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Strategic approaches to overcoming bias, stigma & discrimination in chronic disease

Investments and advances in person-centred health services and medical therapies over the past several decades have transformed how we treat and live with chronic diseases. Not all patients, however, are created equal in the eyes of research and healthcare ecosystems.

Implicit, explicit, internalized negative beliefs and attitudes (bias) about chronic diseases can interact with deeply rooted social stereotypes and labels and lead to stigmatizing healthcare practices, as well as discriminatory health and social policies. Stigma and discrimination can result in health and social inequalities at individual and population levels.

Evidence-based, practical, and context-specific actions are urgently needed to eliminate stigmatizing and discriminatory practices and policies in healthcare, education, and public policy.

That's why we're here.

"Noncommunicable diseases are the leading cause of death worldwide. "1

"Globally, it's estimated that roughly one in three adults suffer from multiple chronic conditions."2

"People living with chronic illnesses report a variety of forms of experienced stigma in their daily lives, including within healthcare settings."3

"People living with chronic illnesses may internalize, experience, and anticipate stigma / social devaluation or discrediting due to their illness."4

"Many people are exposed to multiple stigmas, preventing them from attaining the resources they need to achieve optimal health such as education, employment, housing, and health services."5

1. World Health Organization 2. Hajat 2018 3. Earnshaw 2022 4. Earnshaw 2012 5. Chief Public Health Officer’s Report on the State of Public Health in Canada 2019

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"20% of Canadians with a mental health illness reported being affected by negative opinions or unfair treatment due to their poor mental health."1

"49% of people currently in recovery from addiction reported experiencing stigma or discrimination during their active addiction."2

"Individuals with obesity perceive weight discrimination across life domains, such as employment, schools, healthcare and interpersonal relationships, ranging from 19.2% among individuals with Class I obesity to 41.8% among individuals with severe obesity."3

"Stigma is a significant public health concern, and effective and comprehensive interventions are needed to counteract the damaging effects of the infodemics during infectious disease epidemics, including COVID-19, and reduce infectious disease-related stigma."4

"The majority of youth who identified as transgender (ages 19 to 25 years) reported having experienced discrimination in the last year."5

"Almost one in five older patients with a chronic disease report experiencing health care discrimination."6

"People with disabilities who perceive discrimination are less likely to seek healthcare. This association was higher for people with communication and physical disabilities."7

Chief Public Health Officer’s Report on the State of Public Health in Canada 2019

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Our approach

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1

Prioritize global and local issues related to stigma and health

Engage global and local stakeholders to prioritize issues and actions in healthcare, education, employment, and public policy sectors

2

Implement, synthesize, and disseminate research

Conduct timely and rigorous research on chronic disease stigma; communicate findings and build scientific consensus

3

Develop collaborative evidence-informed and people centred solutions

Develop measurable and adaptable solutions to prevent and reduce stigma in healthcare, education, employment, and public policy, focusing on impact

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4

Challenge social stigma associated with chronic diseases

Develop and disseminate practical resources and tools to eliminate chronic disease stigma; challenge damaged identities and labels (public/social campaigns, communities of support, personal stories)

5

Build capacity to eliminate chronic disease bias and stigma

Create and implement training programs and resources to change practices in healthcare, workplaces, schools and public settings

6

Support evidence-informed and person-centred policy-making

Make stigma evidence accessible, timely, and relevant to policy-makers; collate evidence base to inform public policies; provide high quality evidence, norms, standards, resources, and training to policy-makers

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Inaugural board of directors

image of Dr. Angela Alberga
Dr. Angela Alberga

is an Associate Professor, Quebec Health Research Scholar and Research Chair at Concordia University in Montreal, Canada. She completed her MSc and PhD in Kinesiology and Postdoctoral research training in weight bias and stigma. She has over 15+ years experience in health research and knowledge translation with expertise in pediatric obesity and weight bias, stigma and discrimination. She leads an interdisciplinary research program working with researchers, clinicians and patients around the world to better understand how societal, school and other institutional factors, influence weight-related issues including obesity, eating disorders, physical inactivity and weight stigma across the lifespan.

image of Ted Kyle
Ted Kyle

founded ConscienHealth in 2009. He is a pharmacist and healthcare innovation professional working with health and obesity experts for sound policy and innovation. Ted is active in the Obesity Action Coalition, serving on the national board of directors for 12 years and as its chair. He advises The Obesity Society on advocacy, and consults with organizations to address the needs of people living with obesity. He publishes a widely-read daily commentary at

conscienhealth.org/news, and his peer-reviewed publications relate to obesity, weight bias, and health policy.

image of Dr. Ximena Ramos Salas
Dr. Ximena Ramos Salas

has a PhD in public health and 20+ years’ experience in health research and policy (Can. Inst. of Health Research) and obesity education, advocacy, and patient engagement (Obesity Canada). As a weight stigma and obesity expert she works with several international organizations such as the European Ass. for the Study of Obesity and the World Health Organization. She coordinated the 2020 Canadian Adult Obesity Management Clinical Practice Guidelines, which used a patient-centred approach and provided recommendations to reduce weight stigma.

image of Prof. Francine Small, MA
Prof. Francine Small, MA

has a 20-year background in social justice work, consisting of project management, support services and advocacy in the areas of sexual health education (through Planned Parenthood and Public Health), HIV/AIDS, youth advocacy and non-profit housing. She completed a Master’s of Social and Cultural Analysis with a focus on racial and ethnic categories in biomedical research. Francine is currently a working as a sociology professor in Montreal Quebec.

image of Brad Hussey
Brad Hussey

has 20+ years’ experience as a communications consultant in public- and private-sector healthcare and research settings. He has worked to reshape the understanding of and narratives about obesity nationally and globally. Brad has led and collaborated on multiple multi-disciplinary, high-visibility collaborations in obesity and other chronic disease areas, building trust among cross-sectoral partners to leverage unique knowledge, shared values and a commitment to improve lives.

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