Polarized Perspectives on Health Equity: Results from a Nationally Representative Survey on US Public Perceptions of COVID-19 Disparities in 2023

Abstract

Republicans and Democrats responded in starkly different ways to the COVID-19 pandemic, from their attitudes in 2020 about whether the virus posed a threat to whether the pandemic ended in 2023. The consequences of COVID-19 for health equity has been a central concern in public health, and the concept of health equity has also been beset by partisan polarization. In this essay, we present and discuss nationally-representative survey data from 2023 on U.S. public perceptions of disparities in COVID-19 mortality (building on a multi-wave previous survey effort), as well as causal attributions for racial disparities, the contribution of structural racism, and broader attitudes about public health authority. We find anticipated gulfs in perspectives between Democrats on the one hand, and Independents and Republicans on the other. The results offer a somewhat pessimistic view on the likelihood of finding common ground in how the general public understands health inequities or the role of structural racism in perpetuating them. However, we show that those who acknowledge racial disparities in COVID-19 are more likely to support state public health authority to act for other infectious disease threats. We explore the implications of these public opinion data for advocacy, communication, and future needed research.

Promoting public health equity through strategic information campaigns on social media during the COVID‐19 pandemic: An analysis of pandemic health information campaigns on Twitter in Houston, Texas

“…However, in a separate analysis of elected officials and equitable health information by political partisanship, we found that Democrats were more likely than Republicans to share public information on Twitter addressing health barriers. These findings emphasize the need for what Gollust et al (2023) refer to as depolarizing public health. One potential path forward, especially on social media platforms, is what Fowler et al refer to as an "inoculation language, " where individuals receive a warning of potential controversy or political bias before reading a post (Fowler, 2022).…”

“…However, we expect the partisanship of the elected officials in our sample to explain our dependent variable. Previous work suggests stark differences in partisanship in acknowledging health inequities (Gollust et al, 2023). During the pandemic, Democrats exhibited higher rates of risk perception in response to the pandemic (Bruine de Bruin et al, 2020) and were more likely to engage in healthy and safe behaviors during the pandemic (Gadarian et al, 2021) compared with Republicans.…”