Differences in COVID-19 response

Women, college graduates, Democrats more likely to self-isolate to reduce coronavirus risks

Survey also finds differences in prevalence of COVID-19 testing based on geographic, personal and socio-economic factors

MEDFORD/SOMERVILLE, Mass (July 20, 2020)—Women, older Americans, Democrats and people with more education are more likely to try to isolate themselves from contact with other people to reduce COVID-19 transmission risks, according to a new Tufts University national survey.

The survey also identified notable differences in whether people have received testing for COVID-19 based on geographic regions, age group, educational level, political affiliation, income, race/ethnicity and gender. Those who have been tested for COVID-19 most commonly live in the Northeast, are affiliated with the Democratic party, and are African American, according to the research.

“The results of our survey indicate that there are significant demographic and geographic differences in how people respond to COVID-19 pandemic risks, and that these disparities in protective responses need to be taken into account by public health and public policy officials,” said Tom Stopka, an epidemiologist at Tufts School of Medicine, and a co-lead on the study.

“As public health officials continue to increase access to testing  across the U.S. in light of persistent surges in COVID-19 infections in many states, they need to consider how to increase testing in geographic hotspots and the highest-risk groups to better understand infection patterns and inform data-driven public health and clinical responses,” Stopka added.

The survey was designed and analyzed by Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement. The research group previously released data showing that only 57 percent of Americans plan to get vaccinated for COVID-19. The group will soon release additional research about the economic impacts of the pandemic.

Self-isolation rates differ

Overall, 71% of adult Americans say they have tried to separate themselves from others to avoid COVID-19.

Women are about nine percentage points more likely to self-isolate (75% versus 66% for men). People with a bachelor’s degree are almost 20 percentage points more likely to self-isolate than those with a high school diploma (79% versus 59.3%, respectively). Democrats (77.5%) and Independents (73%) are about 10 points more likely to self-isolate than Republicans (66%). Almost eight out of ten Americans who are 60 or older report trying to self-isolate, while two-thirds of respondents in all other age categories report similar attempts.                        

The disparities among those who are more likely to self-isolate may reflect opportunities and perceived risks, according to the researchers. For instance, retired people and people who work at computers can isolate more easily than people who provide in-person services. Also, people in older age groups may be paying close attention to the elevated risks that they face based on national and international epidemiological data and news.

“Below age 60, all age groups are self-isolating at the same rate. That may counter speculation that the young are flouting restrictions,” said Peter Levine, an associate dean of academic affairs at Tufts’ Tisch College.

Testing rates vary by geographic region

Overall, 7% of those polled say that they have personally been tested for COVID-19, and 17% report that someone in their family has been tested.

These testing rates vary by region. In the Northeast, 10% have been tested, and 21% have a family member who has been tested, compared to 5% and 14% in the Midwest, respectively, with the other regions in between. Democrats are significantly more likely to have been tested (9%) or to have a tested family member (22%) than Republicans (6% and 13.5%, respectively). African Americans are the most likely to be tested (10%) or to have had a test in the family (26%), compared to 5% and 14% for Whites, respectively. Increased testing may reflect the higher rate of infection among African Americans that has been widely reported.

About the survey

The survey was fielded online by Ipsos between May 29 and June 10, 2020, using its KnowledgePanel. The sample was nationally representative, and the number of complete responses was 1,267 non-institutionalized adult residents of the United States. More technical information about the survey is at https://equityresearch.tufts.edu/the-survey/.

Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement was established in 2019 as part of a strategic effort to use resources and expertise across the university to address major global issues. It brings together researchers from across Tufts campuses and schools to discuss and investigate aspects of equity and inequity in the United States and the world. The research has been funded by Tufts University’s Office of the Vice Provost for Research as one of several such initiatives.

The group’s principal investigators are Jennifer Allen, professor of Community Health in the Tufts School of Arts and Sciences; Levine; and Stopka. Other members of the group can be found here.

By September 2020, the Research Group will launch a website at https://equityresearch.tufts.edu that will allow anyone to explore numerous dimensions of equity and inequity with an interactive data-visualization tool. Tufts’ Jonathan M. Tisch College of Civic Life is funding the data-visualization tool.

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About Tufts University

Tufts University, located on campuses in Boston, Medford/Somerville and Grafton, Massachusetts, and in Talloires, France, is recognized among the premier research universities in the United States. Tufts enjoys a global reputation for academic excellence and for the preparation of students as leaders in a wide range of professions. A growing number of innovative teaching and research initiatives span all Tufts campuses, and collaboration among the faculty and students in the undergraduate, graduate and professional programs across the university’s schools is widely encouraged.

Shelley: England in 1819

England in 1819

by Percy Bysshe Shelley

An old, mad, blind, despised, and dying King;
Princes, the dregs of their dull race, who flow
Through public scorn,—mud from a muddy spring;
Rulers who neither see nor feel nor know,
But leechlike to their fainting country cling
Till they drop, blind in blood, without a blow.
A people starved and stabbed in th' untilled field;
An army, whom liberticide and prey
Makes as a two-edged sword to all who wield;
Golden and sanguine laws which tempt and slay;
Religion Christless, Godless—a book sealed;
A senate, Time’s worst statute, unrepealed—
Are graves from which a glorious Phantom may
Burst, to illumine our tempestuous day.

This is one sentence. Minus the adjectives and adjectival phrases, it says: “A king, princes, rulers, people, army, laws, religion, and senate are graves from which a phantom may burst to illumine our day.” (It’s interesting that one phantom will arise from all these separate graves.)

The “king” is George III, suffering by now from advanced dementia. He has seven surviving sons, which would be the narrowest definition of “princes.” But Shelley could mean a broader category–“princes” in the sense of the crowned heads of Europe. They are back on their thrones after Waterloo, erecting a system of reactionary absolutism that will last until 1830.

“Rulers” would mean the whole government, starting with the Prime Minister, Robert Jenkinson, 2nd Earl of Liverpool, who suspended civil liberties from 1817-19. The “people” are suffering from the Corn Laws (which prohibit importation of grain) and early industrialization. The “army” refers to the cavalry who charged a peaceful demonstration for parliamentary reform (the Peterloo massacre of August 16). The “senate” is parliament, although I don’t quite follow how that noun relates to “Time’s worst statute.” And the “Phantom” is something like liberty.

The situation is bad but unsustainable. The rulers may be evil, but they “drop, blind in blood, without a blow.” The army wields a two-edged sword, liable to slice its own bearer. The people, however, seem passive: they think and do nothing in particular but are “starved and stabbed in th’ untilled field.” The Phantom may (or may not) burst forth; it’s not clear that the people can decide that.

The poem is a sonnet: fourteen 10-syllable lines, rhymed, with a final couplet that answers the question posed by the rest of the poem: What will happen? However, the form is not strictly conventional. Shelley uses just four endings (-ing, -ow, -ield, and -ay) in an ABABAB CDCD CC scheme.

Christopher Spaide says that the poem was too radical to publish in 1819. By the time Mary Shelley included it in Shelley’s posthumous Poetical Works (1839), she thought it needed an explanation, since the “younger generation … cannot remember the scorn and hatred with which the partisans of reform were regarded some few years ago.” In other words, the sonnet went from revolutionary to quaint in 20 years–not because an actual revolution ensued in Britain, but because the political situation mellowed as reforms eased the crises of the day. No Phantom burst, but the laws arguably became less sanguine and the people less likely to be starved and stabbed.

See also Brecht, To Future Generations.

there has been no decrease in toleration of differences

The Harper’s Letter decries “A new set of moral attitudes and political commitments that tend to weaken our norms of open debate and toleration of differences in favor of ideological conformity.”

If the Letter is reasonable at all, such claims must be testable. I think that someone who fully endorses the Letter should hypothesize that Americans have–for better or worse–grown less likely to tolerate hateful speech, such as explicit expressions of anti-Black racism.

Have they? Since 1976, the General Social Survey has asked Americans whether someone should be allowed to give an anti-Black racist speech in their community. There is no significant change in responses to this item. It is true that the lowest rate was measured in the most recent year: 2018. But the difference between 2018 and the average year was within the margin of error (+/- 2.6 points), and the line has long wobbled around the mean.

Maybe the left has forgotten about the First Amendment? Here is the trend for people who identify on the left end (1 or 2) of a 7-point ideology scale:

Liberals (as the survey names this group) have been a bit more likely than the population as a whole to think that a racist speech should be allowed (mean = 67.6% vs 61.3% for the whole sample). The only reason this second line wiggles more than the first is that the sample is smaller. The trend is again essentially flat.

Or perhaps it is “the young” who have forgotten the First Amendment?

Maybe, to a limited extent. The third graph shows the trend for people who were 18-29 at the time of each survey. There has not been much change since 1982, but the 2018 result is well below the 1976 number.

By the way, I am not sure that I believe a racist speech should be allowed in my community. The First Amendment applies–there should be no state censorship–but if my “community” is something like my school, religious congregation, university, or town council, I’m against a sanctioned, formal speech “claiming that Blacks are inferior” (which is how the GSS phrases the question).

The GSS has also asked about other forms of speech or speakers: a speaker who is gay, a speech advocating military dictatorship in the USA, a communist speaker, or a Muslim clergyman preaching hatred of the USA.

Generally, the trends are up. I find it troubling that ten percent still don’t want to permit a person who is gay to speak in their community. I also find the level of tolerance for the Muslim clergy-person worrying, although the question is worded in a particular way that’s arguably Islamaphobic itself. But overall, the trend is that more people would tolerate more differences.

Of course, another trend is taking place–albeit harder to quantify. Nowadays, an incident that reinforces the beliefs or concerns of a given group can easily “go viral.” Given our tendency to confirmation bias, we can select and share news items that confirm almost any belief. Incidents that are widely shared represent severe selection bias. I have read about true stories of problematic (or even scandalous) intolerance on the left. I see no evidence that these stories are common or becoming more so. Absent empirical evidence, can we avoid making sweeping empirical claims?

See also: the Harper’s letter is fatally vague; a civic approach to free speech; what sustains free speech?

the Harper’s letter is fatally vague

This is the text of the letter that is working as a national Rorschach Test, appearing self-evident and overdue to some, offensive to others.

It is remarkably and intentionally vague. Trends are described, but without any data, timeframes, or evidence. For instance, “a new set of moral attitudes and political commitments” is “weaken[ening] our norms of open debate and toleration of differences in favor of ideological conformity.” Is that true? Which moral attitudes? Are they new (since when)? What is the degree to which disagreements are tolerated today? How does that vary by institution and community? How has it changed?

No proper names are used, but specific cases are surely being alluded to. For instance, “a researcher is fired for circulating a peer-reviewed academic study.” That must be David Shor, fired from Civis Analytics for tweeting a summary of research by Omar Wasow. That sounded like an injustice to me and a way of blocking an important topic, but does it generalize? Why exactly did it happen? (I am guessing it was a business judgment, which doesn’t make it fair but does suggest that it wouldn’t happen in many other organizations.) Are there other cases like it?

“Journalists are barred from writing on certain topics.” That has happened since the dawn of journalism: reporters constantly negotiate their story ideas with editors. I presume the concern is about journalists who want to write on topics uncomfortable to the left, but that isn’t specified. How common are such cases? After all, a vast amount of journalism is uncomfortable–if not downright hostile–to the left.

The vagueness is fatal because the issues at stake are complex and subtle. I think all these points are valid but in tension:

  1. It pays to wrestle constantly with diverse and conflicting ideas. That keeps you sharp, tough-minded, and creative.
  2. Social movements are often essential to positive change. They work to create unity because it’s an asset for them (along with worthiness, numbers, and commitment–Charles Tilly’s WUNC acronym). They therefore tend to discourage internal disagreement.
  3. It is much harder to face an open discussion if you are the topic of it. If people are talking about why you are socially disadvantaged, that can be (at best) deeply uncomfortable. Oppressed people are usually familiar with a wide range of opinions, including ones that are explicitly hostile to them. They may need a break rather than more exposure to challenging opinions.
  4. Regardless of their social position, people tend to prefer ideas that confirm their own prior beliefs and avoid or minimize conflicting beliefs in ways that distort their thinking.
  5. Strongly criticizing people is an act of free speech. Preventing or decrying strong criticism is not a way of supporting free speech.
  6. Being criticized can have tangible costs, including losing your job.
  7. Marginalizing odious views can be an appropriate way for communities to uphold norms. All decent communities marginalize some opinions.
  8. We navigate a world of massively disaggregated media by making constant individual choices about what to read, watch, and share. Much more of our speech is now visible, searchable, and sharable compared to pre-Internet days. What is odious in one space is an assumed truth in another. Anyone can be perceived as an outlier and a threat somewhere.
  9. Impartiality is a worthy goal for some people, such as public school teachers and editorial-page editors. Impartiality is not an empty concept, as you can tell by actually trying to act impartially.
  10. No institution is a free-speech zone, because it must decide whom to admit, hire, promote, publish, reward, etc. These are inevitably value-judgments and they cannot and should not be content-neutral.

If we interpret the Harper’s letter charitably, it’s saying that people are forgetting #1 because they are only concerned about #2 and #3. I’m sure this is the case for some people, but how many? Is there any basis for thinking that “censoriousness is … spreading more widely in our culture”? In my experience, a lot of people actually see merit in many of the ten points listed above and struggle to find the right balance.

If the question is whether the government should censor speech, the answer should almost always be no. That case is worth defending and propagating. I would welcome a letter from diverse and distinguished thinkers that made the positive case for intellectual diversity and individual rights against the state.

If the question is whether you should join with other people on Twitter to criticize an individual in strong terms for saying something, that’s a much more complicated matter. It’s highly context-specific. It may depend how bad you think the targeted opinion was, how many other people have already piled on, and what consequences you expect to follow from the critique. If, for example, the target is the President of the United States, go for it. If it’s an untenured professor whose claim was subtly problematic, maybe you should back off. Your criticism is itself protected by the First Amendment, but that doesn’t mean it is justified or helpful–or effective.

I have no more right to generalize than the authors of the Harper’s letter, but if I dared to describe the American left in broad strokes, I would begin by observing that a lot of people are wrestling with versions of the ten points above and trying to land in the right place. Any given controversy provokes diverse and often conflicted reactions.

People are more aware of #3 (the negative impact of a diverse debate on the people being discussed) than they were in the ’60s or the ’80s, presumably because of the growing diversity of our population and leaders. We should be concerned about #3, but it doesn’t erase the importance of robust debate or the need to counter confirmation bias. A balance is required.

All of this is playing out in a very problematic institutional context. Twitter allows just a few words and makes it easy to amplify an attack without even reading the original text. Most professors hold precarious (non-tenured) jobs that can vanish if they become targets of controversy. More than half of reporters have been laid off, creating a massive shortage of paid positions for journalists and an unprecedented concentration of those jobs in a few newsrooms. Malicious actors love to stir the pot.

It would be hard to navigate this context even if we all radiated wisdom and beneficence. Considering that everyone is fallible and biased–and some of us are actually Russian bots–I would like to celebrate the many among us who are doing their best.

See also: marginalizing odious views: a strategy; marginalizing views in a time of polarization; trying to keep myself honest; we need SPUD (scale, pluralism, unity, depth); the value of diversity and discussion within social movements; diversity, humility, curiosity; and Francis Bacon on confirmation bias.

only 57 percent of Americans say they would get COVID-19 vaccine

Vaccine interest higher among Whites and Hispanics, wealthier households, and Democrats

This is the latest product from the Tufts Research Group on Equity in Health, Wealth, and Civic Engagement, which I co-lead; and I did some of this analysis.

MEDFORD/SOMERVILLE, Mass. (July 9, 2020)—Despite widespread agreement among experts that having a prophylactic COVID-19 vaccine will be critical to the nation’s ability to safely return to some form of normalcy, only 57% of Americans say they would get a COVID-19 vaccine if it were available today, according to a national survey designed and analyzed by Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement.

The nationally representative survey also uncovered significant variations in vaccination acceptance by race/ethnicity, household income, educational background and party affiliation. Whites and Hispanics, Democrats, those with more formal education, and those with higher incomes reported being more likely to get vaccinated than Blacks, Republicans, those with less education, and those with lower incomes. Fully one-quarter of respondents said they didn’t know if they would get the vaccine, possibly indicating the need for more public health education and information.

 “It’s really concerning that only 57% of our respondents said they would get vaccinated. It’s evident that we need to begin working on a national vaccine strategy and education campaign right now– even before we have the vaccine in hand,” said Jennifer Allen, professor of community health in Tufts University’s School of Arts and Sciences and co-leader of the study. “There is still some uncertainty, but some studies show that we need between 60 and 70% of the population to be vaccinated in order to confer herd immunity.”

There has been growing resistance to all vaccines in the U.S. over the past decade, which has led to reduced compliance with vaccine recommendations and the re-emergence of diseases like measles and mumps, which were previously well-controlled. Growing anti-vaccination sentiment has been fueled by misinformation about vaccines, including the widely de-bunked theory that vaccines could cause autism.

Whites and Hispanics more likely to vaccinate

The study also revealed marked differences of opinion toward vaccination across racial groups, with 58% of non-Hispanic whites and Hispanics reporting they would get the vaccine as compared with 48% of non-Hispanic Blacks.

“The pandemic has disproportionately affected Black individuals,” said Allen. “The lower level of vaccine acceptance within this population is worrisome, as it suggests the vaccine could further exacerbate COVID-19 racial/ethnic disparities. Given the legacy of medical experimentation on African Americans, there is understandable mistrust in medical science and in government.

“The accelerated time-frame for vaccine development and testing could further raise concerns about the safety and efficacy of an eventual vaccine,” Allen continued. “Targeted efforts will be needed to make sure that a vaccine doesn’t further widen the gap in health outcomes.”

Income and education plays factor

Surprisingly, those with higher levels of income and education were more likely to report that they would get the COVID-19 vaccine. “Historically, those most likely to refuse vaccines have been those with higher levels of income and education,” said Allen.

Among those with incomes less than $20,000, only 41% said they would get the vaccine, compared with 72% among those with incomes of $150,000 or more. Less than half of those with a high school education or below said they would get the vaccine, compared with 74% among those who had a college education.

Differences across political parties

Sharp polarization by political party affiliation also emerged in the responses. Willingness to be vaccinated was highest among Democrats (71%) compared with Independents (61%) and Republicans (47%).

“Differences between political parties are striking. As with many aspects of the pandemic, vaccination is a highly partisan issue,” said Peter Levine, an associate dean at Tufts’ Tisch College of Civic Life. “The partisan gap may pose an obstacle to widespread vaccination.”

While public health officials, clinicians and pharmaceutical companies race to develop a COVID-19 vaccine, it is evident that, should a successful vaccine become available, distribution and administration will need to be accompanied by health communication, promotion and education campaigns,” said Tom Stopka, an infectious disease epidemiologist and associate professor with the Tufts University School of Medicine, and a co-leader of the study. “Such campaigns can help to increase understanding of how the vaccine will work, decrease doubts and mistrust of local, state, and federal officials, and potentially demonstrate that the benefits of the vaccine far outweigh the risks.

“The U.S. population has been overwhelmed with COVID-19 information and stress, as well as massive changes to their day-to-day lives,” added Stopka. “When and if a vaccine becomes available, and has been thoroughly tested in human populations, it will be necessary to also develop a massive public health communication campaign to provide community members with the information they need to make an informed decision to protect themselves, and to protect their families and local communities.”

The survey was fielded online by Ipsos using its KnowledgePanel. The sample was nationally representative, and the number of complete responses was 1,267. More technical information about the survey is at https://equityresearch.tufts.edu/the-survey/.

Tufts University’s Research Group on Equity in Health, Wealth and Civic Engagement was established in 2019 as part of a strategic effort to use resources and expertise of Tufts campuses and schools to address major global issues. It brings together researchers from across the university to discuss and investigate aspects of equity and inequity in the United States and the world. The research has been funded by Tufts University’s Office of the Vice Provost for Research as one of several such initiatives

The group’s principal investigators are Allen, Levine and Stopka. Other members of the group can be found here

By September 2020, the Research Group will launch a website at https://equityresearch.tufts.edu that will allow anyone to explore numerous dimensions of equity and inequity with an interactive data-visualization tool. Tufts’ Jonathan M. Tisch College of Civic Life is funding the data-visualization tool.

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About Tufts University

Tufts University, located on campuses in Boston, Medford/Somerville and Grafton, Massachusetts, and in Talloires, France, is recognized among the premier research universities in the United States. Tufts enjoys a global reputation for academic excellence and for the preparation of students as leaders in a wide range of professions. A growing number of innovative teaching and research initiatives span all Tufts campuses, and collaboration among the faculty and students in the undergraduate, graduate and professional programs across the university’s schools is widely encouraged.