CCSR - Stigma and Behavioral Health in Urban Employers from China and the United States

Stigma and Behavioral Health in Urban Employers from China and the United States

Abstract & Stages
Theoretical Review and Models
1. Behaviorally-Driven Health Conditions and Causal Attribution
2. Behaviorally-driven Health Conditions and Dangerousness
3. Cross-Cultural Differences
4. References
Researchers & Acknowledgements

Cross-Cultural Differences

As outlined in Figure 3, the individualist/collectivist continuum helps to explain the experience of people with these behaviorally-driven health conditions and their corresponding stigma (Triandis, 2001). Individualism, which is largely an American perspective (especially a European American perspective), emphasizes autonomy and personally meaningful goals that have dominance over the needs of the group. American individualism is influenced by strong Judeo-Christian and Puritan causes that emphasize self-sufficiency, self-determination, and independence (Triandis, 1993). Conversely, Chinese tend to embrace collectivist world views which make minimal distinctions between personal and group goals. The Chinese sense of collectivism has its roots in Buddhist, Taoist, and Confucian philosophies (Bond, 1986). Furthermore, the high population density and tight ecology of China dispose individuals to form close-knit ecosystems and relationships that impact individuals' sense of self (Ekblad, 1996; Fang, 1988; Markus & Kitayama, 1991), which in turn affect their attitudes, belief systems, and behavioral practices. As a result of a collectivist perspective, Chinese may view individual health conditions as not sufficiently important to bother the collective (Tracey, Leong, & Glidden, 1986). Behaviorally-driven health conditions, which are perceived as weaknesses of the personally responsible patient, are viewed as taxing the group and therefore shameful. Families in particular will own this shame and seek to protect themselves further by keeping the health condition and corresponding treatment a secret.

Related to these concerns is loss of face. Defined in terms of an individual's identification with a strong collective, loss of face refers to the threat to the social integrity of the individual and, perhaps of greater importance, the clan (Agbayani-Siewert, Takeuchi, & Pangan, 1999). Behaviorally-driven health conditions are seen as a threat to familial integrity. As a result, family's and the member with the health condition will try to keep secret the condition, often opting to avoid treatment altogether. Note that the social cognitive variables that played a central role in our earlier model (i.e., responsibility attributions) have a central role in how collectivism and loss of face are understood.