The Politics of Health Beliefs: Cross-National Evidence

Abstract

Purpose

This study evaluates cross-national differences in public beliefs about the causes of health and the role of these beliefs in shaping attitudes regarding health policy.

Methodology/approach

The study uses data from the 2011 International Social Survey Program, which includes questions on health and health care, asked in 29 countries. Respondents were asked about four specific causes of poor health (i.e., genes, behavior, the environment, and poverty). Respondents were also asked about their attitudes regarding three aspects of health policy: their support for government-provided care, the perceived fairness of income disparities in medical treatment, and their support for providing health care to noncitizens.

Findings

The study has three findings. First, the study reveals the global reach of a multicausal view. The four beliefs about the causes of poor health are positively correlated in all countries. However, there is considerable cross-national variation in the average support for specific causes. Although in some countries proximate causes, such as genes, are endorsed more frequently than distal causes, such as poverty, this is by no means a uniform pattern. Support for genetic causes is high, but genetic reductionism is rare. Second, the study reveals that health beliefs are fundamentally political beliefs. The single most important determinant of beliefs about the causes of health is the country in which the respondent resides, exceeding in influence religion, education, and even personal experiences with health and health care. Third, the study reveals that the political connotations of health beliefs vary between countries, especially beliefs regarding genes. In general, those who endorse behavioral arguments favor less government involvement in health care and are more accepting of income disparities in the quality of care. Those who endorse the environment and poverty, meanwhile, tend to support a stronger role of government. Yet, the magnitude of these associations varies and, in the case of genetic arguments, even the direction of the association varies. Genetic arguments are frequently associated with support for a stronger role of government, but genetic arguments also are occasionally associated with support for the exclusion of noncitizens from the health care system.

Research limitations/implications

International survey research is valuable for exploring the scope of patterns revealed in a limited set of countries, but it is difficult to pinpoint the source of cross-national differences.

Originality/value

The study demonstrates the importance of national context in shaping health beliefs, as well as the role of beliefs regarding the causes of health in setting the stage for public receptivity to government-provided care. The study also illustrates the value of thinking about beliefs about genes as reflecting larger projects of biocitizenship, at least in some countries.

Citation

Schnittker, J. (2015), "The Politics of Health Beliefs: Cross-National Evidence", Education, Social Factors, and Health Beliefs in Health and Health Care Services (Research in the Sociology of Health Care, Vol. 33), Emerald Group Publishing Limited, Leeds, pp. 17-42. https://doi.org/10.1108/S0275-495920150000033002