Why Public Health Experts Aren’t Reaching Conservatives on Covid

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As American public health officials wring their hands over how to reach resolutely unvaccinated people, one glaring disconnect has emerged: Politically speaking, the people spreading the message about the Covid vaccine don’t look or sound much like the people who need to heed this message.

Surveys show that the Americans dug in against the vaccine skew decidedly conservative. And as a public health expert, I can attest that my colleagues—to put it mildly—do not.

The palpable lack of conservative students, scholars and thinkers within the main academic institutions that train our public health and social service workforce should be obvious to everyone in the field. I’ve spent the past three decades in the worlds of public policy, public healthm and social work research. For understandable reasons, conservatives have always been scarce in our seminar rooms and hallways—probably more scarce today than any time I can remember.

It’s an especially immediate problem in 2021, but it has much deeper consequences than just the vaccination campaign. Consider some recent anecdotal examples I’ve witnessed recently: A colleague praised a student for convincingly espousing a conservative perspective in classroom discussion, when the student himself obviously didn’t hold that view. A second colleague noted in lecture, with properly distanced intonation: “What would you say to a conservative, who might respond ….”

The implicit presumption in both conversations was clear, and likely correct: No one was actually present who held those conservative views—or, really, to know that they were being accurately captured at all.

The overall academic world has always leaned liberal, but even in that context, the political imbalance within social work and public health is striking. In a 2018 survey of public health scholars in the Society for Epidemiologic Research, 72.4 percent reported their politics as “liberal/left-leaning.” Less than 5% responded: “conservative/right-leaning.” A 2014 analysis of one social work program found that 9.4% of students identified as Republican; 55.9% identified as Democrats.

In many fields, not just mine, conservative estrangement from our professional and academic communities damages discourse on both sides of the partisan divide. In public health, particularly, it hurts the credibility and cultural competence we need to do our jobs across vast swathes of America. In our political conversation, it deepens the moral and intellectual decline of American conservatism itself—a palpable decline exemplified and worsened by the Trump presidency.

The partisan “wonk gap” provides fodder for jokes on social media. The gap is real, though, and it’s not funny. And it hurts conservative priorities as well as liberal ones.

In early 2017, I attended a health policy dinner with Democratic and Republican House members. In casual conversation, it was obvious that Democrats were connected with a cadre of health policy professionals. Republicans were not. Soon after, House Republicans passed a conspicuously shoddy bill to repeal and replace Obamacare—a bill that was supposedly the Congress’s first priority under a Republican president. The bill had so many basic flaws—including a nearly $13,000 proposed increase in yearly health insurance premiums for low-income 64-year-olds—that it politically self-immolated once it faced real scrutiny.

That same estrangement enables palpable absolutism and lazy groupthink among progressives. Many of our students do not have—may never have had—the experience of being openly challenged by conservative peers in our classrooms.

I fear that many struggle to distinguish truly unworthy arguments presented by some conservatives—say, prevarication about climate change, or denying the Republican Party’s long history of voter suppression and appeals to white racism—from more worthy and serious arguments presented by conservatives that everyone should learn from and address.

For decades, for instance, conservatives and libertarians argued that public employee unions wield excessive influence on state and local governments. It should not have taken front-page police misconduct cases, union opposition to evidence-based vaccine mandates, or my own state’s seriously unfunded pension liabilities, for progressives to see merit in these views.

I don’t write these words as a conservative attacking supposed evils of cancel culture. I don’t write as a conservative at all. I’m an emphatic liberal Democrat. Over my career, I have witnessed many harms inflicted by conservatives’ opposition to syringe exchanges and other essential public health efforts— most definitely including our current public health crisis. Angered by such memories, ensconced within a community of like-minded scholars, I might forget that liberal/left communities are collections of imperfect humans like any other—with our own blind spots and biases arising from group conformity. Progressive academia often lacks sufficient voices in the room to call us on our errors. John Stuart Mill reminds us: Those who know only their own side of the argument know little of that.

Conservative fears about job discrimination strike me as understandable, too. Imagine two job candidates, Martin and Michael. Martin finds that cultural norms among recent immigrants promote upward mobility, and that the role of structural barriers to block that mobility is overstated—challenging the consensus in his field. Michael conducts an analysis of equally high quality, but finds the opposite result. Or imagine Lynne and Laurie. They conduct essentially identical statistical analysis of mandatory minimum sentences for illegal gun possession in 43 jurisdictions, Lynne finds that mandatory minimums reduce gun crime by 4 percent, and concludes that such policies are valuable. Laurie finds that mandatory minimums have zero impact on gun crime, and that such policies exemplify mass incarceration as a futile strategy that fails to address structural causes of crime.

I suspect that Michael and Laurie would have an easier job talk at many schools, because they come bearing findings more congenial to the liberal professors in the room. Martin and Lynne might have narrower margins for methodological judgment calls or presentation stumbles. They would face the additional burden of addressing the (potentially quite real) danger that their findings will be used by political figures who do not wish minority communities well. If the issue were truly sensitive—say the efficacy of affirmative action, the comparative successes of charter schools for minority and low-income students, or the unintended consequences of “Ban the Box” policies barring employers from inquiring about criminal convictions—I’d be even more worried that someone would face a competitive disadvantage because of her views, or her substantive findings.

We should be open and intentional in addressing these concerns, and in guarding against our own group-think and biases.

What can universities and other institutions do? Targeted student outreach would definitely be wise, particularly toward conservative rural communities where students might be very socially engaged, but might not be considering graduate study or PhD-level research. As with other forms of outreach, this requires thoughtful, culturally competent engagement on the part of universities hoping to broaden their student bodies.

I’ve also come to support a radical policy with obvious ironies: We should practice affirmative action for religious, social and economic conservatives in areas of academia where those holding these views are scarce. If someone applies to our school who was (say) president of University of Texas Students for Life—I want her in my classroom. I want progressive students to present, defend, refine and improve their arguments knowing that a peer who disagrees with them is right there, ready to engage. Of course, I want conservative students to have the same experience, learning from their peers, ready to defend, refine and improve their own views.

Targeted outreach to conservative groups, to communities and campuses where conservative views are common, would be useful tools to address this challenge. So would admission preferences to promote viewpoint diversity. Yes, there are plenty of awkward ironies here across the usual political lines. And for a million reasons, conservatives may always be scarcer in public health and social work than in the corporate sector. Still, we can do better. Countless American conservatives honor, through their lives and service, values of compassion, self-sacrifice and inclusion dear to liberals; they care about exactly the same issues that draw people into public health and social-service professions.

George W. Bush saved millions of lives around the world through the President’s Emergency Program for AIDS Relief (PEPFAR)—a program we might well emulate in vaccinating the world against Covid; liberal students would be well-served by appreciating the impact of the Christian conservatives who helped drive the effort. And a conservative student in our programs would meet countless residents of Chicago’s South Side who identify with the political left, and who honor, through their own lives and service, values of entrepreneurship, faith-based service and personal responsibility dear to conservatives.

We can learn from each other, honor and challenge each other, across partisan and ideological divides. To do this, we need both sides routinely present on our faculties and in our classrooms. That’s not the reality right now. We must fix that.

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