Deviance, difference, and stigma as social determinants of health

Sociologist Emile Durkheim (1895-1982) suggested that deviance is a universal feature of all societies because it implies the vales and norms of a culture. Moral interpretation exists in all societies, and some qualities and conduct are perceived as more desirable than others, so deviance is always present in every society. By identifying what is deviant, societies identify what is not. This in turn creates shared standards within a society. Often the notion that some people are different in an unacceptable way leads to stigma, which refers to certain traits and behaviours that are devalued by others. The word 'stigma' is derived from an ancient Greek word meaning 'mark'. Marks were impressed on slaves as a way to identify their position in the social structure, which was one of inferiority. Although deviance, difference, and stigma are socially constructed concepts, they are often thought of as somehow intrinsic, and so have a negative impact on the life and well-being of the individuals and groups who are so labelled. As such, they form an important component of the social determinants of health. This chapter will bring readers through several important issues relevant to deviance, difference, and stigma, The chapter will first introduce these notions, then discuss the impact they have on the health and well-being of those who are stigmatised, It also discusses stigma and HIV/AIDS and what has been done to combat HIV-related stigma as a case study.