King's College London

Research portal

Holding a stigmatizing attitude at the start of the COVID-19 outbreak: A cross-sectional survey

Research output: Contribution to journalArticlepeer-review

Louise E Smith, Henry WW Potts, Richard Amlot, Nicola Fear, Susan Michie, James Rubin

Original languageEnglish
JournalBritish Journal of Health Psychology
Early online date4 Oct 2021
Accepted/In press2021
E-pub ahead of print4 Oct 2021

Bibliographical note

Funding Information: All authors had financial support from NIHR for the submitted work. RA is an employee of Public Health England; HWWP receives additional salary support from Public Health England and NHS England; HWWP receives consultancy fees to his employer from Ipsos MORI, and has a PhD student who works at and has fees paid by Astra Zeneca; and NTF is a participant of an independent group advising NHS Digital on the release of patient data. All authors are participants of the UK’s Scientific Advisory Group for Emergencies or its subgroups. There are no other financial relationships with any organizations that might have an interest in the submitted work in the previous three years and no other relationships or activities that could appear to have influenced the submitted work. Funding Information: This work was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme. LS, RA, and GJR are supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London, and the University of East Anglia. RA is also supported by the NIHR HPRU in Behavioural Science and Evaluation, a partnership between Public Health England and the University of Bristol. HWWP receives funding from Public Health England and has from NHS England. NTF is part funded by a grant from the UK Ministry of Defence. The views expressed are those of the authors and not necessarily those of the NIHR, Public Health England, the Department of Health and Social Care, or the Ministry of Defence. Surveys were commissioned and funded by Department of Health and Social Care (DHSC), with the authors providing advice on the question design and selection. DHSC had no role in analysis, decision to publish, or preparation of the manuscript. Preliminary results were made available to DHSC and the UK’s Scientific Advisory Group for Emergencies. Publisher Copyright: © 2021 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Objectives: To identify the prevalence of a stigmatizing attitude towards people of Chinese origin at the start of the COVID-19 outbreak in the UK population and investigate factors associated with holding the stigmatizing attitude. Design: Online cross-sectional survey conducted 10–13 February 2020 (n = 2006, people aged 16 years or over and living in the UK). Methods: We asked participants to what extent they agreed it was best to avoid areas heavily populated by Chinese people because of the COVID-19 outbreak. Survey materials also asked about: worry, perceived risk, knowledge, information receipt, perception of government response to COVID-19, and personal characteristics. We ran binary logistic regressions to investigate associations between holding a stigmatizing attitude, personal characteristics, and psychological and contextual factors. Results: 26.1% people (95% CI 24.2–28.0%, n = 524/2006) agreed it was best to avoid areas heavily populated by Chinese people. Holding a stigmatizing attitude was associated with greater worry about COVID-19, greater perceived risk of COVID-19, and poorer knowledge about COVID-19. Conclusions: At the start of the COVID-19 pandemic, a large percentage of the UK public endorsed avoiding areas in the UK heavily populated by people of Chinese origin. This attitude was associated with greater worry about, and perceived risk of, the COVID-19 outbreak as well as poorer knowledge about COVID-19. At the start of future novel infectious disease outbreaks, proactive communications from official sources should provide context and facts to reduce uncertainty and challenge stigmatizing attitudes, to minimize harms to affected communities.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454