University of Minnesota School of Public Health, USA.
J Health Polit Policy Law. 2011 Dec;36(6):1061-95. doi: 10.1215/03616878-1460578. Epub 2011 Sep 26.
This research investigates the impact of cues about ascriptive group characteristics (race, class, gender) and the causes of ill health (health behaviors, inborn biological traits, social systemic factors) on beliefs about who deserves society's help in paying for the costs of medical treatment. Drawing on data from three original vignette experiments embedded in a nationally representative survey of American adults, we find that respondents are reluctant to blame or deny societal support in response to explicit cues about racial attributes--but equally explicit cues about the causal impact of individual behaviors on health have large effects on expressed attitudes. Across all three experiments, a focus on individual behavioral causes of illness is associated with increased support for individual responsibility for health care costs and lower support for government-financed health insurance. Beliefs about social groups and causal attributions are, however, tightly intertwined. We find that when groups suffering ill health are defined in racial, class, or gender terms, Americans differ in their attribution of health disparities to individual behaviors versus biological or systemic factors. Because causal attributions also affect health policy opinions, varying patterns of causal attribution may reinforce group stereotypes and undermine support for universal access to health care.
本研究考察了关于归因群体特征（种族、阶级、性别）和健康不良原因（健康行为、先天生物特征、社会系统因素）的线索对谁应该获得社会帮助支付医疗费用的观念的影响。本研究利用来自三个原始情境实验的数据，这些实验嵌入在一项针对美国成年人的全国代表性调查中，我们发现，受访者不愿意因为种族属性的明确线索而指责或拒绝社会支持——但同样明确的关于个体行为对健康影响的因果线索对表达的态度有很大影响。在所有三个实验中，关注疾病的个体行为原因与增加对个人医疗费用责任的支持以及对政府资助的医疗保险的支持降低有关。然而，社会群体的信念和因果归因是紧密交织在一起的。我们发现，当健康状况不佳的群体按种族、阶级或性别来定义时，美国人在将健康差距归因于个体行为与生物或系统因素之间存在差异。由于因果归因也会影响卫生政策意见，因此不同的因果归因模式可能会强化群体刻板印象，并破坏对全民获得医疗保健的支持。
