Editorial: Growing up in a High-Stigma Context: An Unseen Driver of Neurodevelopment, Health, and Pathology

Growing research establishes that stigma can play a key role in driving population health inequalities, particularly among minority groups.¹ Indeed, stigma related to gender, race/ethnicity, sexual orientation, mental illness, or disability has been linked to elevated risk of mental and physical health problems ranging from depression to cardiovascular disease. Recent neuroimaging studies point to changes in brain structure and function-particularly in stress-responsive brain networks-in mediating the link between stigma and risk of mental disorders. For example, recent neuroimaging research links racial discrimination to elevated neural response to threat in Black women in the United States.² Importantly, stigma can occur at multiple levels, and most research to date has focused on stigma experienced at individual or interpersonal levels (eg, identity concealment, victimization). However, structural stigma (eg, laws and social norms) is increasingly recognized as a critical social determinant of health for people in marginalized groups. However, structural stigma is methodologically challenging to study at the level of neurobiology because relatively large, multisite studies are needed that span different sociopolitical contexts. An innovative study by Hatzenbuehler et al.³ in this issue of the Journal examines for the first time the impact of structural stigma on neurodevelopment in children. This study paves the way for future studies examining how contexts-particularly stigmatizing contexts-can act as unseen drivers of neurodevelopment, health, or pathology.