“A Double-Edged Sword”: The Role of Social Identity Dimensions in the Intention to Use Healthcare Services by People With Type 2 Diabetes

Social identity has been linked to both positive and negative health outcomes. Using a correlational design with a sample of N = 501 individuals with type 2 diabetes, this study examined how the affective (i.e., affectivity) and cognitive (i.e., centrality) dimensions of social identification with the group of individuals with type 2 diabetes are associated with the intention to use healthcare services. We hypothesized that stronger affective identification with this group would be positively associated with intentions to use healthcare services through two parallel mechanisms: fostering positive self-evaluation (encompassing self-esteem and self-efficacy) and mitigating the effects of diabetes-related stigma. Additionally, we hypothesized that centrality would be negatively associated with healthcare-seeking intentions through the same mechanisms. The results revealed a negative correlation between affectivity and centrality within this group. Consistent with our hypotheses, affectivity was associated with greater intentions to use healthcare services, whereas centrality was associated with lower intentions. In both cases, these associations were simultaneously mediated by self-evaluation and the experience of stigma. These findings reveal the distinct effects of different facets of social identity on health-related behaviours, highlighting the importance of considering both affective and cognitive dimensions in understanding healthcare utilisation among individuals with type 2 diabetes.