The stigma turbine:A theoretical framework for conceptualizing and contextualizing marketplace stigma

Stigmas, or discredited personal attributes, emanate from social perceptions of physical characteristics, aspects of character, and “tribal” associations (e.g., race; Goffman 1963). Extant research emphasizes the perspective of the stigma target, with some scholars exploring how social institutions shape stigma. Yet the ways stakeholders within the socio-commercial sphere create, perpetuate, or resist stigma remain overlooked. We introduce and define marketplace stigma as the labeling, stereotyping, and devaluation by and of commercial stakeholders (consumers, companies and their employees, stockholders, institutions) and their offerings (products, services, experiences). We offer the Stigma Turbine (ST) as a unifying conceptual framework that locates marketplace stigma within the broader sociocultural context, and illuminates its relationship to forces that exacerbate or blunt stigma. In unpacking the ST, we reveal the critical role market stakeholders can play in (de)stigmatization, explore implications for marketing practice and public policy, and offer a research agenda to further our understanding of marketplace stigma and stakeholder welfare

African American Public Housing Residents in the HOPE VI Era: Relocation, Social Networks and Health.

This dissertation is a three paper mixed-methods project that explores the significance of public-housing policy and urban development for the health of low-income African-American communities. Specifically, it seeks to better understand how relocation that has occurred in the context of public-housing demolition and concurrent urban revitalization affects access to social ties and social support for this population. Chapter 2 is a critical literature review of the US Department of Housing and Urban Development’s HOPE VI program. HOPE VI has funded the demolition of public-housing developments across the country and created in their place, mixed-income communities that are often inaccessible to the majority of former tenants. This chapter considers the potential health consequences of HOPE VI for relocated individuals, particularly through the disruption of supportive social networks. Chapter 3 uses the Census Bureau's Survey of Income and Program Participation to estimate the relationship between residence in a federally owned public-housing project and reported presence of community-based social support among African Americans who receive rent assistance. This study finds that in comparison to other rent-assisted households, public-housing residents are significantly more likely to report that people in their neighborhood count on each other, watch each other’s children and help each other out. It also finds that measures of community support are associated with reduced odds of school expulsion and grade repetition among children. This study contributes to the literature by quantifying the presence of social support resources in a national sample of public-housing residents and its findings are consistent with concern for social resources that may be disrupted by policies of demolition and dispersal. Through in-depth interviews and participant observation, Chapter 4 examines the experiences of 25 low-income African American women and men who have relocated from Chicago to Johnson County, Iowa. Many of these individuals were displaced by public-housing demolition in Chicago and were looking for safe neighborhoods and affordable housing that were unavailable in the city. Chapter 4 focuses on how this experience of interstate migration affects access to social support, as well as a sense of rootedness that is located in geographically stable social ties.Ph.D.Health Behavior & Health EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/63742/1/danyak_1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/63742/2/danyak_2.pd

COVID-19 and Hidden Housing Vulnerabilities: Implications for Health Equity, New Haven, Connecticut

COVID-19 has laid bare our connectedness, with early maps demonstrating its movement from person to person and community to community. But over time, the maps have revealed a darker truth, exposing vast inequality and shameful rifts within societies, exemplified in the case of the United States. One such dimension of inequality impacting the pandemic is housing. Our research on housing as a social determinant of HIV risk reveals understudied and neglected housing vulnerabilities that may impact COVID-19 risk. The concept of “household” is key to COVID-19 because our current best defense against the virus is social distancing, a household level strategy. Policy makers have recognized that those without a household are at risk: COVID-19 responses, although likely inadequate in many places, have included assistance for people who are homeless. One such response has been contracting with now empty hotels to provide rooms for people without residences, so they can observe social distancing guidelines. Leaseholders have also been included in COVID-19 responses, with temporary forgiveness of late rental payments (though these plans include many caveats). These responses, however imperfect, do little for those with less visible but often highly insecure housing arrangements. Traditional dichotomies of housed versus homeless, or even stably versus unstably housed, do not adequately capture the varied housing arrangements in low income communities. Through the Justice, Housing and Health Study (JustHouHS) we examine housing vulnerability and mass incarceration to document how they operate and intersect to impact health, with a specific focus on HIV risk. 400 low income residents of predominantly minority neighborhoods in New Haven, CT, half recently released from prison, completed biannual surveys about housing, criminal justice history and health between 2017 and early 2020. Fifty-four participants also participated in in-depth qualitative interviews. These data have deepened our understanding of housing vulnerability. The term “household” takes on different meanings when housing scarcity and community ties create webs of shifting units of people living together, from temporary stays to lifelong arrangements, and from homeowners to renters, to those with no legal ties to the place they stay. Many of our participants struggle regularly, or even daily, in their quest for housing; nonetheless, they are not considered homeless because they neither stay in shelters nor live on the streets. They are ‘housed,’ albeit precariously. For example, while over 30% reported homelessness in the last 6 months, more than half of those were homeless for only part of that time. Many of them were among the nearly three quarters of participants who reported ever having lived or stayed with someone to avoid being homeless. Brandon, an African American man in his late fifties, represents just one example. During the 3-year JustHouHS study period, he stayed at different shelters until settling most recently at his sister’s house. As with Brandon, participants’ residences changed regularly: 66% responded that there was a 50% or greater chance that they would not be living in the same place in 6 months. People moved between multiple households in their social network to avoid overstaying their welcome, and in response to changing social ties. For example, many male participants returning from prison or leaving a halfway house, sober house, or treatment program found temporary shelter at girlfriends’, sisters’ or parents’ homes, going in between households as circumstances changed. Tom, an African American man in his late forties and a native of New Haven, landed a full-time job at a recycling plant, but his criminal record prevented him from securing his own housing. To lessen the burden on any one household, he split his time between his father’s place and the home of his daughter’s mother, with whom he had maintained a friendship after their partnership ended. Conversely, the more stably housed within the JustHouHS sample often felt obligated to provide shelter to those relatives, friends, and partners locked out of housing due to low wages, unstable employment, or failed criminal background or credit checks. A quarter of respondents in the most recent JustHouHS survey said that in the last 6 months, they let someone stay with them because they had no place to go. For example, Rayna, an African American woman in her early forties with five children, housed her daughter, her daughter’s partner, and her daughter’s child at different points during the study period. Her daughter’s family would stay in a shared space such as the living room, or in a room with one of Rayna’s four sons. Brooklyn, also African American in her early forties, now lives in a one bedroom apartment with two of her adult sons. Although tenuously housed herself throughout the study period, moving several times, she always prioritized having a place where her adult sons could stay when they had no other options. Such housing situations have implications for the social distancing recommended to stem the COVID-19 pandemic. For some people who are precariously housed, social distancing as one household unit can require a dramatic change in living arrangements, necessitating living at only one place. Efforts to comply with social distancing guidelines may strain or upend close relationships within or outside of the household, negatively impacting mental and physical health. For other people, living in only one household isn’t possible due to childcare, elder care, and other multiple household situations. Even with efforts to carefully follow recommendations to the best of their ability, people may be placed at increased risk, along with all those in their housing network. Since such networks are located in areas where many residents have similar arrangements, the risk for entire communities may be elevated. For those that house others, the financial, personal and health risks they take on in doing so will likely be exacerbated by COVID-19. At the same time, the pandemic, the public health response to it, and its aftermath will likely increase the need for community members to provide housing to others: as homeless shelters close, more people are released from incarceration due to the virus, economic opportunities are scarce or non-existent, and housing opportunities are increasingly limited. It did not take long for the race inequities in COVID-19 infection, hospitalization and death rates to become apparent, and though harder to document, it seems clear that poor communities are disproportionately impacted as well. We seek to understand these inequities by applying what we have learned through JustHouHS about how social determinants of health impact on race inequities in HIV. Housing vulnerability, criminal justice involvement, complicated histories of medical mistrust and disparate healthcare treatment all combine to render people of color at increased risk for HIV. These same social determinants of health are now implicated in the inequities increasingly documented in COVID-19 infections, hospitalizations and death. In the next phase of our research, we hope to focus on how housing vulnerability creates inequities in the pandemic’s impacts. While many of those studying health inequities have long understood the connection between housing vulnerability and health, we will focus on an oft-overlooked group of the housing vulnerable—the precariously housed and their hosts. We aim to document and analyze how this group is impacted by the virus and the public health response to it. Our hope is that the crisis brought on by the COVID-19 pandemic will expand public discussion of the critical need to rethink our entire approach to housing—to see safe and affordable housing as a critical social good and fundamental right for all. And, as we work to translate that awareness into new policies and programs, we will do so in ways that recognize the many different forms that housing vulnerability can take

My neighborhood has a good reputation: Associations between spatial stigma and health

Health researchers increasingly recognize the influence of spatial stigma, or negative reputation of place, as a social determinant of health. Drawing from a New Haven-based cohort study (n=251), we assessed the relationships between spatial stigma, self-rated health, and psychological distress using generalized estimating equation models. Adjusting for neighborhood-level poverty and racial composition, those who perceived living in spatially stigmatized neighborhoods were significantly more likely to report severe psychological distress compared to those that did not perceive their neighborhoods to be stigmatized (B=1.09, CI: 0.31, 1.87). Our findings contribute to a growing body of literature that suggests that socially constructed meanings of place may influence health

Spatial stigma and health in postindustrial Detroit

An emerging body of research suggests that those who reside in socially and economicallymarginalized places may be marked by a stigma of place, referred to asspatial stigma, which influences their sense of self, their daily experiences, and theirrelations with outsiders. Researchers conducted 60 semistructured interviews atpartnering community-based organizations during summer 2011 with AfricanAmerican and Latina/o, structurally disadvantaged youth of diverse gender andsexual identities who were between 18 and 26 years of age residing in Detroit,Michigan. The disadvantaged structural conditions and dilapidated built environmentwere common themes in participants’ narratives. Beyond these descriptions, participants’framings and expressions of their experiences in and perceptions of thesespaces alluded to reputational qualities of their city and particular areas of their citythat appear related to spatial stigma. Young Detroit residents articulated the waysthat they experience and navigate the symbolic degradation of their city

Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT

We sought to examine whether and how landlord-related forced moves (inclusive of, but not limited to, legal eviction) were associated with emergency department (ED) use over time. We used survey data collected between 2017 and 2019 among 283 low-income participants in New Haven, CT to examine whether experiencing a legal eviction or other landlord-related forced move (T0) was associated with increased odds of ED use 6 months (T1) and 12 months (T2) later. We conducted bootstrapped mediation analyses to examine indirect effects of post-traumatic stress symptoms. One-fifth of participants (n = 61) reported a recent forced move at baseline (T0); half of these were legally evicted. Landlord-related forced moves were associated with ED use at T1 (AOR = 2.06, 95 % CI: 1.04-4.06) and T2 (AOR = 3.05, 95 % CI: 1.59-5.88). After adjustment for sociodemographic factors and other health-related confounders, legal eviction was not significantly associated with ED use at T1 (AOR = 1.61, 95 % CI: 0.68-3.81), but was significantly associated with ED use at T2 (AOR = 3.58, 95 % CI: 1.58-8.10). Post-traumatic stress symptoms accounted for 15.1% of forced moves\u27 association with ED use (p \u3c.05). Landlord-related forced moves are positively associated with subsequent ED use, and post-traumatic stress symptoms are one factor that may help explain this association. Structural interventions that promote housing stability are needed to advance health equity, and they may also help to reduce preventable ED use. Such interventions are imperative in the context of the COVID-19 pandemic, which has strained health system capacity and exacerbated housing instability for many low-income renters. Results underscore the relevance of trauma-informed care and integrated care management to clinical practice in emergency settings