Communication Currents

When an epidemic breaks, public health agencies may attempt to communicate with the general public. The goals of such communication may vary, from simply promoting awareness to encouraging prevention and treatment responses. One unintended consequence of health alerts is creating a stigma around the epidemic. Stigmas are stereotypes about the disgrace of a particular group and its members. To date, little attention has been paid to understanding and testing communication’s role in creating stigmas. Communication about health issues comes with risks and benefits.  It is important to critically consider not only how our communication choices can motivate health-promoting actions but also how they can result in the devaluation of a particular group and its members. History shows that once stigmas are in place, they are terribly difficult to eradicate. During disease outbreaks, stigmas may diffuse further into a community and faster than the disease itself, and be more challenging to treat.

My study systematically tested multiple versions of a health alert. The basis of the alert was a CDC media story on hantavirus pulmonary syndrome. In the experiment, the disease is given a fictitious name, cautela acervusary virus, and varied to represent different types of communication content, described in the model of stigma communication. For example, one version of the story described visual symptoms of infected persons, while another did not. I then measured how readers felt (disgust, anger, and fear) and thought (perceived responsibility and perceived dangerousness) about infected people after reading one of 16 different versions of the health alert.  

Participants were also asked whether they would share the alert with others and how much they believed that the condition would be stigmatized. They reported being more likely to share the alert with others when visible symptoms of the infection were present. Sharing such messages may have particular appeal, because the visible symptoms can clearly identify infected members and facilitate social distancing from infected persons, which can spur social bonding among the uninfected.

Readers were also asked if they agreed with certain types of interventions, including isolation of infected persons from the non-infected public, registering infected persons to be monitored and tracked, and providing a map for locating infected persons. Readers varied in their support for intervening in the lives of infected persons, from strong disagreement with intervention to strong support for intervention. One argument for interventions is that, for conditions transmitted directly from one human to another directly, protecting public health may require quarantining, registering, locating, and treating infected persons. On the other hand, for vector-borne conditions, those spread through contact with another organism (e.g., a tick, mouse, or bird), these same interventions have little benefit. In these cases, attention must be paid to the vector (e.g., finding and removing the mice). Hantavirus pulmonary syndrome is an important example of a vector-borne condition, in which exposure to mouse urine, droppings, or saliva is the mode of transmission. Notably, in 1993, before the CDC diagnosed hantavirus,media coverage of the “navajo flu” was spread, which has been associated with stigmatization. In my experiment, changing descriptions of the disease’s transmission (mouse versus human to human) did not reliably shift readers’ support for person-based interventions.

In addition to varying response to messages based on the message content, individuals’ personalities affected their interpretation of the alerts. Readers with more cynical worldviews were more likely to report stronger stigma beliefs and to perceive infected people as more dangerous, regardless of which alert they read. This finding may lead us to a source of hope:  If we can induce trust, hope, or optimism, people may become more resistant to engaging in stigma-related processes and may, instead, focus on the health issue. The research suggests that health alerts should avoid focusing on the person as the illness in order to avoid attention to person-centered transmission when it may not be the case, and person-centered blame and perceptions of infected people as dangerous.