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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  

16  J A N U A R Y  2002  


The Impact Of Terrorism And The Recession 
On Americans' Health Priorities

by Robert J. Blendon, Catherine M. DesRoches, John T. Young, and
Kimberly Scoles

This is the second in a series of brief essays about how Americans' health and health care priorities have changed since September 11th. The first, "Americans' Health Priorities Revisited after September 11," appeared on HealthAffairs.org on 13 November 2001. Since then the economy has been declared to be in recession. Here we address the implications of this on the nation's health priorities.

DATA SOURCES AND METHODS

The survey data in this paper are derived from four primary sources: (1) a Harris Interactive Poll of 14-19 December 2001; (2) a Harvard School of Public Health/Robert Wood Johnson Foundation/International Communications Research poll of 28 November-2 December 2001; (3) a Harvard School of Public Health/Robert Wood Johnson Foundation/International Communications Research poll of 30 November-4 December 2001; and (4) three polls shown in our earlier essay.¹

RESULTS

Most important issue for government to address. Exhibit 1 shows that by December 2001 the war/defense had become Americans' top priority for government action, followed by the economy and jobs.² Health care continues to be a much lower priority than it was in May 2001.

Satisfaction with the health care system and the system for protecting the nation's health. In addition to health care being a lower priority for government action, public dissatisfaction with both the public health system and the health care system has declined since May 2001 (Exhibit 2).³

Importance of health issues. Exhibit 3 shows that the top health issues for the public continue to be cancer, heart disease, and HIV/AIDS.⁴ There has been no change in the ranking of the top health problems when compared with May 2001, with the exception of health problems relating to terrorist attacks. This is in contrast to early November 2001, when there was a sharp increase in concern about diseases in general.⁵

Priorities for government action on health issues. Cancer and HIV/AIDS are the top public priorities for government action on health (Exhibit 4). Health problems resulting from the terrorist attacks rank higher with the public as a priority for government action than as a health problem.⁶

Importance of health care issues. Most of the important health care problems reported by the public in December 2001 were also reported in May 2001 (Exhibit 5). In contrast to early November, health care problems resulting from the terrorist attacks continue to be a public priority, albeit a lower one.⁷ The top problems are cost of health care and the lack of or inadequate coverage, followed by issues directly affecting the elderly. Concerns about specific health care issues are returning to their pre-September 11 levels.

Priorities for government action on health care issues. Compared with Exhibit 5, Exhibit 6 shows a change in priorities when Americans are asked about their top issues for government action. The lack of or inadequate health coverage and issues directly affecting the elderly top the public's list. The cost of prescription drugs ranks similarly on both lists.⁸

CONCLUSION

Prior to September 11 health care was one of a number of issues that were ranked similarly by the public. Now the war, the economy, and terrorism dominate the public's priorities for government action. If the recession continues over a long period of time, we are likely to see the salience of the issue of the uninsured rise among the public, since most coverage is tied to employment.⁹ Of note, the cost of health care tops the public's list of important health care problems. However, at this time it is not a priority for government action for a large proportion of the public. Last, despite Americans' concerns about terrorism, they continue to place a high priority for government action on cancer and HIV/AIDS.

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. The poll asked the public: "What do you think are the two most important issues for the federal government to address?" (14-19 December 2001). Harvard School of Public Health/Robert Wood Johnson Foundation/International Communications Research poll, 28 November-2 December 2001 (Roper Center for Public Opinion Research, 2001). Harvard School of Public Health/Robert Wood Johnson Foundation/International Communications Research poll, 30 November-4 December 2001 (Roper Center for Public Opinion Research, 2001). R.J. Blendon et al., "Americans' Health Priorities Revisited after September 11," HealthAffairs.org (13 November 2001).
2. Harris Interactive (14-19 December, 2001).
3. Harvard/RWJF/ICR poll (30 November-4 December 2001). The poll asked the public (n = 1,007), "For each of the following areas, please tell me whether you are very satisfied, somewhat satisfied, not too satisfied, or not at all satisfied. How about the availability and affordability of health care" and "How about the nation's system for improving and protecting the public's health."
4. Harvard/RWJF/ICR poll (30 November-4 December 2001). This poll was split-sampled; 503 adults were asked this question: "What do you thing are the two or three most important health problems facing Americans today?"
5. Blendon et al., "Americans' Health Priorities Revisited after September 11."
6. Harvard/RWJF/ICR poll (28 November-2 December 2001). This poll was split-sampled; 504 adults were asked this question: "What do you think are the two or three most important health issues for the government to address?"
7. On health problems resulting from terrorism, Harvard/RWJF/ICR poll (30 November-4 December 2001). This poll was split- sampled; 503 adults were asked this question: "What do you think are the two or three most important health care problems facing Americans today?" On changing priorities since the earlier surveys, see Blendon et al., "Americans' Health Priorities Revisited after September 11."
8. Harvard/RWJF/ICR poll (28 November-2 December 2001). This poll was split-sampled; 504 adults were asked this question: "What do you think are the two or three most important health care issues for the government to address?"
9. U.S. Census Bureau, Health Insurance Coverage: 2000 (Suitland, Md.: U.S. Census Bureau, Economics and Statistics Administration, September 2001).

Robert J. Blendon is a professor of health policy and political analysis, Catherine M. DesRoches and John T. Young are project directors, and Kimberly Scoles is a research manager at the Harvard School of Public Health.

©2002 Project HOPE–The People-to-People Health Foundation, Inc.