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The Politics of Diabetes

Rachel Dry reports on a new study showing the reactions of Democrats and Republicans to news articles about diabetes. Turns out political affiliation does a good job predicting people's reactions to public health problems: When Democrats read articles emphasizing the environmental factors around diabetes, they became more sympathetic to public health programs meant to combat the disease. When conservatives read those articles, they became less sympathetic.

Participants in the study read a mock news article on the American Diabetes Association lobbying Congress for greater attention to Type 2 diabetes, the sixth-leading cause of death in the United States. Some people read a straight news report, with minimal mention of what causes diabetes. Others read one of three versions of the story: one that pegged the disease primarily to genetic factors; one that emphasized personal choices; and one that focused on social and environmental factors, such as access to safe places to exercise and affordable, healthy food.

The study's authors, University of Pennsylvania researcher Sarah E. Gollust, along with the University of Michigan's Paula M. Lantz and Peter A. Ubel, were most interested in how people responded to the notion that "social determinants" -- how easy it is to buy fresh vegetables or exercise, among other things -- are underlying causes of disease. Public health advocates have been promoting the importance of these factors, believing that the more people know about these circumstances, the more likely they are to want to help.

But that assumption doesn't hold up. When people who identified themselves as Democrats read specifically about the social factors that can lead to Type 2 diabetes, they expressed greater backing for public health policies aimed at addressing those factors; Republicans, by contrast, registered much lower levels of support.

In other words, the more conservatives know about the factors that lead to diabetes, the less likely they are to support efforts to eliminate those factors. Presumably, the article is tapping into some preexisting bias toward "personal responsibility," though it's not exactly clear what people are supposed to do when their kids can't play outside because the streets are too dangerous.

By Ezra Klein  |  October 19, 2009; 10:55 AM ET
Categories:  Health  
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Comments

"it's not exactly clear what people are supposed to do when their kids can't play outside because the streets are too dangerous."


No, Mr. Klein; they expect you to die!

Posted by: adamiani | October 19, 2009 11:31 AM | Report abuse

"it's not exactly clear what people are supposed to do when their kids can't play outside because the streets are too dangerous."

This is a problem of law enforcement, not public health. It's not clear what Klein thinks should be done about it either.

Posted by: tomtildrum | October 19, 2009 12:12 PM | Report abuse

The Republican reaction is part of their overall denial of reality position.

Basically, they want to believe that diabetes is a choice, so they can blame the person with the disease for eating too much sugary food. But if you present them with a set of environmental conditions that contribute, then there's no way to say "we need to tell that person to stop eating too much! It's their own fault!" Now, they have to contemplate that there is an external factor at play, that is not self-regulating. It is a Policy Problem. But they don't think anything should be regulated, so they just shift into denial.

Hmmmmm....sounds like their reaction to climate change, or the banking meltdown, or runaway health care costs, or balancing the budget, or winning wars of occupation on foreign soil....all these things present hard problems, so ....let's avoid thinking about them!! Let's find a way to make it the fault of poor people!

Drill, baby drill! It was ACORN and The Community Reinvestment Act! Flat Tax! They'll greet us with open arms and flowers, and the Iraqi Oil will pay for the war! Make fat people pay more for health insurance!

Anything to avoid thinking hard about problems and coming up with sensible, workable solutions to them.

Posted by: Dollared | October 19, 2009 1:20 PM | Report abuse

dollared,

while you are correct in many things you're saying the fact of the matter is that some of the issue does relate to personal responsibility. How much of it? 20%, 40% more? Less?? Are there no rich fat people? Poor thin people? The answer lies somewhere in the center which is not where most of the democrats and almost none of the Republican's are.

There's plenty of blame to go around. Don't just throw it at Republicans.

Posted by: visionbrkr | October 19, 2009 1:40 PM | Report abuse

"...though it's not exactly clear what people are supposed to do when their kids can't play outside because the streets are too dangerous."

Part of the problem (part of quite a few social problems, actually) is that conservatives think of children as part of *your* personal responsibility. And that watching them suffer, when they suffer, is part of *your* punishment for whatever shortcoming they think the market should be punishing you for.

Which would be fine, I guess, if your children magically evaporated after your 18 year sentence for the "wages of sin" or whatever. Instead they turn into, you know, adults who, as Hannah Arendt pointed out, must be prepared to shoulder their share of the weight of the world or else add to everyone else's.

If I was advising promising young grad students I'd say there's at least one nice master's thesis waiting for someone who wants to study the perception of the scope of children in society.

figleaf

Posted by: figleaf | October 19, 2009 2:04 PM | Report abuse

The conservative response is that a bad environment is the result of failure to be successful enough to afford a safe environment, clearly a personal failure.

Posted by: zosima | October 19, 2009 2:09 PM | Report abuse

i should adjust my post, BUT CAN'T.

I should have said "don't just throw it ALL at Republican's"

Posted by: visionbrkr | October 19, 2009 2:38 PM | Report abuse

That's hilarious. Of course, without Gollust's and Ubel's study, one can't be sure Dry is accurately representing it, but it's still hilarious.

Here's Klein: "Turns out political affiliation does a good job predicting people's reactions to public health problems". DUH!?! What good would political affiliation be if it didn't segregate people by their attitudes toward public (i.e. political) policy? OMIGOD. TOTALLY.

Klein: "When Democrats read articles emphasizing the environmental factors around diabetes, they became more sympathetic to public health programs meant to combat the disease. When conservatives read those articles, they became less sympathetic." Actually, a close reading of Dry finds that she did NOT say that. She wrote, "Republicans, by contrast, registered much lower levels of support," but she does NOT say whether the study finds lower levels of support *than Democrats* or lower levels of support *than Repugs that read other versions of the story registered.* To make the leap Klein does is either dishonest, careless, or ignorant (yeah, levels of redundancy.)

Klein: "In other words, the more conservatives know about the factors that lead to diabetes, the less likely they are to support efforts to eliminate those factors." Wrong, again, Klein. You cannot know that from the article that Dry wrote. People of principle would normally be against remedial efforts by *government*, but *for* such efforts by the private sector.

Klein: "[I]t's not exactly clear what people are supposed to do when their kids can't play outside because the streets are too dangerous." That appears to be a raging non sequitur. The CDC sez: "A statistically significant increase in the prevalence of type 2 diabetes among children and adolescents was found only for American Indians." I was not aware that American Indians dwelt in such dangerous places. Or maybe Klein can elaborate.

CDC link: http://www.cdc.gov/diabetes/projects/cda2.htm

Posted by: msoja | October 19, 2009 10:21 PM | Report abuse

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