Public attitudes about equitable COVID-19 vaccine allocation: a randomised experiment of race-based versus novel place-based frames

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

Republicans and Democrats responded to the COVID-19 pandemic in starkly different ways, 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 have been a central concern in public health, and the concept of health equity has also been beset by partisan polarization. In this article, the authors present and discuss nationally representative survey data from 2023 on US public perceptions of disparities in COVID-19 mortality (building on a previous multiwave survey effort) as well as causal attributions for racial disparities, the contribution of structural racism, and broader attitudes about public health authority. The authors 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 of the likelihood of finding common ground in how the general public understands health inequities or the role of structural racism in perpetuating them. However, the authors show that those who acknowledge racial disparities in COVID-19 are more likely to support state public health authority to act in response to other infectious disease threats. The authors explore the implications of these public opinion data for advocacy, communication, and future needed research.

Effects of communicating health disparities using social comparison framing: A comprehensive review

Communicating health disparities in mass and social media has typically taken the form of comparing disease risks and outcomes between two or more social groups, a strategy known as social comparison framing. This comprehensive review examined the design and results of 17 studies from 15 peer-reviewed journal articles about the effects of social comparison framing of health disparities. Most studies focus on race-based disparities across a variety of health topics. For individual-level outcomes, social comparison tends to reduce perceived disease risks for the lower disease prevalence group while prompting negative emotions and yielding inconsistent impact on health behavioral intentions among members of the higher prevalence group. For societal-level outcomes, social comparison often has either null or polarizing effects on support for policies to address these disparities that vary by racial identity/attitudes of the respondents. Studies also find that racial comparisons trigger lower levels of support for policy remedies relative to economic, educational, or geographic comparisons. We conclude that social comparison framing of health disparities, in the absence of broader discussion of the social and structural causes of these disparities, is more likely to incur negative consequences. We propose several possible strategies to communicate health disparity information more effectively.

The Supreme Court's Rulings on Race Neutrality Threaten Progress in Medicine and Health

This Viewpoint examines the recent Supreme Court rulings on race neutrality, striking down affirmative action programs in higher education, which will affect efforts to eliminate health inequities in the US.

Ethnic homophily affects vaccine prioritization strategies

People are more likely to interact with other people of their ethnicity-a phenomenon known as ethnic homophily. In the United States, people of color are known to hold proportionately more high-contact jobs and are thus more at risk of virus infection. At the same time, these ethnic groups are on average younger than the rest of the population. This gives rise to interesting disease dynamics and non-trivial trade-offs that should be taken into consideration when developing prioritization strategies for future mass vaccine roll-outs. Here, we study the spread of COVID-19 through the US population, stratified by age, ethnicity, and occupation, using a detailed, previously-developed compartmental disease model. Based on historic data from the US mass COVID-19 vaccine roll-out that began in December 2020, we show, (i) how ethnic homophily affects the choice of optimal vaccine allocation strategy, (ii) that, notwithstanding potential ethical concerns, differentiating by ethnicity in these strategies can improve outcomes (e.g., fewer deaths), and (iii) that the most likely social context in the United States is very different from the standard assumptions made by models which do not account for ethnicity and this difference affects which allocation strategy is optimal. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".