The elephant in the room? Why spatial stigma does not receive the public health attention it deserves.

In the context of health inequalities, spatial stigma refers to the ways that areas experiencing socioeconomic inequalities become negatively portrayed and labelled in public, official and policy discourses. With respect to the body of research on social determinants of health and health inequalities, and attention accorded to this issue in policy or practice, spatial stigma remains significantly under-represented compared with other possible causal factors. We suggest three explanations contributing to this neglect. First, the lack of research into spatial stigma originates from a more limited public health focus on the symbolic meanings of places for health, compared to their physical and social dimensions. Second, lay involvement and evidence of lived experiences of health inequalities continues to be under-represented in public health decision-making. Finally, it is the case that public health organizations may also be contributing to negative area portrayals in their communications of health inequalities. There are growing examples of social action being taken by groups of residents to resist this stigma through the promotion of more positive portrayals of areas and communities. Greater public health attention to this issue as well is likely to result in health gains and aid the development of more effective health inequalities strategies.