Opposing views: associations of political polarization, political party affiliation, and social trust with COVID-19 vaccination intent and receipt.

INTRODUCTION: Political polarization has increased in the USA within recent years. Studies have shown Republicans are less likely to accept COVID-19 vaccinations than Democrats; however, little is known regarding the association between COVID-19 vaccination acceptance and political polarization. METHODS: We used data from a nationally-representative survey of 1427 participants conducted between 9 February 2021 and 17 February 2021. We estimated multivariate-adjusted odds ratios for COVID-19 vaccination intent and receipt according to perceived political polarization (measured as the perceived size of the ideological gap between Democrats and Republicans), political party affiliation, and social trust, controlling for demographic and socioeconomic factors. RESULTS: Among participants perceiving high levels of polarization, Republicans (versus Democrats) reported a 90% lower odds of vaccination intent (OR = 0.10 [0.05, 0.19], P < 0.001). Participants with high (versus low) social trust and low perceived polarization had a 2-folder higher vaccination intent (OR = 2.39 [1.34, 4.21], P = 0.003); this association was substantially weaker in the high perceived polarization group. CONCLUSIONS: High perceived levels of political polarization appear to magnify the decrease in the odds of receiving the COVID-19 vaccine and the intent to get vaccinated among Republicans versus Democrats. Political polarization may further attenuate the protective associations of high social capital with vaccination.

Political polarization on COVID-19 pandemic response in the United States.

Despite calls for political consensus, there is growing evidence that the public response to the COVID-19 pandemic has been politicized in the US. We examined the extent to which this polarization exists among the US public across two national studies. In a representative US sample (N = 699, March 2020) we find that liberals (compared to conservatives) perceive higher risk, place less trust in politicians to handle the pandemic, are more trusting of medical experts such as the WHO, and are more critical of the government response. We replicate these results in a second, pre-registered study (N = 1000; April 2020), and find that results are similar when considering partisanship, rather than political ideology. In both studies we also find evidence that political polarization extends beyond attitudes, with liberals consistently reporting engaging in a significantly greater number of health protective behaviors (e.g., wearing face masks) than conservatives. We discuss the possible drivers of polarization on COVID-19 attitudes and behaviors, and reiterate the need for fostering bipartisan consensus to effectively address and manage the COVID-19 pandemic.

County-level political group density, partisan polarization, and individual-level mortality among adults in the United States: A lagged multilevel study.

Objective: To investigate the associations between county-level political group density, partisan polarization, and individual-level mortality from all causes and from coronary heart disease (CHD) in the United States. Methods: Using data from five survey waves (1998-2006) of the General Social Survey-National Death Index dataset and the County Presidential Election Return 2000 dataset, we fit weighted Cox proportional hazards models to estimate the associations between (1) political group density and (2) partisan polarization measured at the county level in 2000 (n = 313 counties) categorized into quartiles with individual-level mortality (n = 14,983 participants) from all causes and CHD, controlling for individual- and county-level factors. Maximum follow-up was from one year after the survey up until 2014. We conducted these analyses using two separate measures based on county-level vote share differences and party affiliation ideological extremes. Results: In the overall sample, we found no evidence of associations between county-level political group density and individual-level mortality from all causes. There was evidence of a 13% higher risk of dying from heart disease in the highest quartile of county-level polarization (hazards ratio, HR = 1.13; 95% CI = 0.74-1.71). We observed heterogeneity of effects based on individual-level political affiliation. Among those identifying as Democrats, residing in counties with high (vs. low) levels of polarization appeared to be protective against mortality, with an associated 18% lower risk of dying from all causes (HR = 0.82, 95% CI = 0.71-0.94). This association was strongest in areas with the highest concentrations of Democrats. Conclusions: Among all study participants, political group density and polarization at the county level in 2000 were not linked to individual-level mortality. At the same time, we found that Democratic party affiliation may be protective against the adverse effects of high polarization, particularly in counties with high concentrations of Democrats. Future research should further explore these associations to potentially identify new structural interventions to address political determinants of population health.

Election-Related Post-Traumatic Stress: Evidence from the 2020 U.S. Presidential Election.

The 2020 U.S. presidential election saw rising political tensions among ordinary voters and political elites, with fears of election violence culminating in the January 6 riot. We hypothesized that the 2020 election might have been traumatic for some voters, producing measurable symptoms of post-traumatic stress disorder (PTSD). We also hypothesized that negative sentiment toward the opposing party correlates with PTSD. We measured PTSD using a modified version of the PCL-5, a validated PTSD screener, for 573 individuals from a nationally representative YouGov sample. We modeled the association between affective polarization and PTSD, controlling for political, demographic, and psychological traits. We estimate that 12.5% of American adults (95% CI: 9.2% to 15.9%) experienced election-related PTSD, far higher than the annual PTSD prevalence of 3.5%. Additionally, negativity toward opposing partisans correlated with PTSD symptoms. These findings highlight a potential need to support Americans affected by election-related trauma.

The harmful effects of partisan polarization on health.

Partisan polarization significantly drives stress and anxiety among Americans, and recent aggregate-level studies suggest polarization may be shaping their health. This individual-level study uses a new representative dataset of 2,752 US residents surveyed between December 2019 and January 2020, some US residents report more days of poor physical and mental health per month than others. Using negative binomial models, zero inflated models, and visualizations, we find evidence that polarization is linked to declines in physical health: the more distant an individual feels politically from the average voter in their state, the worse health outcomes he or she reports. By uncovering the individual-level political correlates of health, this study aims to encourage further study and attention to the broader consequences of political polarization on American communities.

Is divisive politics making Americans sick? Associations of perceived partisan polarization with physical and mental health outcomes among adults in the United States.

OBJECTIVES: To investigate whether changes in perceived partisan polarization since the 2016 US presidential election and current perceptions of polarization are associated with the onset of physical and mental health conditions in adults. METHODS: We surveyed a nationally-representative sample (n = 2752) of US adults between December 2019 and January 2020. We used multivariable logistic regression to estimate associations between perceived polarization and the incidence of hypertension, high cholesterol, obesity, diabetes, and anxiety, depressive, and sleep disorders in or after 2016 and current self-rated health. Our secondary exposure variables measured perceptions of mass and elite polarization at the state and national level. Perceived mass polarization measured perceptions of the partisan gap between Democrat and Republican voters; perceived elite polarization measured perceptions of the partisan gap between Democrat and Republican elected officials. RESULTS: Participants reporting an increase in polarization had 52-57% higher odds of developing depressive disorders (OR = 1.52, 95% CI: 1.01, 2.29, P = 0.047) and anxiety disorders (OR = 1.57, 95% CI: 1.07, 2.29, P = 0.02) compared to participants who perceived no change in polarization. Those reporting high (vs. low) levels of perceived state-level mass polarization had a 49% higher odds of incident depressive disorders (P = 0.03). Participants who perceived high levels of state-level elite polarization reported a 71% higher odds of incident depressive disorders (P = 0.004) and a 49% higher odds of incident sleep disorders (P = 0.03). CONCLUSIONS: Perceptions of partisan polarization may represent important factors that are linked to the onset of mental health and sleep disorders.

Ideological asymmetries in conformity, desire for shared reality, and the spread of misinformation.

Ideological belief systems arise from epistemic, existential, and relational motives to reduce uncertainty, threat, and social discord. According to system justification theory, however, some ideologies-such as those that are conservative, religious, and legitimizing of the status quo-are especially appealing to people whose epistemic, existential, and relational motives are chronically or temporarily heightened. In this article, we focus on relational motivation, describing evidence that conservatives are more likely than liberals to: prioritize values of conformity and tradition; possess a strong desire to share reality with like-minded others; perceive within-group consensus when making political and non-political judgments; be influenced by implicit relational cues and sources who are perceived as similar to them; and maintain homogenous social networks and favor an 'echo chamber' environment that is conducive to the spread of misinformation.