How stigma makes pandemics worse for marginalized groups

COVID-19 isn’t affecting everyone equally, says U of A diversity expert who recommends ways to help overcome harmful biases.


Helly Goez, pediatric neurologist and assistant dean of diversity in the Faculty of Medicine & Dentistry, says assuming the COVID-19 pandemic is affecting everyone equally is wrong—and contributes to unhelpful stigmatization of socioeconomically disadvantaged groups. (Photo: Laughing Dog Photography)

The assumption that pandemics affect everyone equally is wrong and is helping to unnecessarily stigmatize socioeconomically disadvantaged groups, according to a University of Alberta diversity expert.

“If we are focusing on the aspect of stigma and bias alone, viruses or bacteria might have an address,” said Helly Goez, a pediatric neurologist in the Faculty of Medicine & Dentistry. “Throughout history data shows that some equity-seeking groups who have specific social determinants are known to be more predisposed and affected with higher rates of disease and worse outcomes.

“The stigmatization and shaming is subsequently way higher.”

Even for people who are not members of equity-seeking groups, Goez said there is a false assumption that “normal life” will resume simply because someone has recovered from COVID-19.

“There are many stories from people feeling social isolation because of being sick and after they had recovered,” she said. “Some report that they feel blamed for working and maybe not being very careful at work, or possibly getting others sick.”

“Now imagine if this was a person of colour, who also has a low socioeconomic status, was sick and suffered the consequences of being ill. Can you imagine the burden of the social determinants as related to that social isolation? It's huge.”

Higher risk among marginalized groups

Goez said during the Spanish flu outbreak in 1918, refugees were stopped at borders across Europe, as they were thought to carry the virus and minority groups were blamed for spreading the disease.

And while that of course was a fallacy, it is being shown that negative social determinants—including but not limited to crowded living conditions, low socioeconomic status and fewer employment opportunities—put marginalized groups at higher risk of contracting COVID-19 and an increased burden to add to the recovery from the illness.

In July, U of A social psychologist Kim Noels released the results of a survey in which two-thirds of Chinese Canadians surveyed reported experiencing at least some level of disrespect as a result of COVID-19, and half of respondents said they had been called names or otherwise insulted.

According to Goez, perceptions of the “other,” or those that are different, are programmed into the animal brain as survival instincts that are processed in milliseconds and result in fight, flight or freeze biological mechanisms.

She said there is data coming from functional brain imaging studies, that when people see pictures of individuals with different skin colour for an example, or clearly depict someone from a socioeconomically disadvantaged background, the brain immediately engages areas involved in understanding social differences.

However, while people are programmed as animals to screen for and acknowledge differences, Goez said human beings have the advantage of having a more developed brain that can be trained. 

“While in animals it is an instinct, for people a lot of the content of bias and stigma is learned, and can also decrease and change with education, and this is a route to go” she said.

Getting beyond bias

To remove stigmas and bias, Goez said the first step is to understand that the one commonality we all share is that we are all different.

Next, she said we need to increase awareness of how social determinants affect health. 

“Wherever we can, we have to show that a pandemic is not an equalizer, but that it is hitting marginalized groups even more,” she said.

She added that health authorities—and by extension their presence on social media and media channels—play an important role in enhancing the public’s understanding of facts and scientific terms in times of uncertainty, hence contributing to the educational mission on bias and stigma.

“Education is a must around the topic of understanding, race, racism and anti-racism,” she said. “It should be taught at every level of age and development.

“Every audience is the right audience, and each moment is the right time.”