Alarming Support for Threatening Public Health Officials Grows

Support for harassing or threatening public health workers grew during the COVID-19 pandemic, even among the economically advantaged and those who say they trust science, according to new survey results.

Among over 1,000 respondents, significant increases in those who believed threatening public health workers was valid were observed among those earning an annual income of $75,000 or more (7 percentage point increase; P=0.03), those with some college education (6 percentage points; P=0.003), the employed (8 percentage points; P=0.01), and those who trusted science “a lot” (8 percentage points; P<0.001), reported Rachel Topazian, BA, of the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues.

Overall, from November 2020 to July-August 2021, the proportion of those who believed harassing public health officials due to business closures was justified increased from 20% to 25% (P=0.046), and those who believed threatening was justified increased from 15% to 21% (P=0.01), they noted in JAMA Network Open.

Unsurprisingly, a multivariable regression analysis showed that respondents who trusted science “not much or not at all” were more likely to believe that threatening public health workers was valid compared with those who trusted science “a lot” (November 2020: 35% vs 7%; July and August 2021: 47% vs 15%, both P<0.001).

“We found significant increases in the share of adults believing threatening of public health officials was justified … with increases among respondents who were male, Hispanic, ages 18 to 49 years or 65 years and older, higher earners, those with more education, the employed, those not working for another reason, Independents, Republicans, and those who trusted science a lot,” Topazian and colleagues wrote.

“In July to August 2021, 8 months into the Biden administration and amidst optimistic projections about vaccination and falling case rates, U.S. adults’ support for harassment and threatening of public health officials had increased significantly,” they continued.

Harassment and threats to public health workers occurring in person, over the phone, and on social media have led many to resign or retire, Topazian’s group noted. Healthcare workers have also reported harassment during the pandemic.

The team noted that the largest increases in those who believed threatening was valid were among men (12 percentage point increase), Hispanics — although few were included in the analysis — (18 percentage points), and Republicans (13 percentage points).

Younger individuals (ages 18-34) were more likely to report believing that harassment was justified compared with older people (28% vs 15% for ages 50 and up).

“This important study not only documents the overall prevalence of these concerning beliefs, but it goes deeper to identify particular groups who are more likely to endorse either of these beliefs at 1 or more of the time points: men, those with lower income and education, Hispanic people, younger people, and those with less trust in science,” wrote Sarah Gollust, PhD, of the University of Minnesota School of Public Health in Minneapolis, in an accompanying editorial.

The results of this survey study should encourage “all readers to consider the many ways in which they can advocate for more investment in public health, including advocacy for investment in the training and education of future public health professionals, supporting increased resource allocation to protect the safety and mental health of the current workforce, and individual acts of outreach to support and thank public health workers in our communities — all of which could better protect those workers on whom our collective health and well-being depend,” she added.

For this study, Topazian and colleagues examined data on a nationally representative sample of 1,086 adults who completed the Johns Hopkins University COVID-19 Civic Life and Public Health online survey during two waves — from Nov. 11-30, 2020, and July 26 to Aug. 29, 2021. Mean age was 49 years, 52% were women, 64% were white, 16% were Hispanic, and 11% were Black.

In November 2020, nearly all adults who believed attacks on public health officials were justified also said that attacks on politicians were justified. Of 512 respondents who believed that harassing public health officials, politicians, or both was justified, 38% supported harassment of both, and of 285 respondents who believed that threatening these groups was justified, 51% supported threats against both.

The authors acknowledged that recall bias and sampling bias were possible.