of vigilance and wariness and fear. And that is a direct public health threat.”

Minority stress

Many studies have found that LGBTQ teens and adults face higher rates of mental illnesses than the general population, with one study arguing that depression now poses a greater mental health risk to gay and bisexual men than HIV. Disparities in physical health have been more complicated to measure, but many have found elevated cardiovascular disease risks in sexually or gender diverse individuals.

Why does the LGBTQ community face health risks? Could it be related to social stigmas? In 2003, epidemiologist Ilan Meyer of UCLA proposed that LGBTQ health disparities could be explained by the concept of “minority stress” — a cumulative burden of exposure to stressful discriminatory or violent events that reinforce a stigmatized or minority status.

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