Americans’ Perceptions of Health Disparities in the COVID-19 Pandemic

• In Event: Public Opinion and the COVID-19 Pandemic

Abstract

COVID-19 has starkly illuminated the consequences of structural racism in the United States. The burdens of disease and death – as well as the social welfare consequences of the inept governmental response – are much higher among Black and Indigenous people and other people of color. Disparities by income status are also profound, as lower-wage essential workers were unable to adopt mitigating behaviors like their higher-income counterparts. These health disparities became part of the political narrative of 2020, with media accounts documenting the intertwined epidemics of racism and COVID-19 following George Floyd’s murder in May 2020. But how much did the public perceive of these disparities in COVID-19, and how did public recognition change over the summer of 2020? Previous research has demonstrated low awareness and even resistance to health inequities, well-documented in numerous chronic and infectious illnesses prior to COVID-19. To address these questions, we analyze data from two nationally-representative public opinion surveys, collected using the NORC AmeriSpeak sample in late April 2020 (N=1,007) and August 2020 (N=2,716). The key outcome variables were 4 items asking respondents about their agreement with statements about disparities in COVID-19 mortality by age, chronic illness, income, and race. We found that in April 2020, 52% of Americans recognized racial disparities in COVID-19 mortality while 52% recognized income disparities, as compared to 82% who recognized disparities by age and 86% by chronic illness. Despite a summer of attention to the role of racism in health outcomes, we observed consistent or even slightly lower recognition of socially-patterned disparities in August 2020: 47% of respondents perceived disparities by race, 48% by income, 82% by age, and 86% by chronic illness. In August, regular readers of print news perceived racial disparities significantly more than those who reported lower consumption of print news; there were no differences by viewing local TV news or consuming news via social media. Rates of perceiving racial disparities differed among subgroups across the time periods; for instance, among white respondents, recognition declined somewhat (54% in April, 47% in August) while among Black respondents, recognition of racial disparities increased (49% in April, 59% in August). We discuss these results through the lens of motivated reasoning, integrating these findings with those of other recent studies that suggest the limitations of media awareness campaigns to persuade the general public about health inequity.

Authors

• Sarah E. Gollust, University of Minnesota

• Rebekah Nagler

• Erika Franklin Fowler, Wesleyan University