This case study highlights the benefits of mapping the potential aspects of social inequalities that could be relevant to the topic you are interested in and describes some of the approaches that can be used. It illustrates aspects of mapping inequalities and of designing and conducting research sensitive to inequalities. Accordingly, it appears as a case study in Sections 1 and 3 of the HIAT.

During a study of a place-based programme in England, researchers undertook qualitative fieldwork in several localities to understand how the initiative was unfolding on the ground.  Although not an explicit focus of the original study, ‘place stigma’ (the ways in which negative public attitudes or media coverage of particular neighbourhoods causes stereotyping or stigmatisation of residents) emerged as a priority for people living in some but not all of the localities where the fieldwork took place.

The researchers identified that this topic was poorly understood in public health research, policy and practice and became interested in developing research on this topic.  To get a better picture of the diverse ways in which place stigma could affect health inequalities, the team organised public involvement workshops with residents and community organisations from different parts of the country.  The sessions provided insights into how negative area portrayals could have economic consequences when prospective employers were reluctant to employ residents from particular areas. The workshop also drew attention to the impacts for certain groups, such as the risks posed to young people’s aspirations or confidence because they felt ashamed of their neighbourhood.

The public involvement activities and fieldwork provided key insights into the experiences and impacts of place stigma and how this could affect groups differently.  Alongside this, researchers also scoped the international research literature to gain a broader understanding of underlying causes of place stigma. This scoping suggested there was no single aspect that results in place stigma although it is almost exclusively associated with localities characterised by disadvantage and social exclusion. In the United States, place stigma is often associated with the historical legacy of racial segregation linked to urban neighbourhoods experiencing high poverty. In comparison, UK research highlighted how stigma is evident in low-income areas or post-industrial areas, as well as neighbourhoods with predominantly white working-class populations or ethnic minority populations. This initial scoping of published evidence also revealed a lack of systematic reviews on the topic, with research studies located across a range of disciplines including housing, health, geography and sociology.

The researchers decided to undertake a systematic review of qualitative studies reporting residents’ accounts of living in a stigmatised place.  The mapping work helped to shape the review questions and the intersectional approach taken to the review.  For example, during the data extraction and synthesis, the reviewers looked specifically at the interaction of place stigma with different social categories (e.g. race/ethnicity, gender, age), including the ways in which these social categories interacted, as well as the underlying causes of spatial stigma. For example, one finding from the review illuminated how young men of colour were more likely to be stopped and questioned by the police, and that this was also compounded by their place of residence.