Survey: Attitudes, Views, and Values around Health, Equity, and Race Amid COVID-19

In the United States, public recognition of racial inequities and the impact of systemic racism—despite mounting evidence—is fading.

Living through a global pandemic and high-profile racial injustices has not fundamentally shifted how many view the impacts of systemic racism on the health and economic well-being of people of color.

COVID-19 has upended the lives of people living in the United States, but some groups are facing more challenges than others. This national survey from RAND Corporation attempts to understand the views and values of those who are most at risk to the adverse impacts of COVID-19 by surveying people with lower and middle incomes with a focus on communities of color. It measures the attitudes of the same group of respondents over a year with four waves of collection. For the first and final waves, a nationally representative sample of adults was surveyed in addition to the targeted sample.

In the summer of 2020, when calls for racial justice and the disproportionate impacts of COVID-19 were on full display, some speculated that the country seemed to be at a turning point for acknowledging how much racism affects people’s health and economic well-being. But the data suggest that was a moment in time, not a seismic shift or enduring change in perceptions. A little more than a year later, recognition of health and economic disparities declined significantly, but when breaking the findings down by race, people of color see things differently. Among the targeted sample of those with lower and middle incomes, Black and Latino respondents continue to be more likely to recognize inequities than White respondents.

People are more likely to see social and economic inequities than racial inequities.For instance, most people surveyed are more likely to cite having a low income and living in a rural area as barriers to accessing healthcare than being Black or Latino.

There are reasons to be hopeful. More than two-thirds of respondents believe the pandemic presents a moment for positive change. With the pandemic still looming, 1 in 4 people see improving access to healthcare as the change they would most like to see. And most people are supportive of sending extra vaccine supplies to other countries.

Key Findings

These findings are for the general population sample.

• In July 2020, about two-thirds of respondents (61.1%) agreed that people of color face more of the health impact of COVID-19 than White people, and more than half (57.5%) agreed that they face more of the financial impact. More than a year later, these numbers dropped to 52.7 percent and 50.3 percent, respectively.

   

• From July 2020 to September 2021, there was a consistent but more narrow decline (3.2%) in the number of people who agreed that poorer health outcomes, like higher rates of diabetes and more deaths from COVID-19, among people of color stemmed from systemic racism. Nearly 60 percent of respondents in September 2021 did not see systemic racism as an important determinant of these differential health outcomes.

   

• People are more likely to see social and economic inequities than racial inequities. In September 2021, about two-thirds (63.8%) of respondents felt that it is harder for Americans with low incomes to access healthcare. Two-thirds (63.5%) agreed that Americans living in rural areas also struggle disproportionately with healthcare access. In contrast, less than half of respondents felt that Black Americans (44.4%) and Latinos (42.4%) face such challenges compared to White Americans.

   

• Respondents are relatively evenly split on whether talking about race divides us. Black respondents and those making more than $100,000 annually are much more likely to disagree with this notion.

   

• Compared to July 2020, fewer people trust that their state government is doing enough to confront the pandemic and to look out for the interests of all people. The percentage of people feeling states were doing “a fair amount” or “a great deal” declined dramatically from 55.5 percent to 43 percent from July 2020 to September 2021.

   

• About two-thirds (68%) of respondents see the pandemic as a moment for our society to make positive change, with improving access to healthcare being the change they would most like to see. This has declined some since July 2020, when about three-quarters (74.3%) felt this way. 

   

• Most people (nearly two-thirds) support sending extra vaccines to other countries and more than 60 percent feel that if we do not fight the spread of COVID-19 in other countries that puts our country at greater risk. There were no differences in this sentiment by race or income.

   

About the Survey

The COVID-19 and the Experiences of Populations at Greater Risk survey is a national poll measuring attitudes, views, and values toward health, equity, civic engagement, and systemic racism during COVID-19. Data were collected via the RAND American Life Panel and the KnowledgePanel (administered by Ipsos). This survey was conducted in four waves. Data collection for the first wave occurred from June 29 to July 22, 2020; the second wave was fielded October 9 to November 2, 2020; the third wave was fielded February 22 to March 22, 2021; and the fourth wave was fielded September 7 to October 4, 2021.

This longitudinal survey followed the same group of people over time, with a sample size of more than 4,000 people. This is a nationally representative sample of adults living in lower- and middle-income households (with household incomes less than $125,000) and includes oversamples of Black, Hispanic, and Asian Americans. The household income limits allowed a focus on individuals in households that were likely eligible to receive the federal COVID-19 stimulus funds (CARES Act). The research team oversampled households with income under $75,000, representing approximately 85 percent of our sample, and allowed income to go up to $125,000, households with income $75,000 to $125,000 represented approximately 15 percent of our sample. Findings for a general population sample were also collected in the first and fourth waves.