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Lookup NU author(s): Dr Steph ScottORCiD, Professor Clare BambraORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
This paper explores the connection between stigma and the Inverse Care Law (ICL) by focussing on the idea that people who have the greatest needs often have the least support from healthcare services. Twenty-four semi-structured interviews were undertaken with people who used class A & B illicit drugs, in the northeast of England. Many of the people in this study who used illicit drugs were not able to access quality healthcare in a timely way to meet their needs because of structural and relational stigma. We discuss four themes: (i) pressure on health services and long waiting lists, (ii) sensitivity to compassion fatigue from staff and impacts on engagement, (iii) complex systems that are difficult to navigate and (iv) stigma and drug use. These themes illuminate the harms of stigma and support Tudor Hart's ICL. Stigma is a key contributor to the inverse experience of good quality healthcare and requires greater attention from policymakers and practitioners. The structural and relational aspects of stigma embedded in healthcare are central to the ICL and reproduce inequities in access to and experience of good quality healthcare, which in turn impacts health inequalities.
Author(s): Addison M, Scott S, Bambra C, Lhussier M
Publication type: Article
Publication status: Published
Journal: Sociology of Health and Illness
Year: 2025
Volume: 47
Issue: 1
Online publication date: 19/01/2025
Acceptance date: 17/12/2024
Date deposited: 25/07/2025
ISSN (print): 0141-9889
ISSN (electronic): 1467-9566
Publisher: Wiley-Blackwell Publishing Ltd.
URL: https://doi.org/10.1111/1467-9566.70000
DOI: 10.1111/1467-9566.70000
Data Access Statement: Due to the sensitivity of this data regarding personal drug usage of participants, and given it is a small qualitative dataset, it is justifiable that the data are not made available.
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