Why is this important?
The COVID-19 pandemic has illuminated the harmful consequences of health communication that becomes politicized – when people interpret health messaging through a political lens. We have seen in 2020, for instance, that Democrats and Republicans differed sharply in their views about the pandemic and strategies to mitigate its risk. This is far from a new phenomenon, however. Our research demonstrates that many health issues are communicated in ways that invite politicization, including topics like obesity prevention, vaccine requirements, health inequities, the Affordable Care Act, and the social determinants of health. The increasingly politicized information environment in the US creates substantial challenges for communication, elevating the risk of polarized responses that entrench differences. Those who seek to effectively communicate about health and social issues can benefit from recognition of the political content of certain health topics in media (and the potential for new politicization of health topics) and evidence on the effects of health messaging in the context of political polarization.
What do we know?
Research has long acknowledged that members of the public tend to process information through a lens of “motivated reasoning”, which occurs when individuals have different reactions to messaging based on their prior beliefs or identity, such as their partisanship. For example, partisan gaps have been demonstrated after exposure to messaging about sugar-sweetened beverage taxes and the social determinants of health, demonstrating that certain health messages – even when not overtly partisan in nature – can activate underlying political beliefs.
People are more likely to engage in selectively processing messages in line with their existing partisan beliefs when there is a higher volume of partisan cues in the information environment, such as prominent party politicians taking stances or weighing in on health topics either through news coverage or their campaign advertising. In other words, motivated reasoning occurs and gaps between Democrats and Republicans can widen when there are plentiful opportunities for members of the public to connect a health issue to a partisan stance. Our research shows that these types of cues in health media are common. For example, roughly 50 percent of television news coverage about health insurance in 2013-2014 and in 2018-2019 included political party cues, and partisan candidates for office discuss issues relevant to population health frequently in their campaign commercials.
Another feature of media content in a politically-charged health messaging environment is the appearance of conflict or controversy toward health issues and the tendency of news media to frame issues as part of a game of strategy between opposing sides. Although the public’s attitudes are more open to change for newly emergent issues, once an issue becomes characterized by controversy (as in the case of the HPV vaccine) or by partisan disagreement (in the case of the Affordable Care Act), the media tends to perpetuate these characteristics. This contributes to long-lasting partisan patterns in public opinion – such as the decade-long polarized views about the Affordable Care Act.
That said, messages do not always lead to polarized reactions between political groups. Our research has shown that messages which successfully connect health and social issues to broader ideals that are valued across political lines (such as helping parents to offset marketing of unhealthy products to children; or fairness in access to the social safety net) can increase support for policies focused on creating equitable communities.
Implications for Journalists, Advocates, and Policymakers
Public communicators should be aware of the complexity of the existing message environment and recognize that the most trusted messengers for health information differ by political party. Credible messengers are those that share interests and values with their audience. Research shows, for instance, that health messaging to Republicans may be more effective coming from a Republican source than from a Democrat. Trusted media sources also differ across partisan groups, meaning that strategic outreach across a wide variety of outlets may be important. And, local news sources are more trusted across partisan groups than are national or cable news outlets.
The extent to which health issues become and stay politicized can have a big influence on the probability that individuals listen to and follow the advice of scientific experts and the guidance of public health officials. Journalists should be aware that the inclusion and focus on partisan disputes in health stories, and the extent to which stories are focused on conflict and strategy (rather than policy details), are likely to erode and divide opinions and affect behaviors among the public. Advocates and policymakers should carefully consider the opposing messages in the environment and consider what types of messages and messengers are most likely to shift attitudes among the target audience, while being aware of possible effects among other audiences.
