A call for Measuring Partisanship in U.S. Public Health Research

An important lesson learned fromCOVID-19 is that partisanship matters. Democrats and Republicans differed on a host of behaviors including masking, vaccination, and social distancing. In fact, the impact of partisanship on COVID-19–related attitudes and behaviors overwhelmed other widely studied explanations including education and income. This led to differential infection and mortality rates across communities. In one study, majority-Republican counties experienced 72.9 additional deaths per 100,000 people relative to majority-Democrat counties. These partisan divides surprised many in the medical and public health communities.

In this commentary, we make the case that US-based public health researchers—including researchers de-signing survey-based studies and agencies that conduct health surveys for surveillance and research purposes—should ask questions about partisanship as part of their demographic data collection. Zero of the 69 surveys con-ducted and publicly available from the Centers for Disease Control and Prevention, including vital surveys like the Behavioral Risk Factor Surveillance System, the National Health Interview Survey, and the National Health and Nutrition Examination Survey, include a measure of partisanship.

Not accounting for the role of partisanship on health might lead to ineffective policy and health promotion interventions if partisan differences are not properly targeted. In some cases, our interventions could even lead to resistance among those needing care, potentially exacerbating health inequalities if certain target groups are motivated by partisan dispositions to reject them—a possibility that has empirical evidence.4,5In short, the exclusion of partisanship from public health surveys limits our understanding of scientific phenomena and our capacity for advancing population health and health equity.