Populism, Community-Based Inequalities, and Public Health Policies: How Will Populism Attitudes Determine the COVID-19 Preventive Policy Support Under Different Local Socioeconomic Contexts?

Along with the global rise of populism in the current society, numerous studies have explored how populism attitudes affect individuals’ support toward policies, including the ones in public health. Some of such attempts demonstrated that populism attitudes, including anti-intellectualism, can provide better explanations than party identification and political ideology for accepting scientific advice and adopting preventive health behaviours, such as mask-wearing amid the COVID-19 pandemic (Merkley & Loewen, 2021). In other words, populism attitudes can capture distrusts toward the scientific community and public health policies beyond the right/left political spectrum. Therefore, examining the role of populism attitudes in predicting support of public health policies is one of the most critical agendas to obtain policy support from the broader public. Nonetheless, it has not been sufficiently uncovered how populism attitudes can be salient in predicting public health policy support. Specifically, a crucial research gap exists in the scarcity of studies considering the community-level socioeconomic and health disparities. A growing literature has shown that individuals’ place of residence matters significantly in predicting attitudinal variables, including evaluation toward politicians (Suk et al., 2020) and anti-intellectualism (Lunz Trujillo, 2022.) In particular, Suk et al. (2020) illuminate that the county-level socioeconomic (i.e., the change in population size due to out/in migration and unemployment rate) and health disparities significantly moderated the effects of partisanship and media use in predicting the evaluations toward politicians. Based on these existing studies, we examine the following RQ: How will local socioeconomic and health disparities -contextual factors in the place of residence- moderate populism attitudes in predicting policy support toward public health amid the pandemic (i.e., preventive COVID-19 policies)? To answer this RQ, we conducted an online survey among U.S. adults from February to March 2021(N = 1622.) Considering Suk et al. (2020), using a series of two-level multi-level analyses, we tested cross-level interactions of populism attitudes and socioeconomic (i.e., population size change due to out/in migration) and health inequalities (cumulative COVID-19 infection rate (%.)) In addition, we investigated the impacts of county-level educational disparity (i.e., % of bachelor’s degree holders per population size) and political leaning (i.e., Democrat vote shares in the 2020 presidential election.) Populism attitudes (i.e., People-centrism: Anti-elitism, and Manichaean outlook) were measured using the questions proposed by Castanho Silva et al. (2018), and we keep these subdimensions of populism attitudes separate given the role of each component uniquely contributed to the public discourse toward politicians (e.g., Jungherr et al., 2022.) Preliminary analysis results indicate two significant cross-level interactions. The interaction of anti-elitism and cumulative covid-19 infection rate suggests that the more cumulative covid-19 infection rate led to lower support among the low Anti-elitism group and higher support among the high Anti-elitism group toward the COVID-19 preventive policies. The interaction of the Manichaean outlook and the population size change implies that the increase in population size led to lower support among the high Manichaean outlook group and higher support among the low Manichaean outlook group toward the preventive policies. We discuss community-based inequalities with populism.