Both those who perceived COVID-19 racial disparities to be greater & those who read more about those disparities (which reduced empathy) reported reduced fear of COVID-19 & less support for safety precautions

Highlighting COVID-19 racial disparities can reduce support for safety precautions among White U.S. residents. Allison L.Skinner-Dorkenoo et añ- Social Science & Medicine, Volume 301, May 2022, 114951. https://doi.org/10.1016/j.socscimed.2022.114951

Highlights

• Tested relations with White US residents' awareness of COVID-19 racial disparities.

• Perceiving greater COVID-19 racial disparities predicted reduced fear of COVID-19.

• Exposure to information about COVID-19 racial disparities reduced empathy.

• Reduced empathy and fear of COVID-19 predict reduced support for safety precautions.

• Highlighting racial disparities may paradoxically perpetuate racial inequalities.

Abstract: U.S. media has extensively covered racial disparities in COVID-19 infections and deaths, which may ironically reduce public concern about COVID-19. In two preregistered studies (conducted in the fall of 2020), we examined whether perceptions of COVID-19 racial disparities predict White U.S. residents’ attitudes toward COVID-19. Utilizing a correlational design (N = 498), we found that those who perceived COVID-19 racial disparities to be greater reported reduced fear of COVID-19, which predicted reduced support for COVID-19 safety precautions. In Study 2, we manipulated exposure to information about COVID-19 racial disparities (N = 1,505). Reading about the persistent inequalities that produced COVID-19 racial disparities reduced fear of COVID-19, empathy for those vulnerable to COVID-19, and support for safety precautions. These findings suggest that publicizing racial health disparities has the potential to create a vicious cycle wherein raising awareness reduces support for the very policies that could protect public health and reduce disparities.

Keywords: Racial disparitiesCOVID-19Systemic racismPublic healthAttitudes

8. Discussion

In Study 2, we replicated the systemic knowledge findings from Study 1 and observed initial evidence that informing White U.S. residents of COVID-19 racial disparities can causally reduce fear of COVID-19 and support for safety precautions. Previous research had shown a similar pattern of results among White U.S. residents who reported relatively high racial biases (Harell and Lieberman, 2021; Stephens-Dougan, 2021), but our findings—which were largely unmoderated by political orientation—suggest a more general phenomenon. We had speculated that framing COVID-19 racial disparities as a product of persistent health inequalities might serve as a buffer against this tendency, consistent with individual differences in systemic knowledge. However, we observed even less concern about COVID-19 when racial disparities were framed as a result of systemic inequalities. In addition, our exploratory mediation analysis provided suggestive evidence that the reduced fear and empathy for those vulnerable to COVID-19 that resulted from framing COVID-19 racial disparities as a product of persistent health inequalities, may have reduced support for safety precautions. Taken together, these findings point to the potential drawbacks of highlighting COVID-19 racial disparities among White U.S. residents.

8.1. General discussion

Our studies examined the association between White U.S. residents’ perceptions of COVID-19 racial disparities and their attitudes toward COVID-19. We hypothesized that those who perceived racial disparities in COVID-19 to be greater would be less concerned about COVID-19—as indicated by reduced fear and support for safety precautions. Indeed, both studies provided some evidence of this tendency. In Study 1, we observed that those who perceived COVID-19 racial disparities in the U.S. to be greater were less fearful of COVID-19, and our exploratory mediation was consistent with the notion that this may lead to reduced support for safety precautions. Our experimental manipulation (Study 2) provided evidence that informing White U.S. residents of COVID-19 racial disparities can reduce fear, empathy, and support for COVID-19 safety precautions. We postulated that framing COVID-19 racial disparities as a product of persistent health inequalities could undermine the tendency to justify the status quo (Kay et al., 2009) and help increase concern about COVID-19. However, our findings indicate that this framing further reduced fear and support for safety precautions—perhaps because this information signaled that these disparities were not just transitory epidemiological trends which could potentially shift and disproportionately impact White people in the future. In fact, our exploratory mediation analysis provided suggestive evidence that both reduced fear of COVID-19 and empathy for those most vulnerable may contribute to the observed reduction in support for safety precautions. Emerging evidence is consistent with this interpretation: White U.S. residents who perceived COVID-19 racial disparities to be a result of genetic susceptibility reported lower adherence to CDC COVID-19 safety recommendations (Crist and Schlegel, 2021). Our findings are also in line with trends observed in public opinion polls indicating that White U.S. residents increased their support for reopening the economy—in spite of public health risks—between late March and early June of 2020 (Cox, 2020), which corresponds with the release of data indicating racial health disparities in COVID-19.

Overall, individual differences in systemic knowledge of the contributors to COVID-19 racial disparities predicted greater fear of COVID-19, support for safety precautions, and empathy for those most vulnerable. Given the parallels between the systemic knowledge measure and the persistent inequalities framing condition, it may be surprising that these factors had opposing effects on our outcomes. However, the persistent inequalities article merely framed racial disparities as a product of persistent inequalities and did not provide extensive education on the systemically biased policies and practices that gave rise to persistent inequalities. The systemic knowledge measure, in contrast, captures a deeper understanding of systemic racism, consistent with prior work on theories of racial ignorance (e.g., Bonam et al., 2019; Mueller, 2018; Nelson et al., 2012; Salter et al., 2018). Furthermore, supplementary analyses indicated that across both studies systemic knowledge was strongly correlated (rs > 0.70) with acknowledgement of systemic racism in the U.S. (Neville et al., 2000).

Examining the impact of efforts to address and educate people about population health disparities is critically important (Lewis et al., 2020), and our work is not the first to conclude that informing people of racial health disparities has the potential to backfire (Harell and Lieberman, 2021; Lee et al., 2017; Niederdeppe et al., 2008; Stephens-Dougan, 2022). Experimental investigation of reactions to systemic inequality in an entirely different domain—the criminal justice system—has shown a pattern similar to our study, such that alerting White U.S. citizens of racial disparities in the criminal justice system reduced support for criminal justice reform (Hetey and Eberhardt, 2014, 2018). Indeed, psychologists and communications scholars have argued that educating the public about systemic inequalities in a way that motivates (rather than depresses) health and social policy changes could be critical to addressing inequalities (Hetey and Eberhardt, 2018; Niederdeppe et al., 2008). Previous scholarship has recommended the use of narratives and visual images in public communication about population health disparities; thus, incorporating these factors in future research may lead to more optimal outcomes (Niederdeppe et al., 2008).

Future work should also examine the generality of these findings across U.S. residents and messages about racial disparities. Although our data included White participants from all U.S. states and was fairly representative of the White U.S. adult population, our participants tended to be younger (residents 65+ were underrepresented) and had lower incomes than the median U.S. household (U.S. Census Bureau, 2019). It is also worth considering how discussions of disparities develop over the course of a public health crisis. For instance, the emergence of COVID-19 vaccines in early 2021—which were disproportionately received by White U.S. residents during the initial rollout (DiRago et al. in press; Sacarny and Daw, 2021)—may have further reduced fear of COVID-19 and support for safety precautions beyond what we observed in our samples. Future work will also be critical for determining the extent to which the findings observed here generalize to other public health issues and messages about disparities. Even if the effects observed here do not generalize to all messages about racial disparities, the fact that some such messages can reduce public concern about health crises and dampen support for precautions among White U.S. residents should raise serious concerns. Future research that examines a broader stimulus set (Yarkoni, 2020) and considers how to publicly address racial and ethnic disparities without spurring these unintended consequences will be essential.