Who Deserves Health Care? The Effects of Causal Attributions and Group Cues on Public Attitudes about Responsibility for Health Care Costs
40 Pages Posted: 19 Jul 2010 Last revised: 30 Aug 2010
Date Written: 2010
How do beliefs about race, class, and health behaviors affect health policy opinions? Analysis of vignette experiments embedded in a nationally representative survey shows that cues about the behavior of sick individuals exert a more powerful effect on health policy opinions than do explicit racial or class group cues, which in American policy discourse are more traditional signals of deservingness. Attributing health status to personal behaviors is associated with increased support for individual versus societal responsibility for health care costs, and lower public support for government-financed health insurance. However, Americans differ in their attribution of health disparities to behaviors (versus biological or systemic factors) depending on whether groups are defined in racial, class, or gender terms. Because causal attributions also strongly affect health policy opinions, varying patterns of attribution may reinforce harmful group stereotypes and undermine support for universal access to health care.
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