Since the earliest days of the COVID-19 pandemic, there have been clear partisan differences around public health guidelines such as mask use and vaccinations. A new study from the University of Minnesota School of Public Health (SPH) shows how public perceptions of COVID-19 health disparities are shaped by partisan affiliation.

The study, published in the Journal of Health Politics, Policy and Law, examined several issues, including partisan gaps in public attitudes about the contribution of structural racism to health, as well as the authority of public health agencies to combat future disease threats. Researchers used a nationally representative survey from the spring of 2023. 

The study found:

• Democrats were consistently more likely than Republicans to agree that race or income level contributed to COVID-19 mortality disparities. There were no partisan differences when asked about mortality disparities by age or chronic illness status.
• The most commonly provided causal explanation for racial disparities, regardless of political orientation, was differences in access to health care; however, Republicans were much more likely (64%) than Democrats (35%) to cite individual-level causes, such as an individual’s personal choices.
• Though few respondents overall (30%) agreed that systemic racism is a cause of health inequities, there were differences across partisan groups. 54% of Democrats, 12% of Republicans and 17% of Independents agreed that systemic racism is a cause of health inequities.
• Overall, a slim majority (53%) of respondents supported the authority of public health departments to reduce the spread of infectious disease. 75% of Democrats supported this authority, while 39% of Republicans and 35% of Independents did so.
• Those who recognized racial disparities in COVID-19 were more likely to support states’ authority to act, even after adjusting for these partisan differences.

“For public health professionals and others who believe that health equity and the protection of the public’s health should be priorities, these data are sobering,” said SPH Professor and lead author Sarah Gollust.

The authors noted that elected officials and public health leaders will need to establish effective communication strategies to explain the existence and causes of racial disparities as well as strategies to address them. Additional work is needed to contribute new evidence about how to depolarize public health concepts as part of a broader preparedness strategy to build public trust in science and support for public health authority.

“In spite of all the attention to racial justice in policing as well as in the pandemic, we found that over half of the public recognized racial disparities the first time we fielded these survey items in April 2020, and only about one-third recognized this in April 2023,” Gollust said. “The rapidity with which the COVID-19 pandemic has accelerated political polarization surrounding public health is a crisis that demands all of our attention. There is an urgent need to build recognition of the importance of public health and find ways to mobilize support for addressing persistent inequities.”

Co-authors of the paper include Chloe Gansen and Rebekah Nagler from the University of Minnesota’s Hubbard School of Journalism and Mass Communication, and Erika Franklin Fowler and Steven Moore from Wesleyan University. The authors are part of a research team called the Collaborative on Media & Messaging for Health and Social Policy.

Support for this research was provided by the Robert Wood Johnson Foundation.

About the School of Public Health
The University of Minnesota School of Public Health improves the health and well-being of populations and communities around the world by bringing innovative research, learning, and concrete actions to today’s biggest health challenges. We prepare some of the most influential leaders in the field, and partner with health departments, communities, and policymakers to advance health equity for all. Learn more at sph.umn.edu.