Oct. 16, 2009 Here's a health idea that Democrats and Republicans agree on: when given information on the genetic factors that cause diabetes, both parties equally supported public health policies to prevent the disease.
But a study designed by the University of Michigan showed Republicans were less supportive of such policies after reading news reports that people with diabetes got their illness because of social or economic factors in which they live, such as lack of neighborhood grocery stores or safe places to exercise.
The social factors increased Democrats' support.
The study will appear online October 15 ahead of its December publication in the American Journal of Public Health.
"When people are given the same information they can come away with very different opinions," says Sarah E. Gollust, Ph.D., a Robert Wood Johnson Foundation Health and Society Scholar at the University of Pennsylvania who worked on the study during her doctoral work at U-M.
Increasing public awareness of social factors that impact health may not uniformly increase public support for action because some groups simply do not believe they are credible, authors write.
"Policymakers and journalists should be aware that social values influence people's opinions about health policy, and certain messages in the media might trigger these values," she says.
The findings contribute to evidence that Americans' opinions about health policy are polarized by political party lines, according to the study.
Gollust designed the study with Paula Lantz, Ph.D., a social epidemiologist and chair of the Department of Health Management and Policy at the U-M School of Public Health and Peter A. Ubel, M.D., professor of internal medicine at the University of Michigan and director of the U-M Center for Behavioral and Decision Sciences in Medicine.
Study participants viewed news articles about type 2 diabetes on the Internet and then answered questions about their opinions on health policy and their attitudes about people with diabetes.
When each viewed an article on the links between social and neighborhood factors and diabetes, 32 percent of Democrats agreed with social factors' role on health compared to 16 percent of Republicans.
"If you are more liberally minded the 'neighborhood explanation' can be motivating, but for people who are more conservative politically, that message can backfire and make them even less interested," says Ubel. "The same information can polarize people."
Diabetes was merely used as an example of a common health issue.
While type 2 diabetes is associated with health behaviors, such as poor diet, lack of physical activity and obesity, these behavioral factors can be influenced by social and economic factors such as living in an unhealthy neighborhood. Scientists have also identified numerous genetic variants that increase susceptibility to type 2 diabetes.
So why focus on social factors? The goal of framing health matters according to social factors is increasingly used to shift attention to non-medical strategies to improve health. The media also commonly discuss the prevalence of social factors when describing health issues, but few studies have been devoted to whether it shifts public opinion.
"The problem is these messages aren't going to have the same effect on all people," Ubel says.
The authors do not suggest that news media avoid reporting on social factors. Rather, advocates who want to mobilize the public to support public health policies might consider disseminating information to the media about both social factors and individual behavioral causes to avoid triggering resistance.
"Advocacy groups need to be very careful in thinking about who their audience is and what framing will work best for that audience," Ubel says. "Media should do a richer job of helping people understand each of these different causes."
Authors: Sarah E. Gollust, Ph.D., Paula M. Lantz, Ph.D., and Peter A. Ubel, M.D.
Citation: American Journal of Public Health, Vol. 99, No. 12, December 2009
Funding: Robert Wood Johnson Foundation Health and Society Scholars Program at the University of Michigan and at the University of Pennsylvania, the U-M Center for Behavioral and Decision Sciences in Medicine, and the University of Michigan Rackham Predoctoral Fellowship.
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