Abstract
Despite the fact that sickle-cell disease (SCD) is perhaps the most “racialized” medical condition in the USA, very little is known about how “race” impacts public support for health policies related to the condition. We embedded an experiment within the 2011 Cooperative Congressional Election Study in order to assess perceptions about SCD among 1250 participants from diverse backgrounds and evaluate the extent to which these perceptions were associated with support for government spending on SCD-related benefits. We manipulated the racial phenotype of SCD advocates who requested additional government funding and asked participants to indicate how much the government should provide. Overall, participants expressed moderately positive attitudes about SCD, and there were no differences in funding support based on the race of the advocate. However, white participants supported less funding compared to nonwhite participants, even after adjusting for a number of demographic and attitudinal covariates. These findings suggest that a complex relationship between racial identification and implicit racism may shape public perceptions about SCD that negatively influences perceivers’ support for SCD-related policy.
Similar content being viewed by others
Notes
We also observed the same pattern of results when 27 participants who were familiar with SCD were included in the analysis.
We thank an anonymous reviewer for suggesting this possibility.
References
Ansolabehere, S., & Rivers, D. (2013). Cooperative survey research. Annual Review of Political Science, 16, 307–329. doi:10.1146/annurev-polisci-022811-160625.
Barry, C. L., Brescoll, V. L., Brownell, K. D., & Schlesinger, M. (2009). Obesity metaphors: How beliefs about the causes of obesity affect support for public policy. Milbank Quarterly, 87, 7–47. doi:10.1111/j.1468-0009.2009.00546.x.
Barry, C. L., Brescoll, V. L., & Gollust, S. E. (2013). Framing childhood obesity: How individualizing the problem affects public support for prevention. Political Psychology, 34, 327–349. doi:10.1111/pops.12018.
Bediako, S. M., & Haywood, C, Jr. (2009). Sickle cell disease in a “postracial” America. Journal of the National Medical Association, 101, 1065–1066.
Bediako, S. M., & Moffitt, K. R. (2011). Race and social attitudes about sickle cell disease. Ethnicity and Health, 16, 423–429. doi:10.1080/13557858.2011.552712.
Beeken, R. J., & Wardle, J. (2013). Public beliefs about the causes of obesity and attitudes towards policy initiatives in Great Britain. Public Health Nutrition, 16, 2132.
Berinsky, A. J., Hutchings, V. L., Mendelberg, T., Shaker, L., & Valentino, N. A. (2011). Sex and race: Are black candidates more likely to be disadvantaged by sex scandals? Political Behavior, 33, 179–202.
Berinsky, A. J., & Mendelberg, T. (2005). The indirect effects of discredited stereotypes. American Journal of Political Science, 49, 846–865.
Blackman, T., Harrington, B., Elliott, E., Greene, A., Hunter, D. J., Marks, L., et al. (2012). Framing health inequalities for local intervention: Comparative case studies. Sociology of Health and Illness, 34, 49–63. doi:10.1111/j.1467-9566.2011.01362.x.
Bundorf, M. K., & Fuchs, V. R. (2007). Public support for national health insurance: The roles of attitudes and beliefs. Forum for Health Economics and Policy, 10, 1–31.
Cacari-Stone, L., Wallerstein, N., Garcia, A. P., & Minkler, M. (2014). The promise of community-based participatory research for health equity: A conceptual model for bridging evidence with policy. American Journal of Public Health, 104, 1615–1623. doi:10.2105/AJPH.2014.301961.
Diepeveen, S., Ling, T., Suhrcke, M., Roland, M., & Marteau, T. M. (2013). Public acceptability of government intervention to change health-related behaviours: A systematic review and narrative synthesis. BMC Public Health, 13, 756. doi:10.1186/1471-2458-13-756.
Dovidio, J. F., & Gaertner, S. L. (1998). On the nature of contemporary prejudice: The causes, consequences, and challenges of aversive racism. In J. Eberhardt & S. T. Fiske (Eds.), Confronting racism: The problem and the response (pp. 3–32). Newbury Park, CA: Sage.
Dovidio, J. F., & Gaertner, S. L. (2000). Aversive racism and selection decisions: 1989 and 1999. Psychological Science, 11, 315–319.
Entman, R. M. (2007). Framing bias: Media in the distribution of power. Journal of Communication, 57, 163–173. doi:10.1111/j.1460-2466.2006.00336.x.
Feldman, S., & Huddy, L. (2005). Racial resentment and white opposition to race-conscious programs: Principles or prejudice? American Journal of Political Science, 49, 168–183.
Field, A. (2013). Discovering statistics using IBM SPSS statistics (4th ed.). Los Angeles: Sage Publications.
Gainous, J. (2012). The new “new racism” thesis: Limited government values and race-conscious policy attitudes. Journal of Black Studies, 43, 251–273. doi:10.1177/0021934711417436.
Gollust, S. E., Lantz, P. M., & Ubel, P. A. (2009). The polarizing effect of news media messages about the social determinants of health. American Journal of Public Health, 99, 2160–2167.
Gollust, S. E., Lantz, P. M., & Ubel, P. A. (2010). Images of illness: How causal claims and racial associations influence public preferences toward diabetes research spending. Journal of Health Politics, Policy and Law, 35, 921–959. doi:10.1215/03616878-2010-034.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: The Guilford Press.
Herek, G. M., Capitanio, J. P., & Widaman, K. F. (2003). Stigma, social risk, and health policy: Public attitudes toward HIV surveillance policies and the social construction of illness. Health Psychology, 22, 533–540.
Hutchings, V. L., Walton, H., & Benjamin, A. (2010). The impact of explicit racial cues on gender differences in support for confederate symbols and partisanship. Journal of Politics, 72, 1175–1188.
Jacobs, L. R., & Mettler, S. (2011). Why public opinion changes: The implications for health and health policy. Journal of Health Politics, Policy and Law, 36, 917–933. doi:10.1215/03616878-1460515.
Kikuzawa, S., Olafsdottir, S., & Pescosolido, B. A. (2008). Similar pressures, different contexts: Public attitudes toward government intervention for health care in 21 nations. Journal of Health and Human Behavior, 49, 385–399.
Kinder, D. R., & Sanders, L. M. (1996). Divided by color: Racial politics and democratic ideals. Chicago: University of Chicago Press.
Kinder, D. R., & Sears, D. O. (1981). Prejudice and politics: Symbolic racism versus racial threats to the good life. Journal of Personality and Social Psychology, 40, 414–431.
Korn, D., Gibbins, R., & Azmier, J. (2003). Framing public policy towards a public health paradigm for gambling. Journal of Gambling Studies, 19, 235–256.
Lawrence, E., Stoker, R., & Wolman, H. (2010). Crafting urban policy: The conditions of public support for urban policy initiatives. Urban Affairs Review, 45, 412–430.
Lawrence, E., Stoker, R., & Wolman, H. (2013). The effects of beneficiary targeting on public support for social policies. Policy Studies Journal, 41, 199–216. doi:10.1111/psj.12014.
Lenton, A. P., Blair, I. V., & Hastie, R. (2006). The influence of social categories and patient responsibility on health care allocation decisions: Bias or fairness? Basic and Applied Social Psychology, 28, 27–36. doi:10.1207/s15324834basp2801_3.
Nelson, S. C., & Hackman, H. W. (2013). Race matters: Perceptions of race and racism in a sickle cell center. Pediatric Blood and Cancer, 60, 451–454. doi:10.1002/pbc.24361.
Oliver, J. E., & Lee, T. (2005). Public opinion and the politics of obesity in America. Journal of Health Politics, Policy and Law, 30, 923–954.
Rigby, E., Soss, J., Booske, B. C., Rohan, A. M. K., & Robert, S. A. (2009). Public responses to health disparities: How group cues influence support for government intervention. Social Science Quarterly, 90, 1321–1340. doi:10.1111/j.1540-6237.2009.00646.x.
Robert, S. A., & Booske, B. C. (2011). US opinions on health determinants and social policy as health policy. American Journal of Public Health, 101, 1655–1663. doi:10.2105/AJPH.2011.300217.
Rouse, C. M. (2009). Uncertain suffering: Racial health care disparities and sickle cell disease. Berkeley, CA: University of California Press.
Royal, C. D., Jonassaint, C. R., Jonassaint, J. C., & De Castro, L. M. (2011). Living with sickle cell disease: Traversing ‘race’ and identity. Ethnicity and Health, 16, 389–404.
Sanchez, G. R., Sanchez-Youngman, S., Murphy, A. A., Goodin, A. S., Santos, R., & Valdez, R. B. (2011). Explaining public support (or lack thereof) for extending health coverage to undocumented immigrants. Journal of Health Care for the Poor and Underserved, 22, 683–699.
Savitt, T. L. (2010). Tracking down the first recorded sickle cell patient in Western medicine. Journal of the National Medical Association, 102, 981–992.
Smith, L. A., Oyeku, S. O., Homer, C., & Zuckerman, B. (2006). Sickle cell disease: A question of equity and quality. Pediatrics, 117, 1763–1770.
Telfair, J., Myers, J., & Drezner, S. (1998). Does race influence the provision of care to persons with sickle cell disease? Perceptions of multidisciplinary providers. Journal of Health Care for the Poor and Underserved, 9, 184–195.
Tesler, M. (2012). The spillover of racialization into health care: How President Obama polarized public opinion by racial attitudes and race. American Journal of Political Science, 56, 690–704. doi:10.1111/j.1540-5907.2011.00577.x.
Tesler, M., & Sears, D. O. (2010). Obama’s race: The 2008 election and the dream of a post-racial America. Chicago, IL: University of Chicago Press.
Wailoo, K. (2006). Stigma, race, and disease in 20th century America. The Lancet, 367, 531–533.
White, I. K. (2007). When race matters and when it doesn’t: Racial group differences in response to racial cues. American Political Science Review, 101, 339–354.
Acknowledgments
This study was financially supported by the College of Arts, Humanities, and Social Sciences in conjunction with the Office of the Vice President for Research at the University of Maryland, Baltimore County. The authors wish to acknowledge Rhoanne Esteban, Rosalina Mills, Ebonie Riley, and Morgan Thomas for their research assistance.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bediako, S.M., King-Meadows, T. Public Support for Sickle-Cell Disease Funding: Does Race Matter?. Race Soc Probl 8, 186–195 (2016). https://doi.org/10.1007/s12552-016-9173-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12552-016-9173-x