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November 6, 2020

Weekly line: How the coronavirus influenced voters in this election—and how that could impact response efforts

Daily Briefing

    Americans participated in a one-of-a-kind general election this year, with the novel coronavirus epidemic influencing not only how we cast our ballots, but how we thought about which candidates we opted to support.

    Where voters landed on key election issues—and why it's shocking some public health experts  

    Preliminary exit polls and voter surveys show the economy, racial equality, and the coronavirus epidemic were among the top issues for voters in this year's presidential and general elections.

    In addition, exit polls and surveys conducted on Election Day revealed partisan divides over which issues Americans thought were most important when casting their votes. Generally, the polls showed that voters who favored former Vice President Joe Biden, the Democratic Party's candidate, named the epidemic as the top issue facing the country, while voters who favored President Trump, the Republican Party's candidate, ranked the economy and jobs as the most pressing issue. For example, AP VoteCast found that 60% of respondents who voted for Biden named the coronavirus epidemic as the most important issue facing America, while nearly 50% of respondents who voted for Trump said the economy was the most important issue.

    But the results are surprising to some public health experts—and they say it may signal a broader need to educate Americans about public health issues.

    For instance, Eric Topol, a cardiologist and head of the Scripps Research Translational Institute, told the Washington Post he was surprised by the findings. "That was shocking to me, that [President] Trump could convince so many people it was a choice between the economy and pandemic," he said. "I'm amazed the extent he pulled that off, because it's so obviously a false dichotomy. There's no way for the economy to thrive unless we get control of the [epidemic]."

    But Matthew Seeger, a risk communication expert at Wayne State University who previously has helped CDC develop communications plans, noted that voters had to grapple with vast misinformation about the epidemic when deciding which candidates to support. "The messaging around the [epidemic] has been deliberately confused and strategically manipulated to downplay its significance," Seeger said. "You combine that with the fact that this is a slow-moving crisis with risk fatigue starting to settle in, and you can see why public perception is what it is."

    How public health experts could bridge the political divide

    Georges Benjamin, executive director of the American Public Health Association, told STAT News' Nicholas Florko this election showed that public health officials are "going to have to do some serious soul searching." Benjamin said that, although he doesn't think public health officials are at fault for the political backlash that's occurred in the United States over measures intended to mitigate the coronavirus's spread, they do "play a big role in making sure that we come up with ways to deal with this in the future."

    And while Florko writes that public health experts face an uphill battle in discussing coronavirus transmission mitigation efforts in the current political climate, others believe there's a path forward.

    Lindsey Leininger, a public health educator and clinical professor at Dartmouth College, told Florko that the first step to solving the problem is to acknowledge it. "We have a huge gaping hole in our cultural intelligence and I think that that is really important for us to recognize and embrace," Leininger said. "We need to know that this is a blind spot, and we need to partner with people who believe in the science and have credibility" among those who are resistant to coronavirus mitigation measures.

    Glen Nowak, a former CDC communications staffer who currently heads the University of Georgia's Center for Health and Risk Communication, told Florko that public health officials may need to start by trying to better understand why some Americans are resistant to certain public health measures in the first place. "The approach often used is, 'We just need to tell people who have those beliefs that they're wrong.' Maybe not that directly, but in other ways. Maybe what we need to do is invest in listening to their concerns, and understanding their perspectives, before we start giving them our messages," Nowak said.

    And Krutika Kuppalli, a physician and professor at the Medical University of South Carolina, told Florko that conducting in-person outreach could help to make reluctant communities "feel empowered."

    Overall, Gregg Gonsalves, an assistant professor at Yale School of Public Health, told Florko he believes public health experts are up for the challenge. "This is what we were made for. This is a pandemic, this is our challenge, this is our calling, this is our mission. … We do what we do: Doctors don't give up on patients and we don't give up on the public health."

    In the meantime, Susan Bailey, president of the American Medical Association, stressed that Americans can help by taking matters into their own hands.

    "Regardless of the outcome of the election, everyone in America needs to buckle down," Bailey told the Associated Press. "A lot of us have gotten kind of relaxed about physically distancing, not washing our hands quite as often as we used to, maybe not wearing our masks quite as faithfully. We all need to realize that things are escalating and we've got to be more careful than ever."

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