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US Adults’ Beliefs About Harassing or Threatening Public Health Officials During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  What factors shape US adults’ beliefs regarding whether threatening or harassing public health officials was justified during the COVID-19 pandemic?

Findings  In this survey study of 1086 US adults, the share who believed that harassing or threatening public health officials because of business closures was justified rose from 20% to 25% and 15% to 21%, respectively, from November 2020 to July and August 2021. There were increases in negative views over time among higher earners, political independents, those with more education, and those most trusting of science.

Meaning  These findings suggest that restoring trust in public health officials will require strategies tailored to engage diverse viewpoints.

Abstract

Importance  The rise in attacks on public health officials has weakened the public health workforce and complicated COVID-19 mitigation efforts.

Objective  To examine the share of US adults who believed harassing or threatening public health officials because of COVID-19 business closures was justified and the factors shaping those beliefs.

Design, Setting, and Participants  The Johns Hopkins University COVID-19 Civic Life and Public Health Survey was fielded from November 11 to 30, 2020, and July 26 to August 29, 2021. A nationally representative cohort of 1086 US adults was included.

Main Outcomes and Measures  Respondents were asked how much they believed that threatening or harassing public health officials for business closures to slow COVID-19 transmission was justified. Adjusted differences in beliefs regarding attacks on public health officials were examined by respondent sociodemographic and political characteristics and by trust in science.

Results  Of 1086 respondents who completed both survey waves, 565 (52%) were women, and the mean (SE) age was 49 (0.77) years. Overall, 177 respondents (16%) were Hispanic, 125 (11%) were non-Hispanic Black, 695 (64%) were non-Hispanic White, and 90 (8%) were non-Hispanic and another race. From November 2020 to July and August 2021, the share of adults who believed harassing or threatening public health officials because of business closures was justified rose from 20% (n = 218) to 25% (n = 276) (P = .046) and 15% (n = 163) to 21% (n = 232) (P = .01), respectively. In multivariable regression analysis, respondents who trusted science not much or not at all were more likely to view threatening public health officials as justified compared with who trusted science a lot (November 2020: 35% [95% CI, 21%-49%] vs 7% [95% CI, 4%-9%]; P < .001; July and August 2021: 47% [95% CI, 33%-61%] vs 15% [95% CI, 11%-19%]; P < .001). There were increases in negative views toward public health officials between November 2020 and July and August 2021, among those earning $75 000 or more annually (threatening justified: 7 [95% CI, 1-14] percentage points; P = .03), those with some college education (threatening justified: 6 [95% CI, 2-11] percentage points; P = .003), those identifying as politically independent (harassing justified: 9 [95% CI, 3-14] percentage points; P = .01), and those trusting science a lot (threatening justified: 8 [95% CI, 4-13] percentage points; P < .001).

Conclusions and Relevance  While antagonism toward public health officials was concentrated among those doubting science and groups most negatively affected by the pandemic (eg, those with lower income and less education), the findings of this study suggest that there has been a shift toward such beliefs within more economically advantaged subgroups and those more trusting of science. Restoring public trust in public health officials will require nuanced engagement with diverse groups.

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Article Information

Accepted for Publication: May 31, 2022.

Published: July 29, 2022. doi:10.1001/jamanetworkopen.2022.23491

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Topazian RJ et al. JAMA Network Open.

Corresponding Author: Rachel J. Topazian, BA, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205 (rtopazi1@jhu.edu).

Author Contributions: Ms Topazian had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Topazian, McGinty, Han, Levine, Presskreischer, Barry.

Acquisition, analysis, or interpretation of data: Topazian, McGinty, Han, Levine, Anderson, Barry.

Drafting of the manuscript: Topazian, Levine, Barry.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Topazian.

Obtained funding: McGinty, Han, Barry.

Administrative, technical, or material support: Topazian, McGinty, Levine.

Supervision: McGinty, Han, Levine, Barry.

Conflict of Interest Disclosures: None reported.

Funding/Support: Survey data collection was funded by The Robert Wood Johnson Foundation, the Johns Hopkins Bloomberg School of Public Health, and the Johns Hopkins University Alliance for a Healthier World’s 2020 COVID-19 Launchpad Grant. Ms Topazian receives tuition and stipend support from a grant from the US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health to the Johns Hopkins Education and Research Center for Occupational Safety and Health (award No. T42 OH0008428).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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