Understanding Public Resistance to Messages About Health Disparities

Abstract

Advocates and policymakers strategically communicate about health disparities in an effort to raise public awareness, often by emphasizing the social and economic factors that influence these disparities. Previous research suggests that predisposing political orientation and values related to self-reliance and personal responsibility may produce resistance to such messages. In this study, the authors culled 4 messages about the causes of disparities in life expectancy from public discourse and randomly presented them to a nationally representative sample of 732 Americans. Three indicators of message resistance were measured: belief that messages are weak, elicitation of anger, and production of counterarguments. Expected political differences in message resistance were identified, with Republicans perceiving messages to be weaker, arousing less anger, and eliciting more counterarguing than for Democrats. Among 3 messages that described the social determinants of health disparities, a message that identified the role of personal choices (explicitly acknowledging personal responsibility) produced the least anger and counterarguing among Republicans. Political differences in anger arousal and counterarguing can be explained, in part, by predisposing values toward personal responsibility. These findings have relevance for policy advocates seeking to bridge public divides surrounding health disparities and for scholars advancing theories of reactance to policy-relevant health messaging.

Notes

¹Search terms: ((“world health organization” and (gap OR disparity OR inequality OR determinants)) OR (“unnatural causes” and PBS) OR (“commission to build a healthier America”)).

²However, we recognize that social class and race are closely linked in the United States (Gilens, 1999). To assess whether racial attitudes were primed by messages, we included feeling thermometer measures at the conclusion of the study, asking participants to identify perceived warmth toward six groups: Whites, Blacks, Latinos, poor people, middle-class people, and rich people. Analyses of variance of these measures on the randomly assigned messages identified no significant (p < .05) differences.

Note. All variables collected from Knowledge Networks profile data.

*Republican and Democrat includes those Independents who indicate they lean toward one of the parties; there were 54 respondents with profile data missing on this variable, so n = 678 for political party affiliation.

³Given the small sample size across cells and the distortion that can occur from application of weighting variables in small samples, the Knowledge Networks poststratification weights are not applied in these analyses.

Note. Superscripts indicate the number of the group which is significantly different (two-tailed tests) from that row's group (i.e., for counterarguing, group 4 is significantly different from all other groups). All noted paired differences are significant at p < .05, except for the difference between message 1 and message 3 for perceived strength (where p = .08).

Note. OLS = ordinary least squares.

***p < .001. **p < .01. *p < .05. †p < .10.

Note. Economic individualism and personal responsibility are rescaled to run from 0 to 1 (to be comparable with each other and all other model variables). OLS = ordinary least squares.

***p < .001. **p < .01. *p < .05. †p < .10.