Vaccination, Political Affiliation, and the Role of Public Health Campaigns

When I read this otherwise excellent article by Chris Mooney about why scientific evidence often doesn't persuade people*, I had the exact same reaction Kevin Drum did:

But be prepared to be annoyed when Chris wrenches his spine out of shape bending over backward to find an example of liberals denying science as much as conservatives. It might be true that you can find vaccine deniers in the aisles of Whole Foods, but if there's any rigorous evidence that belief in the vaccine-autism link is especially pronounced or widespread among liberals, I haven't seen it. Surely there's a better, more substantive example than that floating around somewhere?

Mooney responded:

So I want to further explain my assertion that vaccine denial "largely occupies" the political left. It arises, basically, from my long familiarity with this issue, having read numerous books about it, etc.

First, it is certainly true that environmentalists and Hollywood celebrities have been the loudest proponents of anti-vaccine views. To me, that is evidence, although not necessarily definitive. So is the fact that we see dangerously large clusters of the unvaccinated in places like Ashland, Oregon, and Boulder, Colorado, which are very leftwing cities.

What's tricky is, there's not a standard left-right political ideology underlying this. Rather, it seems more associated with a Whole Foods and au natural lifestyle that, while certainly more prominent on the bicoastal left, isn't the same as being outraged by inequality or abuses of the free market.

On the other hand, Massachusetts has a very high rate of influenza vaccination, and it's the definition of a liberal stronghold (e.g., gay marriage). We'll return to that in a bit.

The only data I'm aware of, from a Pew Survey in 2009, suggests the opposite of what Chris claims:

I asked Chris about this by Twitter, and he responded:

@mikethemadbiol @kdrum @JoshRosenau yes but @BrendanNyhan suggests this is an Obama effect

I'm not buying this. Democrats were far more in favor of vaccination than either independents or Republicans (who were indistinguishable from each other). Basically, the 'Obama effect' would have to raise Democrats from about 35% (which is what a statistically significant difference would entail) to sixty percent. At the same time, independents who were favorable to Obama remained unbudged. Doesn't seem likely.

I'll posit my own wild-ass guess hypothesis, which is related to this observation I made about herd immunity:

While I'm tempted to say something snarky, if this political divide holds up, this actually has serious repercussions for the spread of TEH SWINEY FLOO!!.

At both the state and local levels, there are often sharp skews in party affiliation. I've spot checked some county registration data for localities and it's worse than the state differences, which already can be extreme). In a heavily Republican state (e.g., Utah), people will not avail themselves of the vaccine as much as a state like Massachusetts would. Certain regions will have very low vaccination levels, which will mean that 'herd immunity' won't even have a chance in hell of happening.

States also differ in public health infrastructure--often dramatically. In Massachusetts, every day while waiting for the T, there was a public service announcement by a Boston Celtic urging people to get a flu shot. The campaign also appeared in print, on TV, and the radio. I don't think Obama will cause a twenty point swing, but Kevin Garnett and the Boston Celtics certainly could (not to mention the Red Sox, Patriots, and the Bruins). To the extent that Democratic states spend more on public health and public health campaigns, more Democrats are likely to be convinced of the need for vaccination--and, in the U.S., public health is heavily influenced by state efforts. There's also a positive feedback mechanism that helps here: people who approve of vaccination are more likely to convince those on the fence (I know I did). Finally, Democrats, the limousine liberal moniker notwithstanding, are more likely to be low-income, and Medicaid and state programs often 'piggyback' vaccination efforts onto these ongoing programs.

I realize this is supposition and anecdote (although it's not any worse than observations about Whole Foods customers). Nonetheless, like Drum, I'm not buying the 'liberals** hate vaccines' arguments without some hard data; it reminds me of the limousine liberal canard.

Related posts: Razib and Josh also comment.

*Of course, you don't have to persuade everyone, just enough people, but that's a separate post.

**At the risk of veering into No True Scotsman territory, I wouldn't describe Arianna Huffington and Bill Maher as liberals. Until a few years ago, Maher was libertarian, although I think the rise of the batshitloonitarian right budged him from that view. Huffington was active in Republican politics and her economics are quite conventional. Being pro-choice, not hating gays, and not theopolitically nutty-bonkers isn't liberal, but simply sane.