How Health Behaviors Combine to Produce Stigma: A Health Lifestyle Perspective on Social Judgments

Health behaviors often co-occur within individuals, yet research on health stigma typically evaluates behaviors in isolation. I reconceptualize stigma as a configurational process, asking whether social penalties accumulate additively or follow a patterned logic when behaviors co-occur. Using a large factorial experiment ( N = 1,792; 10,744 vignette evaluations), I measure stigma through stereotypes (warmth and competence), devaluation, and social distance. Results indicate that stigma increases as stigmatized behaviors accumulate but not indefinitely. Once a profile includes strongly disapproved behaviors, additional negative behaviors add relatively little to judgments of competence, devaluation, and social distance. Analyses of health lifestyle ideal types reveal a clear moral hierarchy: Health-conscious lifestyles receive the most favorable evaluations, mixed profiles fall in between, and substance-oriented or consistently health-compromising lifestyles are most stigmatized. Together, these findings show that people evaluate behavioral constellations as coherent lifestyles, producing consequential stigma around recognizable patterns of “healthy” and “unhealthy” living.