Who deserves health care? The effects of causal attributions and group cues on public attitudes about responsibility for health care costs

Sarah E. Gollust, Julia Lynch

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

This research investigates the impact of cues about ascriptive group characteristics (race, class, gender) and the causes of ill health (health behaviors, inborn biological traits, social systemic factors) on beliefs about who deserves society's help in paying for the costs of medical treatment. Drawing on data from three original vignette experiments embedded in a nationally representative survey of American adults, we find that respondents are reluctant to blame or deny societal support in response to explicit cues about racial attributes - but equally explicit cues about the causal impact of individual behaviors on health have large effects on expressed attitudes. Across all three experiments, a focus on individual behavioral causes of illness is associated with increased support for individual responsibility for health care costs and lower support for government-financed health insurance. Beliefs about social groups and causal attributions are, however, tightly intertwined. We find that when groups suffering ill health are defined in racial, class, or gender terms, Americans differ in their attribution of health disparities to individual behaviors versus biological or systemic factors. Because causal attributions also affect health policy opinions, varying patterns of causal attribution may reinforce group stereotypes and undermine support for universal access to health care.

Original languageEnglish (US)
Pages (from-to)1061-1095
Number of pages35
JournalJournal of health politics, policy and law
Volume36
Issue number6
DOIs
StatePublished - Dec 2011

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