How Political Bias Shapes Primary Care Approaches to Health Behaviors

Do primary care providers differ in their patients’ social history engagement based on their political worldview?

I stumbled across a study from Yale University examining whether a PCP’s political worldview influences their approach to managing politically salient health issues.  

Researchers used various clinical vignettes to assess a PCP’s clinical management strategy. 

The nine vignettes included scenarios involving issues of:

• Alcohol consumption
• Cigarette and tobacco use
• Use of helmets
• Obesity
• Depression
• Marijuana use
• History of elective abortion
• Firearm storage
• Engagement with sex workers

The researchers had the physicians rate the seriousness of the problem presented by the vignette and asked how the PCPs would manage each issue in the clinical scenario.

Findings

While Democrat PCPs were more likely to be concerned about patients storing firearms in the home, Republican PCPs were more likely to ask about safe storage of firearms.

Republican PCPs were 3 times as likely to be concerned about a patient’s marijuana use; they were more likely to discuss the potential health risks of marijuana use, urge the patient to decrease their marijuana use and discuss the legal risks of marijuana use.

In regards to patients having a history of elective abortion, Republican PCPs are more likely to discuss the mental health aspects of abortion and to encourage the patient not to have more abortions.

Republican and Democrat PCPs expressed equal concern about patient cigarette use, alcohol use, obesity, depression, helmet use, and sexual activity with sex workers.  

Did any of these findings surprise you?

Nikki Rataj Casady, DMSc, PA-C

email@appcolleague.org