The stigma of alcohol-related liver disease and its impact on healthcare
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The stigma of alcohol-related liver disease and its impact on healthcare. / Schomerus, Georg; Leonhard, Anya; Manthey, Jakob; Morris, James; Neufeld, Maria; Kilian, Carolin; Speerforck, Sven; Winkler, Petr; Corrigan, Patrick W.
In: J HEPATOL, Vol. 77, No. 2, 08.2022, p. 516-524.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - The stigma of alcohol-related liver disease and its impact on healthcare
AU - Schomerus, Georg
AU - Leonhard, Anya
AU - Manthey, Jakob
AU - Morris, James
AU - Neufeld, Maria
AU - Kilian, Carolin
AU - Speerforck, Sven
AU - Winkler, Petr
AU - Corrigan, Patrick W
N1 - Copyright © 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
PY - 2022/8
Y1 - 2022/8
N2 - People with alcohol-related liver disease (ALD) experience stigma and discrimination. This review summarises the evidence on stigma in healthcare and its implications for people with ALD, drawing from the literature on the stigma associated with mental illness and, specifically, alcohol use disorder (AUD). Public stigma, self-stigma and structural stigma all contribute to failure to seek help or delays in seeking help, inferior healthcare, and negative health outcomes, which increase the overall burden of ALD. Stigma can be experienced, but also anticipated and avoided, with both scenarios negatively impacting on ALD healthcare. Blaming people with ALD for their condition is central to the stigma of ALD. Stigma affects ALD healthcare at all stages, from prevention, early detection and intervention, to allocation of scarce resources in liver transplantation. People with lived experience need to be empowered to lead action against the stigmatisation of patients with ALD. Promulgating a dynamic model of individual and social responsibility for AUD, a continuum model of harmful alcohol use, and establishing training on ALD-related stigma for healthcare professionals are strategies to address stigma. Integrating addiction and ALD services, providing stigma-free prevention, and overcoming the frequent separation of addiction services from general healthcare are necessary. Beyond healthcare, addressing social inequality, the social dimensions of ALD risk and outcomes, and ensuring equal access to services is necessary to improve outcomes for all people with ALD. More research is needed on the stigma of ALD in low- and middle-income countries and in countries with restrictive drinking norms. Interventions to reduce the stigma of ALD and facilitate early help-seeking need to be developed and evaluated.
AB - People with alcohol-related liver disease (ALD) experience stigma and discrimination. This review summarises the evidence on stigma in healthcare and its implications for people with ALD, drawing from the literature on the stigma associated with mental illness and, specifically, alcohol use disorder (AUD). Public stigma, self-stigma and structural stigma all contribute to failure to seek help or delays in seeking help, inferior healthcare, and negative health outcomes, which increase the overall burden of ALD. Stigma can be experienced, but also anticipated and avoided, with both scenarios negatively impacting on ALD healthcare. Blaming people with ALD for their condition is central to the stigma of ALD. Stigma affects ALD healthcare at all stages, from prevention, early detection and intervention, to allocation of scarce resources in liver transplantation. People with lived experience need to be empowered to lead action against the stigmatisation of patients with ALD. Promulgating a dynamic model of individual and social responsibility for AUD, a continuum model of harmful alcohol use, and establishing training on ALD-related stigma for healthcare professionals are strategies to address stigma. Integrating addiction and ALD services, providing stigma-free prevention, and overcoming the frequent separation of addiction services from general healthcare are necessary. Beyond healthcare, addressing social inequality, the social dimensions of ALD risk and outcomes, and ensuring equal access to services is necessary to improve outcomes for all people with ALD. More research is needed on the stigma of ALD in low- and middle-income countries and in countries with restrictive drinking norms. Interventions to reduce the stigma of ALD and facilitate early help-seeking need to be developed and evaluated.
KW - Alcoholism
KW - Delivery of Health Care
KW - Health Personnel
KW - Humans
KW - Liver Diseases
KW - Social Stigma
U2 - 10.1016/j.jhep.2022.04.026
DO - 10.1016/j.jhep.2022.04.026
M3 - SCORING: Review article
C2 - 35526787
VL - 77
SP - 516
EP - 524
JO - J HEPATOL
JF - J HEPATOL
SN - 0168-8278
IS - 2
ER -
