Vaccine envy during the COVID-19 pandemic

The term vaccine envy (i.e., envy experienced when others are given the opportunity to receive a COVID-19 vaccine) was coined during the COVID-19 pandemic and has received media attention. This study is the first to systematically investigate vaccine envy. In two pre-registered online surveys conducted in May 2021 (N = 1,174) and October/November 2021 (N = 535), we collected data from vaccinated and unvaccinated German participants, including measures of vaccine envy, well-being, personal experiences during the pandemic, and various trait constructs (e.g., justice sensitivity and self-esteem). We found that in May 2021, 47% of participants experienced vaccine envy at least sometimes and that vaccine envy was connected to victim sensitivity, subjective perceptions of being threatened by the pandemic, and an increased willingness to be vaccinated. By November 2021, however, vaccine envy among unvaccinated participants had almost disappeared. Our findings advance the understanding of the psychological impact of the COVID-19 pandemic.

'I don't feel that we are a burden': Latinx immigrants and deservingness during the COVID-19 pandemic

In this paper, we explore the material and symbolic effects of "deservingness projects" (Kline, 2019) for Latinx immigrants as they have played out over the COVID-19 pandemic. On a material level, exclusionary policies have exacerbated Latinx immigrants' disenfranchisement and contributed to disproportionate sickness and economic strife during the pandemic. On a symbolic level, they have contributed to subjective experiences of fear, distress, and desperation, and have eroded many immigrants' trust in institutions and support systems. Crucially, though, the pandemic's injustices have also crystallized a sense of outrage and indignation among some Latinx immigrants, provoking assertions of self-worth and sociopolitical projects of belonging and mutual care. Our findings thus challenge the notion that subjective self-understandings as 'undeserving' are fundamental to the undocumented experience and show that the pandemic's fallout has strengthened some immigrants' ability and willingness to "make claims for inclusion" (Abrego, 2011) and sociopolitical change.

Not all poor are equal: the perpetuation of poverty through blaming those who have been poor all their lives

The economic crisis of 2008 severely affected the welfare states. As the economic situation of a country worsens, the resources that the public administration can devote to improve the situation of the people also decrease, endangering the advancement of those in a disadvantaged situation. People who have always lived in poverty, besides having their opportunities reduced, also face negative public views that affect the perceived legitimacy of such public aid, which can in turn be a mechanism for perpetuating their situation. Two studies (N = 252 and N = 266) analyse how a person in persistent poverty is perceived compared to a person in poverty due to the crisis-a circumstantial poverty. We also study some feasible mechanisms underlying this different perception, as well as their effects on attitudes toward social protection policies. In Study 1, results indicated that people showed more favourable attitudes toward social protection policies when they perceived someone in poverty due to the crisis, compared to the target who had been in poverty all his/her life. Individualistic attributions for poverty mediated this effect: when people think of someone in persistent poverty, they make more individualistic attributions concerning their situation, which leads to worse attitudes toward social protection policies. Identification with the group moderates this relation. Furthermore, Study 2 showed that participants perceive people who are in poverty because of economic crisis as more deserving of help than people who have always been poor. Some theoretical and practical implications for intergroup relations and public policy are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03804-6.

The citizen preferences-positive externality trade-off: A survey study of COVID-19 vaccine deployment in Japan

Objective

Medicine is a scarce resource and a public good that benefits others by bettering patients’ health. COVID-19 vaccines in shortage are, 1) a scarce resource and 2) a public good with the positive externality of building herd immunity. These features are expected to drive citizens’ attitudes in opposite directions, exclusionist and inclusionist, respectively. Scarcity would drive citizens’ exclusionism, while the positive externality might mitigate exclusionism.

Setting and design

We recruited 15,000 Japanese adults and asked them to rank, in the context of a COVID-19 vaccine shortage, the deservingness of hypothetical vaccine recipients who differed according to 1) citizenship status, 2) visa type and duration of stay (if foreign), 3) occupation, 4) age, 5) whether they lived with a child, and 6) whether they lived with an elderly individual. Citizenship options were Japanese, Chinese, Taiwanese, South Korean, American, or European. The occupations were healthcare, education, other employed, self-employed, or not employed. The 6 attributes were randomly combined, and respondents were shown 3 hypothetical vaccine recipients: one was Japanese, and the others were foreigners.

Treatments

First, through a conjoint design, we created hypothetical vaccine recipients whose attributes were randomized except for the benchmark citizenship, Japanese national. Second, we randomly presented two scenarios for vaccination payments: 1) billed at cost or 2) fully subsidized by the government.

Results

1) Whether the vaccines were billed at cost or fully subsidized did not affect the rankings of deservingness. 2) Japanese citizenship was prioritized. 3) The penalty for being a foreigner was higher for individuals from nations with which Japan has geopolitical tensions. 4) Working in health or education reduced the penalty on foreigners, indicating that the positive externality related to occupation amplifies the positive externality associated with vaccination and mitigates exclusionist attitudes.

Conclusions

The positive occupational externalities that amplify the positive externality of vaccination substantially allay the foreigner penalty.

Moral Elites and the De-Paradoxification of Danish Social Policy Between Civil Society and State (1849-2022)

The article argues that in Denmark during the past 150 years, moral elites have been central in settling paradoxes within social policy by developing 'classifications' of citizens and sectors: who are deserving of help and what sector (public or third) should provide care. Contrary to widely held beliefs, historically, there is no logical or practical connection between 'more deserving' and 'state support'. Theoretically, the article integrates elite scholarship and cultural sociology in developing a concept of moral elites' power from-their sources of moral authority-and power to, the way that they have used their power to classify citizens and sectors. Empirically, the Danish moral elite and its involvement in social policy are analyzed based on secondary as well as primary historical sources. Findings: The development of the Danish moral elite has roots in the administrators of the nineteenth-century absolutist state: the clergy, medical doctors, and lawyers. Educational resources and state affiliation continue to be central to moral elite status. Economists have ascended to the top of the moral elite, while clergymen have dropped out. Three major classifications were developed during the period. 'Help to self-help' (late nineteenth century): deserving poor should receive help from private charity, while the public system should deter and discipline. 'Rights' (mid-twentieth century): the state should care for all, philanthropy mostly considered stigmatizing. 'Workfare' (late twentieth century to present): citizens are considered deserving as long as they are 'active', and sectors are considered equal in providing for citizens as long as they reach the economistic goal of activation.

Public Reason, Public Comments, and Public Charge: A Case Study in Moral & Practical Reasoning in Federal Rulemaking

The "public charge" rule is a long-standing immigration policy that seeks to determine the likelihood that a prospective immigrant will become dependent on the government for subsistence. When the Trump administration sought to expand the criteria that would count against an applicant for permanent residency to include public benefits historically excluded from the calculation, thousands of commenters wrote to oppose or support the proposed changes. This paper explores the moral and practical reasons commenters provided for their position on the public charge rule and considers the value of the public comment process for immigration, health, and social policy.

To wish you well: the biopolitical subjectivities of medical crowdfunders during and after Aotearoa New Zealand's COVID-19 lockdown

Crowdfunding platforms apply a marketized, competitive logic to healthcare, increasingly functioning as generative spaces in which worthy citizens and biopolitical subjects are produced. Using a lens of biopower, this article considers what sort of biopolitical subjectivities were produced in and through New Zealand crowdfunding campaigns during the 2020 COVID-19 lockdown. It focuses on a discursive and dialogical analysis of 59 online medical crowdfunding campaigns that were active during lockdown and chose to mention the pandemic. These pages pointed to interrelated biological, social and economic precarities, speaking to questions about how citizens navigate uneven needs during uncertain times. Findings showed that crowdfunders referred to the pandemic in order to narrate their own situation in culturally coherent ways and to establish context-specific relations of care. This included contextualising their needs through establishing shared crisis narratives that also made the infrastructural contexts of healthcare visible and performing relational labour in ways that aligned with nationally specific affective regimes. By highlighting their own vulnerability, crowdfunders strategically mobilised broader lockdown discourses of self-sacrifice on behalf of vulnerable people. In this way, New Zealand's lockdown produced subjectivities both drawing on wider neoliberal moral regimes and specific to the nuanced and emergent moral systems of pandemic citizenship.

A Recast Framework for Welfare Deservingness Perceptions

Many important societal debates revolve around questions of deservingness, especially when it comes to debates related to inequality and social protection. It is therefore unsurprising that a growing body of research spanning the social and political sciences is concerned with the determinants of deservingness perceptions. In this contribution, we engage with the currently central theoretical framework used in deservingness research and point out an important weakness: Partly ambiguous definitions of the framework's central concepts, the criteria for perceived deservingness. We also highlight the negative consequences this has for empirical research, including notably varying and overlapping operationalizations and thereby a lacking comparability of results across studies. Our main contribution is a redefinition of the criteria for perceived deservingness and a demonstration of the empirical implications of using this new set of criteria via original vignette survey experiments conducted in Germany and the United States in 2019. Our results provide a clearer image of which criteria drive deservingness perceptions.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11205-021-02774-9.

Welfare deservingness opinions from heuristic to measurable concept: The CARIN deservingness principles scale

A steadily growing number of studies investigate how popular support for social policies targeting particular groups is rooted in citizens' deservingness opinions. According to theory, people fall back on five criteria - Control, Attitude, Reciprocity, Identity and Need (CARIN) - to distinguish the deserving from the undeserving. Deservingness opinions are assumed to be important predictors of support for particular welfare arrangements. A striking feature of this emerging research, however, is that there is no agreed-upon strategy to measure deservingness. Most previous studies rely on proxy-variables rather than measuring the actual deservingness criteria. Deservingness functions as a heuristic rather than as a measured concept, which leads to conceptual confusion. To remedy this shortcoming, this contribution proposes and validates a new instrument -the CARIN deservingness principles scale- that captures the five basic deservingness principles. We analyse data from the Belgian National Election Study by means of structural equation modelling (SEM) to (1) test the dimensionality, validity and reliability of the scale, and (2) verify to what extent the five deservingness principles predict specific policy preferences (as a test of construct validity). Our analyses confirm that the five deservingness principles are distinct dimensions that are differently related to social structural variables and have divergent consequences for policy preferences. The finding of theoretically meaningful patterns of differentiated effects illustrates that the CARIN criteria represent distinct logics of social justice, and corroborates that our measurement instrument is capable of tapping into the essence of these criteria.

Deservingness put into practice: Constructing the (un)deservingness of migrants in four European countries

The increased comparative research on perceptions of public welfare deservingness studies the extent to which different subgroups of citizens are deemed worthy or unworthy of receiving help from the welfare state. The concept of deservingness criteria plays a crucial role in this research, as it theorizes a universal heuristic that citizens apply to rank people in terms of their welfare deservingness. Due to the mainly quantitative nature of the research and despite the indisputable progress it has made, the subjective existence and actual application of these deservingness criteria remain a bit of a black box. What criteria of deservingness do citizens actually apply, and how do they apply them? This article opens the black box of welfare deservingness and sheds light on the nature and practice of deservingness criteria. Empirically, the paper explores how the deservingness of immigrants is discussed and established within 20 focus groups conducted in Slovenia, Denmark, UK, and Norway in 2016 with a total of 160 participants. All 20 focus groups discussed the welfare deservingness of immigrants based on similar vignette stimuli. Our analysis shows that (1) deservingness criteria are used both to construct images of target groups and as normative yardsticks; (2) deservingness criteria do not work independently of each other, but rather co-function in specific hybridized discourses; and (3) the moral logic of deservingness is supplemented by alternative moral logics, at least in the case of migrants.

Getting what you deserve: How notions of deservingness feature in the experiences of employees with cancer

This article extends deservingness debates in social welfare to a new domain by exploring how deservingness features in the experiences of people who are in paid work when diagnosed with cancer. In doing so, it explores the interrelationship between deservingness criteria and Parsons' sick role. Narrative interview data was collected from people with cancer who were employed when they were diagnosed (n = 14) and line managers with experience of managing an employee with cancer (n = 7). Semi-structured interviews were conducted with members of occupational health and human resources staff (n = 3), health care professionals (n = 5) and staff from a UK cancer support charity (n = 7). Data was analysed thematically. Deservingness featured, and mattered, in how participants understood cancer in relation to work, and ensuing workplace interactions. Though cancer was generally seen as deserving; employees with cancer were perceived to be in need, and not blamed for their condition, this deservingness was subject to question. Employees with cancer were not necessarily considered equally deserving, dependent on their contribution as workers pre-diagnosis, and their efforts to contribute since being diagnosed. In a reflection of the fixed-term, time constricted nature of the sick role, work and welfare institutions required a definite timeline for employees to return to, or depart from work. The paper evidences an important gap between the fixed sick role as perceived by employers and the UK state welfare system, and the complex experiences of people diagnosed with cancer when in paid work.

Depression in a depressed area: Deservingness, mental illness, and treatment in the contemporary rural U.S

People with mental illness face public scrutiny that provokes questions about their ability to cope, membership in society, and entitlement to state support. Less attention has been focused on how such scrutiny occurs at the community level, particularly when shared economic distress has generated a high burden of poor mental health. We employ theorizations of health-related deservingness to examine the local moral economies through which residents of an economically depressed area question who deserves to be depressed, how those with depression should cope, and what forms of treatment are sincere. Drawing on a multi-phase study (2014-2016) in Appalachian Kentucky, we analyze interviews conducted with women with depression and the health practitioners who work with them. In the rural U.S., the dim economy and scarce healthcare resources are attributed to exclusion from broader society. Naturalized as a moral response for enduring dead-end jobs and poverty, participants described how depression coping can positively demonstrate individuals' commitment to providing for their families and mobility. However, when individuals are perceived to use depression diagnoses to access state entitlements or obtain medication as a "quick fix" that facilitates substance use, area residents question the veracity of symptoms and argue that treatment-seeking is insincere. In this way, rural moral concepts about work, entitlement, and self-sufficiency become embedded in contemporary ideas about mental health and its treatment. The tempered normalization of depression may offer possibilities for decreasing stigma and engendering conversations about patterned exclusions of rural Americans from broader U.S. prosperity. However, tense moral meanings about depression coping reveal both deepening and emergent social inequalities within rural communities. Attending to local moral economies that shape mental health deservingness is critical to understanding the complex overlaps and intersections between state, community, and family discourses.

Migrant encounters in the clinic: Bureaucratic, biomedical, and community influences on patient interactions with front-line workers

Ethnographic research on the clinical encounter has focused almost exclusively on what happens in exam rooms-particularly patient-provider interactions-leaving much to be understood about other actors within the clinic. As part of a larger ethnographic study examining the impact of colonialism, transnational migration, discrimination, and gender relations on Chuukese migrant women's reproductive and sexual health outcomes in Guam, I conducted eight months of participant observation in three publicly funded health clinics, 24 interviews with health care workers, and 15 life-history interviews with Chuukese women between September 2012 and February 2014. Findings demonstrated differential treatment of Chuukese patients by front-line workers (FLWs), who engaged in "boundary work" with these patients. Further, care varied by clinic space and the actors in that space. This differential treatment and variation in care impacted Chuukese women's access to and experiences with health care in Guam. Utilizing the concept of "deservingness," this analysis unpacks how FLWs, like Lipsky's "street-level bureaucrats," are influenced by bureaucratic, biomedical, and community hierarchies, all contributing to differential patient treatment. This study concludes by calling for more integrated analyses of clinical environments which utilize Lipsky's concept to include community narratives of "deservingness" and incorporate the influence of clinic and community stratification.

Health workers' perceptions of access to care for children and pregnant women with precarious immigration status: health as a right or a privilege?

The Canadian government's recent cuts to healthcare coverage for refugee claimants has rekindled the debate in Canada about what medical services should be provided to individuals with precarious immigration status, and who should pay for these services. This article further explores this debate, focussing on the perceptions of healthcare workers in Montreal, a large multiethnic Canadian city. In April-June 2010, an online survey was conducted to assess how clinicians, administrators, and support staff in Montreal contend with the ethical and professional dilemmas raised by the issue of access to healthcare services for pregnant women and children who are partially or completely uninsured. Drawing on qualitative analysis of answers (n = 237) to three open-ended survey questions, we identify the discursive frameworks that our respondents mobilized when arguing for, or against, universal access to healthcare for uninsured patients. In doing so, we highlight how their positions relate to their self-evaluations of Canada's socioeconomic situation, as well as their ideological representations of, and sense of social connection to, precarious status immigrants. Interestingly, while abstract values lead some healthcare workers to perceive uninsured immigrants as "deserving" of universal access to healthcare, negative perceptions of these migrants, coupled with pragmatic considerations, pushed most workers to view the uninsured as "underserving" of free care. For a majority of our respondents, the right to healthcare of precarious status immigrants has become a "privilege", that as taxpayers, they are increasingly less willing to contribute to. We conclude by arguing for a reconsideration of access to healthcare as a right, and offer recommendations to move in this direction.