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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.


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.

Bryant-Genevier  J , Rao  CY , Lopes-Cardozo  B ,  et al.  Symptoms of depression, anxiety, post-traumatic stress disorder, and suicidal ideation among state, tribal, local, and territorial public health workers during the COVID-19 pandemic—United States, March-April 2021.   MMWR Morb Mortal Wkly Rep. 2021;70(26):947-952. doi:10.15585/mmwr.mm7026e1PubMedGoogle ScholarCrossref
Barry-Jester AM, Recht H, Smith MR, Weber L; The Associated Press, Lauren. Pandemic backlash jeopardizes public health powers, leaders. Kaiser Health News. December 15, 2020. Accessed July 18, 2021. https://khn.org/news/article/pandemic-backlash-jeopardizes-public-health-powers-leaders/
Ivory  D , Baker  M . Public health officials in the U.S. need federal protection from abuse and threats, a national group says. The New York Times. October 19, 2021. Accessed November 23, 2021. https://www.nytimes.com/2021/10/19/us/public-health-threats-abuse.html
Mello  MM , Greene  JA , Sharfstein  JM .  Attacks on public health officials during COVID-19.   JAMA. 2020;324(8):741-742. doi:10.1001/jama.2020.14423PubMedGoogle ScholarCrossref
Ward  JA , Stone  EM , Mui  P , Resnick  B .  Pandemic-related workplace violence and its impact on public health officials, March 2020‒January 2021.   Am J Public Health. 2022;112(5):736-746. doi:10.2105/AJPH.2021.306649PubMedGoogle ScholarCrossref
Rising stress and burnout in public health. de Beaumont Foundation. Accessed May 10, 2022. https://debeaumont.org/wp-content/uploads/dlm_uploads/2022/03/Stress-and-Burnout-Brief_final.pdf
DeSalvo  K , Hughes  B , Bassett  M ,  et al. Public health COVID-19 impact assessment: lessons learned and compelling needs. National Academy of Medicine. April 7, 2021. Accessed June 21, 2022. https://nam.edu/public-health-covid-19-impact-assessment-lessons-learned-and-compelling-needs/
Weber  L , Barry-Jester  AM . Most states have cut back public health powers amid pandemic. AP News. September 15, 2021. Accessed November 24, 2021. https://apnews.com/article/health-pandemics-infectious-diseases-arkansas-business-6a8c70f9efdd0fb6a3da88ccb59f1334
Baker  M , Ivory  D . Threats, resignations and 100 new laws: why public health is in crisis. The New York Times. Published October 18, 2021. Accessed October 18, 2021. https://www.nytimes.com/2021/10/18/us/coronavirus-public-health.html
Bump  P . After the political violence and the threats come the rationalizations. Washington Post. November 2, 2021. Accessed November 23, 2021. https://www.washingtonpost.com/politics/2021/11/02/after-political-violence-threats-come-rationalizations/
Barry  CL , Anderson  KE , Han  H , Presskreischer  R , McGinty  EE .  Change over time in public support for social distancing, mask wearing, and contact tracing to combat the COVID-19 pandemic among US Adults, April to November 2020.   Am J Public Health. 2021;111(5):937-948. doi:10.2105/AJPH.2020.306148PubMedGoogle ScholarCrossref
Dennis  J . Technical overview of the AmeriSpeak panel: NORC’s probability-based household panel. NORC at the University of Chicago. Updated February 8, 2022. Accessed June 21, 2022. https://amerispeak.norc.org/content/dam/amerispeak/research/pdf/AmeriSpeak%20Technical%20Overview%202019%2002%2018.pdf
Kurtzleben  D . From congress to local health boards, public officials suffer threats and harassment. NPR. December 16, 2020. Accessed January 3, 2022. https://www.npr.org/2020/12/16/946818045/from-congress-to-local-health-boards-public-officials-suffer-threats-and-harassm
Forgey  Q . ‘Everyone is lying’: Trump undercuts public health officials in fresh attacks. Politico. July 13, 2020. Accessed November 23, 2021. https://www.politico.com/news/2020/07/13/trump-questions-public-health-experts-twitter-359388
Achenbach J, Sun LH. CDC says coronavirus could be under control this summer in U.S. if people get vaccinated and are careful. Washington Post. May 5, 2021. Accessed January 18, 2022. https://www.washingtonpost.com/health/2021/05/05/pandemic-under-control-this-summer/
Deane  C , Parker  K , Gramlich  J . A year of U.S. public opinion on the coronavirus pandemic. Pew Research Center. March 5, 2021. Accessed April 26, 2021. https://www.pewresearch.org/2021/03/05/a-year-of-u-s-public-opinion-on-the-coronavirus-pandemic/
KFF. KFF COVID-19 vaccine monitor dashboard. November 8, 2021. Accessed November 24, 2021. https://www.kff.org/coronavirus-covid-19/dashboard/kff-covid-19-vaccine-monitor-dashboard/
Gollust  SE , Nagler  RH , Fowler  EF .  The emergence of COVID-19 in the US: a public health and political communication crisis.   J Health Polit Policy Law. 2020;45(6):967-981. doi:10.1215/03616878-8641506PubMedGoogle ScholarCrossref
Nagler  RH , Vogel  RI , Gollust  SE , Rothman  AJ , Fowler  EF , Yzer  MC .  Public perceptions of conflicting information surrounding COVID-19: results from a nationally representative survey of U.S. adults.   PLoS One. 2020;15(10):e0240776. doi:10.1371/journal.pone.0240776PubMedGoogle ScholarCrossref
Romer  D , Jamieson  KH .  Patterns of media use, strength of belief in COVID-19 conspiracy theories, and the prevention of COVID-19 from March to July 2020 in the United States: survey study.   J Med Internet Res. 2021;23(4):e25215. doi:10.2196/25215PubMedGoogle ScholarCrossref
Overton  D , Ramkeesoon  SA , Kirkpatrick  K , Byron  A , Pak  ES . Lessons from COVID-19 on executing communications and engagement at the community level during a health crisis. National Academies of Sciences, Engineering, and Medicine. December 7, 2021. Accessed January 14, 2022. https://www.nationalacademies.org/news/2021/12/lessons-from-covid-19-on-executing-communications-and-engagement-at-the-community-level-during-a-health-crisis
Narayan  KMV , Curran  JW , Foege  WH .  The COVID-19 pandemic as an opportunity to ensure a more successful future for science and public health.   JAMA. 2021;325(6):525-526. doi:10.1001/jama.2020.23479PubMedGoogle ScholarCrossref
Broady  K , Romer  C . August’s jobs report shows higher unemployment for Black workers, just as jobless benefits and eviction protections end. Brookings. September 8, 2021. Accessed January 17, 2022. https://www.brookings.edu/blog/the-avenue/2021/09/08/augusts-jobs-report-shows-higher-unemployment-for-black-workers-just-as-jobless-benefits-and-eviction-protections-end/
Parker  K , Minkin  R , Bennett  J . Economic fallout from COVID-19 continues to hit lower-income Americans the hardest. Pew Research Center. September 24, 2020. Accessed January 17, 2022. https://www.pewresearch.org/social-trends/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/
World Health Organization: Europe. Pandemic fatigue—reinvigorating the public to prevent COVID-19: policy framework for supporting pandemic prevention and management. 2020. Accessed June 21, 2022. https://apps.who.int/iris/bitstream/handle/10665/335820/WHO-EURO-2020-1160-40906-55390-eng.pdf
Badre  D . How we can deal with “pandemic fatigue.” Scientific American. January 24, 2021. Accessed November 29, 2021. https://www.scientificamerican.com/article/how-we-can-deal-with-pandemic-fatigue/
The National Academy for State Health Policy. 2021 COVID-19 state restrictions, re-openings, and mask requirements. January 11, 2022. Accessed May 10, 2022. https://www.nashp.org/2021-covid-19-state-restrictions-re-openings-and-mask-requirements/
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