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How Race Shapes National Health Debate


I'm Michel Martin and this is TELL ME MORE from NPR News. Coming up, Covergirl pokes fun at actress Sophia Vergara's accent in a new ad. We'll ask the ladies in the beauty shop if they're laughing and we'll get their take on results in the Illinois primary. That's just ahead. But first, as you may know, the Supreme Court is hearing arguments about the healthcare overhaul next week. Later this week, we are going to talk more about what critics and supporters of the measure are going to be saying.

But first, we want to tell you about an intriguing new study that suggests that a factor that is not mentioned in any of the constitutional arguments may have played, and may yet play, a bigger role in political support for healthcare overhaul than many people might think. That factor is race. A new study, published by Professor Michael Tessler at Brown University, suggests that our attitudes about healthcare reform may have more to do with race than we might think.

Joining us to talk more about this is NPR science correspondent Shankar Vedantam. Shankar, welcome. Thanks so much for talking with us.

SHANKAR VEDANTAM, BYLINE: Hi, Michel. Thanks for having me.

MARTIN: Now, Shankar, I think this is one of those things that everybody would agree on. Many people have argued, almost since the beginning of the Obama presidency, that race has a large degree to do with the way some people receive him and address his policies. Like, supporters of the president tended to have made that argument, people like former President Jimmy Carter. But his critics and people who oppose his policies say that that's absolutely ridiculous, that it's really about his policies and not his race and not the man.

What does this research do to kind of settle that argument, or at least to unpack that argument?

VEDANTAM: Well, Michel, I think what it does is it addresses that argument in one of its specific incarnations, which is looking at this specific policy. It's interesting. President Obama himself has tried to argue that race has nothing to do with the healthcare debate, and we can come back to that a little bit later. But the White House actually has tried to in some ways set race aside in speaking about many issues, potentially because of the ramifications of putting race front and center.

But I think what we can say with great confidence is when it comes to healthcare, people's racial attitudes are playing a role. They're playing role, not just in shaping what people think, but how strongly they think. And now, we have empirical, scientific evidence that that's the case.

MARTIN: I understand that you spoke with Michael Tessler and he explained what his research found and I believe you have a clip. And let's listen to it.

MICHAEL TESSLER: African-Americans were about 20 points more supportive of the Barack Obama frame plan than they were of the Bill Clinton plan. And this is consistent with previous political science research, that finds that African-Americans will typically be more supportive of a policy that is framed as belonging to somebody like Colin Powell or Jesse Jackson, and now Barack Obama.

MARTIN: So is this effect only found among African-Americans?

VEDANTAM: No. So this research in general is built on a much larger body of work, which is finding that in many, many domains of our lives, things about our identities play a very powerful role. So in politics, for example, when you share some aspect of your identity with the person who is bringing you a message, with the president or a member of Congress, you're much more likely to find that message believable.

So let me give you an example that has nothing to do with race. When President George W. Bush was in office, he was a strong proponent of going to war in Iraq. There was significant support among evangelical Christians for the invasion of Iraq. And social scientists have found that part of that, part of the support that evangelicals had, was not just about the Iraq war and its justifications, but because they identified with George W. Bush, who was also an evangelical.

And so when we share some aspect of our identity with a leader, and that leader comes to us and says, here's a policy down which we should go, we're much more likely to buy the policy if we feel a kinship with the leader on some core aspect of identity. And we're much more likely to disagree with the leader if we do not share some core aspect of identity.

So in the clip that you just played, what it's suggesting is that with African-Americans, where the messenger of a policy message is himself or herself African-American, that policy becomes much more acceptable to African-Americans. But this is clearly not limited just to African-Americans. It's across the board, that regardless of your race or your gender or your sexual orientation, we are influenced by, not just what the message is, but who the messenger is.

MARTIN: But was the converse also true, that white voters or white respondents to this survey who were supportive of healthcare reform when it was advanced by former President Bill Clinton, were they less likely to support it if it was advanced by President Barack Obama?

VEDANTAM: So let me give you a little bit of context on the research. So this was work, as you said, that was done by Michael Tessler. He's a political scientist at Brown University and he just published a paper about this work in the American Journal of Political Science. And he found two things. The first thing he found is that over the last 20 years, since the time Bill Clinton first introduced the idea of healthcare reform at least in our current era, to the present when President Barack Obama advanced the idea, there has been a growing racial divide in support for healthcare with African-Americans becoming much more supportive of healthcare now than they were 20 years ago and whites, to some extent, becoming less supportive of healthcare reform than they were 20 years ago.

Now, the question that arises from this finding, is what's driving it. And a good scientist would say just because you're finding that two groups grow in different directions, it doesn't necessarily and automatically mean that race is what's driving these two groups apart. It could be some other factor. And so what Tessler did was he conducted an experiment.

He said let me take a healthcare policy and place it before white voters. I'm going to tell some of those white voters that this is a healthcare policy that's being advocated by Bill Clinton. And I'm going to take the very same healthcare policy and place it before another group of white voters and say, this is a healthcare policy being advocated by Barack Obama.

And he says, how will these voters react to these two policies? The policies are identical in every way, shape and form. It's just that the messenger for the policy, the advocate of the policy is different. In one case it's Bill Clinton. In one case it's Barack Obama. So what Tessler found is actually that white voters cleave into two separate groups so the division that we're seeing nationwide is not really between white and black, but it's between black voters clearly are more supportive of healthcare reform.

But among white voters, there's a sharp divide. And the divide is less about party affiliation than it is about attitudes towards race. So what Tessler finds is that whites who have a liberal or a progressive attitude toward race, who, for example, locate problems in the African-American community with the context with discrimination, with historical events, Tessler calls them liberals.

He said these people have a liberal attitude toward race. He says there's another group of white voters that identifies problems in the African-American community as being intrinsic to African-Americans, that says dispositional problems in the African-American community are responsible for outcomes. Tessler calls these people white conservatives. And he finds that these attitudes about race powerfully predict how these two different groups react to healthcare overhaul, which is that people who are white liberals become much more supportive of the healthcare overhaul when they believe that Barack Obama is the advocate of the overhaul.

And white conservatives become much more negative toward the healthcare overhaul when they see that Barack Obama is the advocate.

MARTIN: I'm speaking with NPR science correspondent Shankar Vedantam, and we're talking about a very interesting study that describes the affect of racial attitudes on attitudes about healthcare reform or healthcare overhaul, if you will. Our conversation is based on a study by Professor Michael Tessler of Brown University, that actually attempted to test this theory. So can we dig down even further and say, what is the relevance of race to these white voters?

How does their racial attitude inform their thoughts about healthcare reform? Is it the objection to the idea that undeserving people will benefit from a policy, or is it - what is it? I mean, is it just rank racism, which is they think that African-Americans will disproportionally benefit so that they're opposed to it? And conversely, why would white so-called liberals, under his lexicon, be more supportive? Because they think that African-Americans Americans need it more?

VEDANTAM: Well, I don't think the study necessarily explains to us why it is that racial attitudes are producing this difference in attitudes toward the policy. What the research is telling us is that racial attitudes predict very powerfully that when you have a black president advance an agenda, white liberals become more supportive of those policies, and white conservatives become less supportive of those policies.

The moment we step beyond that to sort of say this is what's actually happening in the minds of individual voters, I think we are on thinner ice than we are with the study itself. So what the empirical facts are is that racial attitudes predict your attitudes about policy outcomes.

MARTIN: Well, but again I have to drill down on the question of is it that Barack Obama is a black man or is it the black man he is? For example, if Colin Powell - for a time was the most popular political figure in the United States across racial groups - had advanced this policy, would there be the same result?

VEDANTAM: I think that's a fascinating question, and I think the truth is in terms of sticking close to the signs, I would have to say we don't know the answer. I think what Tesler is basically saying is that if you have a black president advancing a policy, people who have liberal attitudes about race become more likely than they were before to find that policy appealing, to find that policy something that they can support.

And if you have a black president advance that same policy, white conservatives become less likely to buy that policy. Now, you know, I don't think we necessarily need to characterize it in pejorative terms of sort of saying this is bad or this is good. This is an affect that's essentially pushing these two groups in opposite directions. And you could say it's just as irrational for white liberals to become more supportive of policy just because it's a black president.

I think what's interesting here is that when we think about our attitudes about health care policy, we believe that we are judging health care policy just on its own merits, that we're judging it from our ideological and philosophical standpoints. And all this research is showing us in a very compelling fashion is that something outside our policy and philosophical preferences is driving those preferences in a very powerful way.

MARTIN: Shankar, before we let you go, you've been reporting on this for a couple of days now as you and I are talking. What reaction are you getting to the study and to your reporting?

VEDANTAM: Well, I think some people are very resistant to the idea that race has any role to play at all. There are other people who very strongly believe that race has some role to play, and I think one of the valuable things that science has to offer is it says, we can actually measure some of these things.

So in terms of our vision of do we live in a post-racial America, for example, I think what this research seems to suggest quite clearly, at least on the domain of health care is, no, we don't. That race seems to play a powerful role in this policy domain.

MARTIN: Shankar Vedantam is one of NPR's science correspondents. He joined me here in our Washington, D.C. studios. You can follow him on Facebook and Twitter @HiddenBrain. Shankar, thank you so much for joining us.

VEDANTAM: Thank you so much, Michel.


MARTIN: Coming up, Mitt Romney took home another win in the Illinois primary on Tuesday.

MITT ROMNEY: Tonight, we thank the people of Illinois for their vote and for this extraordinary victory. Thank you so much.


MARTIN: But is that victory enough to lock in the Republican presidential nomination? Our beauty shop panelists weigh in. That's in just a few minutes on TELL ME MORE from NPR News. I'm Michel Martin. Transcript provided by NPR, Copyright NPR.