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Additive and Multiplicative Effects of Socially Stigmatized Identities Using Linear Regression to Model Effects on
Katrine LeStage1, Robert Vogel2, Julia Moore Vogel3
1Hoosic Valley Central School, Schaghticoke, NY, United States.
JMIR Formative Research
|April 2, 2026
Summary
Social stigmas significantly impact health, with intersecting stigmas having complex additive and multiplicative effects on overall well-being. Understanding these combined effects is crucial for improving health outcomes for marginalized populations.
Area of Science:
- Social epidemiology
- Health disparities research
- Quantitative health sciences
Background:
- Socially stigmatized identities are linked to significant health disparities and poorer health outcomes.
- Existing research often overlooks the combined impact of multiple stigmatized identities on health.
Purpose of the Study:
- To quantitatively assess the additive and multiplicative effects of multiple stigmatized identities on self-reported overall health.
- To identify specific individual and intersecting stigmas that negatively influence health outcomes.
Main Methods:
- Utilized survey data from 387,411 participants in the All of Us Research Program.
- Employed a linear model to estimate the effects of 47 individual and pairwise stigmatized identities on self-rated overall health.
- Applied false discovery rate adjustment for multiple hypothesis testing.
Main Results:
- 29 individual and 116 pairs of stigmas showed statistically significant effects on self-reported overall health.
- Negative effects were observed for stigmas such as difficulty walking, unemployment, and low educational attainment.
- Intersecting stigmas exhibited varied effects, with some exacerbating health issues (e.g., depression) and others mitigating them.
Conclusions:
- Multiple intersecting stigmatized identities significantly impact overall health, with both direct and indirect effects.
- Findings highlight the need to consider the multidimensionality of individuals in health research and clinical practice.
- Further research is encouraged to explore higher-order intersectionality of stigmas and their health implications.
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