Political Polarization Is Making Us Sick

If you’ve been feeling sick of the political divisions that get sharper every day, you’re not alone.

A team of American researchers led by Jay J. Van Bavel of New York University recently published an article in Nature Medicine arguing that political polarization is a determinant of health, much like social class and many commercial enterprises.

The American researchers define political polarization as “a state in which the opinions, beliefs or interests of a group or society no longer range along a continuum but become concentrated at opposing extremes. Polarization is a collective phenomenon, whereas ‘partisanship’ applies at the individual level, reflecting deep-rooted social and/or political identities.”

The researchers define two types of polarization: ideological and affective.

With ideological polarization, “A specific issue, such as abortion, vaccination or gun control, is said to be polarized to the extent that people tend to take an ‘all-or-nothing’ position on it,” they write. “Once beliefs or attitudes become polarized, they become less amenable to change or compromise.”

Affective polarization, on the other hand, emerges when “partisans come to love their partisan in-group, loathe the out-group or both.” They note that many streams of research suggest that affective polarization has spiked in the United States over the last 40 years, a phenomenon “largely driven by increased out-group hate.”

Individual partisans declare their membership in the collective by various means: flying the Canadian flag on one’s pickup, wearing a mask — or telling a mask wearer to take it off.

The collective can also declare itself: last summer, Nassau County in New York state made it a misdemeanour for people to “wear a facial covering to hide their identity in public.”

The researchers note that “wearing a mask can become a symbol of partisan affiliation — making one group of citizens more likely to wear masks while leading another group of citizens to forgo or even oppose them. Altogether, polarization between political parties can make public health risks more costly and potentially more lethal.”

Under these conditions, polarized groups find little common ground. It becomes almost impossible to reach a consensus or adopt a policy that both sides can accept. That was dramatically demonstrated early in the pandemic when health-care workers and federal employees were required to be vaccinated or lose their jobs.

The Canadian right wing turned an infection control policy into a civil rights issue and the “Freedom Convoy” paralyzed Ottawa for weeks in early 2022.

Partisanship and ideology, then, can be stressors affecting individuals’ mental health and social relationships. But they can also intensify disease outbreaks, affecting the whole society. The COVID-19 pandemic is a prime example, but polarized responses to it have also enabled serious resurgences of diseases once controlled by vaccines, such as whooping cough and measles.

More scared of protest than pandemic

Protests like the Freedom Convoy seem to have traumatized governments more than the pandemic ever did. Both federally and provincially, government officials say as little as possible about COVID-19 and other public health concerns.

Masking all but vanished from Canadian hospitals in the spring of 2023, and it’s news when some hospitals bring it back — often because hospitalized patients are contracting COVID-19 while being treated for other ailments.

Much health-care policy is developed at the provincial level in Canada and the state level in the United States, and it tends to reflect local ideology.

In the United States, this has a direct, measurable effect on life expectancy.

“People who live in states with more liberal social policies, such as generous Medicaid coverage, higher taxes on cigarettes, more economic support (for example, minimum wages) and more firearm regulations live longer than their counterparts in states that embrace more conservative policies,” the researchers write.

Dying for your political beliefs

Meanwhile, at least one study showed that in Florida and Ohio, “excess mortality was significantly higher for Republican voters than Democratic voters after COVID-19 vaccines were available to adults, but not before.” Evidently Republicans did not accept vaccination as often as Democrats did.

The researchers draw a comparison between the United States and Canada: “Although both nations were politically polarized at the onset of the pandemic, research found that political leaders in Canada took a different approach to those in the U.S.A. Specifically, leaders across the political spectrum in Canada expressed serious concerns about the risk of COVID-19 in their public statements and this was echoed in national surveys of Canadian citizens.

“Moreover, the Canadian public health-care system is more widely trusted by citizens than the privatized system in the U.S.A. These factors appear to have mitigated the impact of the pandemic.”

Citing a study in the Journal of the American Medical Association, the researchers estimate that the United States could have saved the lives of over 200,000 Americans using a Canadian-style approach.

Our response may have been more effective than the Americans’, but that is a low bar.

If we, like the Americans, are polarized, our governments (and their public health departments) have clung like grim death to the centre. They have simply stopped talking about COVID-19 as an avoidable, preventable disease.

The Public Health Agency of Canada, for example, stopped reporting new cases as of May 26 this year — by which time 4,964,587 cases had been recorded.

As of Sept. 20, 60,789 Canadians had died of COVID-19 since the onset of the global pandemic in March 2020.

Far from being over, the pandemic continues, with cases and deaths frequently spiking.

As recently as October 2023, 241 COVID-attributed deaths occurred in B.C., comparable to the monthly tolls in February, April and October 2022.

But those 241 deaths went unreported in the local media.

Is there possibility of repair?

The researchers rightly identify public trust in science and medical institutions as essential to reducing polarization and its health effects. But rebuilding such trust is left to “more research,” which is unlikely to happen any time soon.

If the polarized right doesn’t trust government and public health, the polarized left — which now includes long COVID patients, the immunocompromised and many parents of school-age children — feels betrayed by governments’ silence and misinformation about the ongoing pandemic.

The lack of governments’ interest in planning for future pandemics is also concerning. The Australian government, despite considerable success in mitigating the pandemic, sees little chance that Australians will accept lockdowns again.

The Walport report on Canada’s scientific response to the pandemic was released without fanfare late on Oct. 11, five months after it was submitted. It has drawn very little public discussion, but I hope to add to that discussion in a future article.

Meanwhile, we are now seeing a host of old enemies rise from the dead. Canada has recorded over 12,000 cases of whooping cough so far this year, when a “bad” year for the disease usually means 4,500 cases.

According to the World Health Organization, tuberculosis is once again the world’s leading infectious disease killer, regaining the top spot from COVID-19.

Where right-wing governments like Alberta’s hold power, they can do genuine damage to public health by pleasing their polarized voters. Where centre-left governments hold power, they will “follow the science” at a respectful distance of about 200 years, pleasing very few.

Those of us on the polarized left may have to adopt “trust but verify” as our attitude to public health agencies: understand what the agencies are saying, but verify it through scrutiny of recent scientific studies.

If the agencies show they are indeed following the science, they may be able to regain the trust they once enjoyed.

That will leave only our polarized fellow citizens as serious hazards to our health.