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H E A L T H  A F F A I R S  
W E B  E X C L U S I V E  

13  N O V E M B E R  2001  


Americans' Health Priorities 
Revisited After September 11    

by Robert J. Blendon, Kimberly Scoles, Catherine DesRoches,
John T. Young, Melissa J. Herrmann, Jennifer L. Schmidt, and Minah Kim

In our Health Affairs paper, "Americans' Health Priorities: Curing Cancer and Controlling Costs" (Nov/Dec 2001, 222-232) we state that "in the absence of a perception of crisis . . . the public's agenda will be dominated on the one hand by concerns with cancer, HIV/AIDS, and heart disease and on the other hand by cost, prescription drugs, and the uninsured." This brief paper examines the impact of the tragedy of September 11, and the bioterrorist attacks that have followed.

DATA SOURCES AND METHODS

The survey data in this paper are derived from four primary sources: (1) a Harris Interactive poll of 15-22 August 2001;¹ (2) a Harris Interactive poll of 17-22 October 2001;² (3) two polls shown in the paper mentioned above;³ and (4) a Harvard School of Public Health/Robert Wood Johnson Foundation/International Communications Research poll, 1-4 November 2001.⁴

RESULTS

Overall priorities. Exhibit 1 shows that by mid-October 2001, Americans' top priorities for government action were terrorism, followed by war and defense, and the economy and jobs.⁵ In both relative and absolute terms, health care was a much lower priority than before September 11.

Importance of health problems. The impact of these events has led Americans to have become more concerned about a range of serious diseases (Exhibit 2). In addition, the public is now concerned about the health effects of terrorism.

Importance of health care problems. Exhibit 3 reflects the overall sharp decline in the importance of health care issues shown in Exhibit 1. Significantly, concerns about health care problems related to terrorism now tie with costs as the health care issue the public perceives to be the most important facing Americans today. Reflecting their heightened concern with diseases, many more Americans than in the past listed them as their top concern when asked about health care issues.

IMPLICATIONS

The terrorist attacks are the kind of historical events that lead to major shifts in public opinion.⁶ The events of September 11 have led to major changes in Americans' health and health care priorities.⁷ In the paper published in Health Affairs, Nov/Dec 01, we found that a very high priority for Americans was increasing medical research on diseases such as cancer, AIDS, and heart disease. Our findings imply that medical research will continue to be a top priority both for these diseases and those resulting from bioterrorist attacks. Concerns with bioterrorism will also lead to strong public support for major initiatives to improve our public health system.

In contrast to health problems, health care issues have become less salient to the public. This is likely to lead to decreased support for government action on health care issues that were being debated by the Congress before September 11. These include Medicare reform, a Medicare prescription drug benefit, patients' rights legislation, and coverage for the uninsured.

How long these opinion changes last and what direction they take in the future depend upon three critical yet unknown factors: the occurrence and severity of new domestic terrorist attacks; the duration and success of the war in Afghanistan; and the duration and depth of the economic recession.

This work was supported by a grant from the Robert Wood Johnson Foundation. The views expressed are solely those of the authors, and no official endorsement by the sponsor is intended or should be inferred.

NOTES

1. Harris Interactive poll, 15-22 August 2001. The poll asked the public (N1017), "What do you think are the two most important issues for government to address?" <<www.nationaljournal.com/members/polltrack>> (5 September 2001).
2. Harris Interactive poll, 17-22 October 2001. The poll asked the public (N1011), "What do you think are the two most important issues for government to address?" (New York: Harris Interactive, 2001).
3. See R.J. Blendon, et al., "Americans' Health Priorities: Curing Cancer and Controlling Costs," Health Affairs (Nov/Dec 01): Exhibit 1; and Harvard School of Public Health/ Robert Wood Johnson Foundation/International Communications Research (ICR) poll, May 2001 (Storrs, Conn.: Roper Center for Public Opinion Research, 2001).
4. Harvard School of Public Health/Robert Wood Johnson Foundation/ ICR poll, 1-4 November 2001. This poll was split sampled; 499 adults were asked this question, "What do you think are the two or three most important health problems facing Americans today?," and 499 adults were asked this question, "What do you think are the two or three most important health care problems facing Americans today?" (Roper Center for Public Opinion Research, 2001).
5. Harris Interactive poll, 17-22 October 2001.
6. B.I. Page and R.Y. Shapiro, The Rational Public: Fifty Years of Trends in American Policy Preferences (Chicago: University of Chicago Press, 1992).
7. Blendon et al., "Americans' Health Priorities."

Robert Blendon is a professor of health policy and political analysis, Kimberly Scoles is a research manager, and Catherine DesRoches and John Young are project directors at the Harvard School of Public Health. Melissa Herrmann is vice president/social science research and Jennifer Schmidt is a project director/social science research at International Communications Research. Minah Kim is a doctoral candidate in health policy at Harvard University.

©2001 Project HOPE–The People-to-People Health Foundation, Inc.