Document Type

Capstone Experience

Graduation Date

5-2025

Degree Name

Master of Public Health

Department

Health Promotion

First Committee Member

Dr. Melissa Tibbits

Second Committee Member

Dr. Michelle (Shelley) Strong

Third Committee Member

Dr. David Brett-Major

Abstract

Background: Leprosy, while a treatable condition, continues to be associated with significant stigma, which adversely influences the physical, psychological, social, and economic well-being of affected individuals throughout their lives. The stigma linked to leprosy leads to social exclusion, mental health difficulties, and obstacles to accessing healthcare and employment opportunities (Brakel et al., 2019; Sermrittirong & Van Brakel, 2014). This research employs Life Course Theory to describe the long-term experiences of stigma, coping strategies, and social support individuals living with leprosy. By synthesizing findings from existing literature and conducting a qualitative interview, the study offers an in-depth understanding of how various life stages and social environments shape the experiences of stigma associated with leprosy.

The Public Health Triad (agent, host, and environment) is a critical framework for understanding the interplay of biological, individual, and environmental factors contributing to stigma and its management. In the context of leprosy, the agent Mycobacterium leprae not only causes physical manifestations of the disease but perpetuates societal misconceptions and fear due to its historical associations. The host, representing individuals affected by leprosy, often endures psychosocial challenges compounded by these misconceptions (Bassey, 2012). Finally, the environment, shaped by cultural, economic, and healthcare infrastructures, influences the severity and persistence of stigma. For instance, in Africa, traditional beliefs and fears exacerbate stigma, whereas in the United States, a lack of awareness about leprosy reinforces ignorance and prejudice. It's important to note that the unique cultural contexts in different regions present distinct challenges for individuals affected by leprosy, highlighting the need for culturally sensitive interventions. Addressing these dimensions collectively can inform more effective stigma-reduction strategies.

Methodology: This study employs a triangulated research design, which integrates a comprehensive literature review with an interview with an individual affected by leprosy. The literature search was carried out using databases such as PubMed, PsycINFO, and Embase, with specific inclusion criteria targeting studies on leprosy stigma, coping strategies, and social support networks. Meanwhile, the interview provided valuable personal and professional perspectives on the experience of stigma across various life stages. The analysis was guided by Life Course Theory, facilitating an exploration of how factors such as the timing of diagnosis, the evolution of social relationships, and cumulative stigma-related experiences influence coping strategies and resilience over time (Bryman, 2016; Creswell, et al., 2016).

Findings: The interview and literature review results reveal the enduring stigma associated with leprosy and its significant social, psychological, and economic ramifications. The interview provided insights into the participant's experiences, which included delayed diagnosis, societal judgment, self-imposed isolation, and dependence on religious coping mechanisms. Similarly, the literature highlights how stigma results in social exclusion, courtesy stigma experienced by caregivers, and the perpetuation of misconceptions about the disease. Both the interview and the literature stress the necessity for comprehensive mental health support, which should be a key component of any intervention strategy. This support is crucial in alleviating the psychological effects of stigma and enhancing the quality of life for those affected. The Life Course theory perspective further elucidated how stigma can impact crucial life transitions, including education and employment, ultimately influencing long-term mental health outcomes and resilience (Chatters, 2014).

Conclusion: This research demonstrates that Life Course Theory provides significant insights into the persistent impact of leprosy stigma throughout various life stages, thereby informing the creation of culturally appropriate interventions and public health strategies. Mitigating stigma necessitates the education of both communities and healthcare professionals, the establishment of support networks, and the empowerment of individuals affected by leprosy to more effectively navigate social transitions. Subsequent investigations should focus on the long-term psychological effects of stigma and evaluate the efficacy of community-based interventions across different cultural settings (Sottie & Darkey, 2019). By integrating a literature review and an interview, this study emphasizes the critical need for holistic strategies to diminish the stigma surrounding leprosy. It supports formulating actionable strategies to enhance the quality of life for affected individuals.

Integrating Life Course Theory into the Results underscores the critical role of timing, social relationships, cumulative impacts, and societal attitudes in shaping the stigma experienced by individuals with leprosy. For example, delayed diagnosis during formative years disrupts educational and social development, while cumulative stigma impacts long-term psychological resilience. The Public Health Triad also provides a structured lens to examine how biological, individual, and environmental factors interact to perpetuate stigma and its consequences. Both frameworks collectively elucidate how individuals navigate the challenges of stigma across life stages, emphasizing the importance of timely and culturally sensitive interventions.

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