ArticleSocial science & medicine (1982)2017
"The land of the sick and the land of the healthy": Disability, bureaucracy, and stigma among people living with poverty and chronic illness in the United States.
Article in Social science & medicine (1982), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 112 citations in OpenAlex.
- The experience of financial burden for people with multimorbidity: A systematic review of qualitative research.Health expectations : an international journal of public participation in health care and health policy · 2021Pooled it
- Stigma in health facilities: why it matters and how we can change it.BMC medicine · 2019Pooled it
- Social Support in Group Medical Visits for Chronic Pain in Primary Care.Annals of family medicine · 2026Trial
- Associations Between Extreme Weather Events, Resource Insecurities, and HIV Vulnerabilities Among Adolescent Girls and Young Women in Kenya: Latent Profile Analysis Findings.AIDS and behavior · 2026Article
- Financial Capacity of SSI Recipients and the 2026 ABLE Age Adjustment Act.Journal of financial literacy and wellbeing · 2026Article
- Health insurance, race, and receipt of a postpartum visit among patients giving birth in a referral hospital in the US South.Social science & medicine (1982) · 2025Article
- Understanding and Addressing Mental Health Disparities and Stigma in Serious Illness and Palliative Care.Illness, crises, and loss · 2025Article
- Stigmatization of food insecurity helps explain the association between food insecurity and medication nonadherence among people living with HIV.Psychology, health & medicine · 2024Article
- Moving on income as a social determinant of health: free transit for social assistance recipients in Kingston, Ontario.Canadian journal of public health = Revue canadienne de sante publique · 2024Article
- The study of ableism in population health: a critical review.Frontiers in public health · 2024Review
- Unrealized Cross-System Opportunities to Improve Employment and Employment-Related Services Among Autistic Individuals.The Milbank quarterly · 2023Review
- COVID-19 disproportionately impacts access to basic needs among households with disabled members.Disability and health journal · 2023Article
- The role of resilience in diabetes stigma among young and middle-aged patients with type 2 diabetes.Nursing open · 2023Article
- A Systems Approach to Identify Factors Influencing Participation in Two Tribally-Administered WIC Programs.Nutrients · 2023Article
- "As if we are branded with the mark of Cain": stigma, guilt, and shame experienced by COVID-19 survivors in Israel - a qualitative study.Current psychology (New Brunswick, N.J.) · 2023Article
- How might diabetes organisations address diabetes-related stigma? Findings from a deliberative democratic case study.Health expectations : an international journal of public participation in health care and health policy · 2022Article
- Social Insurance Literacy of Dutch Workers Receiving Disability Benefits and its Associations with Socio-Economic Characteristics.Journal of occupational rehabilitation · 2022Article
- Does resource insecurity drive HIV-related stigma? Associations between food and housing insecurity with HIV-related stigma in cohort of women living with HIV in Canada.Journal of the International AIDS Society · 2022Article
- Ableism and Contours of the Attitudinal Environment as Identified by Adults with Long-Term Physical Disabilities: A Qualitative Study.International journal of environmental research and public health · 2022Article
- Gender Identity, Disability, and Unmet Healthcare Needs among Disabled People Living in the Community in the United States.International journal of environmental research and public health · 2022Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
Disability benefits have become an increasingly prominent source of cash assistance for impoverished American citizens over the past two decades. This development coincided with cuts and market-oriented reforms to state and federal welfare programs, characteristic of the wider political-economic trends collectively referred to as neoliberalism. Recent research has argued that contemporary discourses on 'disability fraudsters' and 'malingerers' associated with this shift represent the latest manifestation of age-old stigmatization of the 'undeserving poor'. Few studies, however, have investigated how the system of disability benefits, as well as these stigmatizing discourses, shapes the lived experience of disabling physical illness in today's United States. Here we present qualitative data from 64 semi-structured interviews with low-income individuals living with HIV and/or type 2 diabetes mellitus to explore the experience of long-term, work-limiting disability in the San Francisco Bay Area. Interviews were conducted between April and December 2014. Participants explained how they had encountered what they perceived to be excessive, obstructive, and penalizing bureaucracy from social institutions, leading to destitution and poor mental health. They also described being stigmatized as disabled for living with chronic ill health, and simultaneously stigmatized as shirking and malingering for claiming disability benefits as a result. Notably, this latter form of stigma appeared to be exacerbated by the bureaucracy of the administrating institutions. Participants also described intersections of health-related stigma with stigmas of poverty, gender, sexual orientation, and race. The data reveal a complex picture of poverty and intersectional stigma in this population, potentiated by a convoluted and inflexible bureaucracy governing the system of disability benefits. We discuss how these findings reflect the historical context of neoliberal cuts and reforms to social institutions, and add to ongoing debate around the future of public social provision for impoverished and chronically ill citizens under neoliberalism.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.