Ep. 33 - The Health Consequences of Political Polarization with Dr. Sameera Nayak

10:41PM Dec 22, 2022

Speakers:

Dr. Ian Anson

Campus Connections

Alex Andrews

Dr. Sameera Nayak

Keywords:

people

polarization

research

election

umbc

study

anson

health

nayak

social

linked

outcomes

thinking

social science research

question

effects

political scientist

stress

impacts

u visa

Hello and welcome to Retrieving the Social Sciences, a production of the Center for Social Science Scholarship. I'm your host, Ian Anson, Associate Professor of Political Science here at UMBC. On today's show, as always, we'll be hearing from UMBC faculty, students, visiting speakers, and community partners about the social science research they've been performing in recent times. Qualitative, quantitative, applied, empirical, normative. On Retrieving the Social Sciences, we bring the best of UMBC's social science community to you.

During the run up to the 2022 election, I heard all sorts of complaints from my friends and relatives in states like Pennsylvania and North Carolina and Georgia. You know, these states, among others, featured fiercely competitive races in this year's midterms and a lot of the folks I know asked me the same question: Why is it the case that every time I turn on the TV, I get blasted by political attack ads from all sides? And how and when will it all stop? Well, the answer to the latter question was November 8th, when the general election was held for most of my friends. But for the unfortunate few who live in Georgia, the runoff election rules there meant that much like Punxsutawney Phil seeing his shadow, four more weeks of all-out campaigning for Raphael, Warnock and Herschel Walker would result. The Leaguer Georgians eventually sorted it out, electing Warnock in a close December contest, but for a lot of people I know the damage had already been done in the form of stress, anger, frustration, and really electoral exhaustion. But could these high-stakes election seasons have an effect on our overall physical and mental health? My anecdotal evidence suggests that my friends in non-competitive states fared a lot better in 2022 than the perennially stressed out denizens of swing states. But the plural of anecdote is not data. To better understand the link between politics and our health I recently decided to talk to an expert.

Dr. Sameera Nayak is an interdisciplinary health inequity scholar who uses quantitative and qualitative methods to study the social and political determinants of health and health inequities. She recently received her PhD in Population Health from Northeastern University in Boston. She also holds undergraduate and graduate degrees in Psychology from the University of California, Los Angeles and Columbia University. Dr. Nayak is passionate about using data driven methods to better understand the health and experiences of women, children, and families around the world. She has conducted research globally in East Africa as well as domestically in the US. Her current research focuses on understanding the lived experiences of immigrants, the role of legal status and their health and health behaviors, and the ways in which the post-migration climate influences immigrant health. Her other lines of research involve studying the effects of political determinants of health, including political polarization, and an evidence-based mental health systems building. I'm really excited to bring you my recent interview with Dr. Nayak right now.

So I'm really pleased today to welcome Dr. Sameera Nayak to the show. Dr. Nayak, thank you so much for taking the time to be on the show today.

Yeah, thank you so much for having me. I'm looking forward to it.

Absolutely. And of course, we want to talk about some of the fantastic research that you've been working on recently, in your time here at UMBC and earlier. And I want to focus today specifically on an article that you publish with some co authors at Northeastern University and some other places about a potential link between health outcomes and perceptions of political polarization. And I gotta say, obviously, as a political scientist, somebody who studies topics related to polarization, I found this article to be really fascinating. And I kind of want to understand, first of all, your kind of assumptions going into this this study. Why would we assume, necessarily, that political polarization might have some kind of an impact on our health?

Right, okay, so I'm gonna start by posing a question to you (Dr. Anson: Sure). Election Night 2016. Results haven't come out yet. How are you feeling?

Oh, no. Don't go there (Dr. Nayak: Right). I'm not feeling good. I'm not feeling good, Dr. Nayak. I gotta say,

Right? You're like (Dr. Anson: Absolutely). I don't know what's gonna happen. And I think that election, particularly, and that's the one we focused on for this paper, was very high stakes, both with what the policy outcomes were going to be depending on who was elected, and then what it meant for society, your neighborhood, your friends and family, based on on who was elected and who they voted for. So kind of the big mechanism or the hypothesis that we went in to the study thinking about was stress and we know that stress impacts your health in a variety of ways. So the most obvious things are with your mental health, depression, anxiety. But it can also like raise your blood pressure, influence your eating habits, your use of substances, your behaviors, which are all linked to your health. So I think that that's kind of the big, like the easiest thing to draw. But the premise of most of my research is that our social and political environment is one of if not one of the most important determinants of your health over your life course. So we have biology, we have genetics, maybe they go together, but where you're born, how you're born, where you grew up, where you live, where you die, are all linked across your life, and are all going to influence how you feel, what your health is, what health care access you have, how you recover from illness, and so on, and so forth.

Wow. So I really see the incredible value of this research that is connecting the physical realm, and obviously, of course, the emotional and psychological realm to the social setting. And the idea that this is, you know, at bay social science research, but social science research that has huge implications for how people live their lives from from a health standpoint. And so I think it's fascinating stuff. And I really appreciate it, though I got I'm still a little bit shaken, having to think about my mental state of the, during the 2016 election, especially as a political scientist, right? I mean, we're a stressed out nation, aren't we? I mean, this is a this is certainly of no, no surprise to many of our listeners, some of whom are students, some of whom are faculty, and others who are just, you know, kind of kind of listening in for various reasons, especially at this time of the year, right? We've got the semester is wrapping up at the time of this recording, obviously, this will be coming out a little bit later, so maybe we'll all have breathed a bit of a sigh of relief, but sort of worrying to me to think that stress can be so determinative of both their physical and mental state. Maybe this is really kind of a call to more broadly try to find some ways to reduce our overall kind of stress, isn't it?

And so, this is not research that I've done, but there's like research on elections specifically. Like they have studies that have shown that there's like an increase in the rates of like heart attacks right after, there's increases in cortisol and your blood right after, in the like, weeks after an election, depending on the outcome of the election and who you were affiliated with. So, you know, I'm not a biologist, so I don't know exactly the mechanisms, but this idea that you're you embody your social environment, and it gets kind of absorbed into your physical being and then manifests through various health conditions is, you know, it's scary, but important to think about, because we can change the social environment, which, if you take my class this semester, that's, like, that's what I say, every, every class is we can change it (Dr. Anson: yeah, that's great). But there's some things we can change. So have some hope.

Yeah, that's great, because yeah, I mean, obviously, as a political scientist I come to this sometimes as well with students saying, Wow, this, you know, this was the the most downer class, you know, that I've ever taken. It's like, well, we gotta build back up, we got to think about ways that we can change the scenario. But this absolutely resonates me resonates with me, this idea of, you know, stress as a result of these kinds of deep attachments to kind of the team loyalties, perhaps, of the parties. I mean, I think there's also some research that, obviously, with the World Cup going on right now, this is quite relevant that, you know, people who are super fans of teams, you know, especially people who are, you know, have some health risks already, tend to experience worse health outcomes when they're watching really, really stressful events, you know, like the finals of the World Cup or something, there's spikes in people having cardiovascular problems, because they're so stressed out over the outcome. And I mean, politics, the way that we practice it in America right now, is essentially a team sport as well. You know, Republicans and Democrats having these deeply embedded party loyalties. I mean, that's, that's, that's a really stressful thing for these individuals who have so much riding on the outcome. And, you know, I think a little bit about how to study this, because I think, as you're saying, Dr. Nayak, there's some pretty reasonable pathways to expect that these things are linked. You know, obviously, as an experimentalist, myself, it would be really fascinating to be able to conduct some kind of experiment where you get people in some kind of, I guess, you construct some society from scratch, and then you manipulate how polarized it is. And you see how healthy people are. But obviously, not only is that impossible, because you know, we'd have a really hard time getting a bunch of people to start a society from scratch on some kind of secluded island somewhere. But also, it would probably be grossly unethical to manipulate things like this in people's lives and to you know, confer negative health benefits on them. So if we're outside of that experimental environment, how do we study this linkage? And so I wanted to ask a bit about the methods and the data that you use to arrive at these conclusions.

Yeah, so definitely the IRB would have a field day. Let's see if this makes people sick (Dr. Anson: Right). So this study was led by Dr. Daniel Kim, who's at Northeastern University. And he's done a tremendous amount of work in social capital and these types of topics. So I came into this a little bit later afterh the study design had already begun. And so for this, we did a survey, and we made it, used Qualtrics. I'm not sure if you're familiar with it.

Absolutely, yeah, but if you were to my telling some of our listeners maybe who aren't as familiar, yeah.

Yeah it's a, like an online company. But they have a website, you can design surveys. In the past, I've used it where we send out our own surveys, but you can also have them send it out. And in this case, you wanted a nationally representative sample. So a sample that kind of mimics what the US demographics look like. As a social epidemiologist, which is kind of where I position myself, you can never manipulate things. So you have to think of, or you have to focus on observational studies and find ways to mimic experimental conditions without actually doing them. So in this study, we used, like control for confounding. So confounding is like that third lurking variable that might influence A and B, and so if we can adjust for it and our statistical models, and maybe we can isolate the effect of A on B. There are other ways to do that as well. So causal inference is this like burgeoning, not burgeoning it's flourished. Flourishing field! Adjacent epidemiology, some people think it's part of epidemiology, where they're coming up with sort of more sophisticated ways of thinking about how can we isolate the effect of X and Y without experimentation using data we already have. You know, controlling for these other variables, and it is closely linked with like biostatistics. So for this study, it was a survey, we used logistic regression, I don't know if you want to go into the detail. But I'm gonna just say no, I'm going to make the executive decision now. What we're trying to do for people who are not familiar was we are trying to measure, we're trying to measure three, three different buckets. So the first was, do you feel and this was a direct question that was just asked like, do you feel like the and we didn't say polarization, we said, like the animosity, hostility between Democrats and Republicans has changed since the 2016. Election, this data was collected in the end of 2019, early 2020. And the options were like, yes, it's in or it's increased, it's decreased or like, it stayed the same. So here, we're just asking you directly, like, looking back, what do you think? And then we're also interested in two types of polarization. So mass polarization, which is like between the average voter and then elite polarization, which is between elected officials. So you ask people to we get like a little scale, it's not an actual scale, but like a scale where they would like place, place, the average voter in your state, or place the average Democrat in your state on this continuum of like liberal to conservative, then place the average Republican and that difference is kind of what we call, what we termed like mass polarization. Like how far do you think they are ideologically? And we did the same thing, but thinking about elected officials. So think about like that average elected official who's a Democrat. Average elected official who's Republican. Where are they on this scale? And if you perceive that they're really far, then that's that you're you're perceiving more polarization. So that's how we define our exposures. And then for our outcomes, we were interested in we incident of new, of disorder. So like new diagnoses of X, Y, and Z, and we might have, like some mental health outcomes, a new diagnosis of depression, anxiety, sleep disorders. And then also I believe we did like high blood pressure, high cholesterol, I should probably go back and look at the paper. And just general self-rated health, which is a very strong predictor of how you actually are. Lke, if you think you're feeling you're not great, you usually are not great.

That's, that's fantastic. So, yeah, I mean, just just responding to the details of the study that you've described. I mean, first of all, that's really interesting that you've got these different conceptualizations and then operationalization, of polarization, what it means for society to be polarized. That definitely resonates with me as a political scientist with this idea that mass polarization might be something qualitatively different than elite polarization. And perhaps there are different implications for the way that we experience that polarization because either it's just on TV, and we can maybe turn it off and walk away. But at the mass level, that's saying that our friends and neighbors are at each other's throats and beyond that, right. It's also the notion that there's kind of two different forms of polarization both ideological, right, the idea that we're different in terms of our, you know, positions on the issues, but then there's also this idea of the affect, the, you know, the animosity that you're describing, and that stuff is, I think, probably some of the more worrying stuff from the perspective of our lived relationships with other people. So, yeah, that's a fantastic design. And then I was also going to mention that I'm really interested in this measure that looks at the actual change in people's health conditions, not just persistent health conditions. And you can imagine, obviously, with this threat of confounders in the observational experience, in this kind of research design, it's really helpful to have something that turns on after the intervention, basically, because then you can say, well, it didn't come before it actually came more recently. And so that I think probably goes a long way in helping to establish some kind of causal order here as well. So yeah, really interesting study design, but obviously we want to talk about what you found. And so I want to know, I mean, of these various outcomes. What happened? Was this, are we are we stressed out? Are we experiencing physical health effects as a result of this perceived polarization in our society?

Short answer yes. Like abstract (Dr. Anson: uhoh, laughter). We definitely saw stronger effects across all of the different exposures for depressive disorders, anxiety, anxiety-related disorders, and sleep disorders. Um,

those are pretty linked, right?

Those are pretty linked. They're usually comorbid, meaning like they occur together. And I that wasn't surprising, I think, or it isn't surprising to me, I don't think it's surprising to you. We saw some effects for other outcomes, but they were much smaller, or they were not statistically significant. And so one of our thinkings were feeling anxious might manifest very quickly after XYZ event, but your cholesterol that might take some time to, to develop. So, you know, it would be nice to look at studies, if we can look at people over a longer period of time and then see if there's like, these longer, we would call it physical health, the physical healthy and mental health are linked, but for the purpose of this conversation, I'll say physical health outcomes. So we did find that people who thought that polarization had increased, like there was more animosity between Democrats and Republicans since the 2016 election, we're more likely to have been told by a doctor or diagnosed with depressive disorders, and anxiety disorders. And then, for both the types of elite, uh both the types of polarization, I think we found similar results. And I believe, with elite, it was a little bit of a stronger association. And we also,and it was also related to sleep disorders. So well, you know, like insomnia, not being able to sleep. And that's for length, right, like you're laying in bed up at night, anxious about the election (Dr. Anson: worried about the election, yeah). They go hand in hand. Another thing we were interested in was, how does this vary, depending on other variables? Like so in epi we would call it like effect modification. So there is research to show that, okay, yes, it impacts your health, but it's different for different people. And that makes sense, right? Like, if your, if your social identity is directly impacted by some policy that people are talking about very, in very black and white terms, you're probably more likely to have these negative effects. So we looked at a couple of different variables. One of the things we were interested in is social capital, so your social networks and social resources, and we looked at social trust, specifically like in your neighbors and in your community. And we found that even if you thought polarization had gone up, or was high, if you had more trust in your social community that almost acted like a buffer. So you're like, okay, things are bad, but because I feel like I have these, this kind of strong social network, I trust my neighbors, coworkers, etc. I'm less likely to suffer these negative health effects. So I think that was a very important finding, because it points to something that you can focus on when you're thinking about interventions, which is obviously the ultimate goal of the research.

Wow, that's a really important finding, I think this idea that there may be an antidote, perhaps to these physical and mental effects of polarization, and that's developing these ties with your community. And obviously, as someone who's deeply invested in sort of democratic politics, you know, as a political scientist, right, that's pretty important. And something that I hope that people can take away from this paper. That you know, if you're, if you're feeling stressed out, or this is something that you feel resonates with your personal life the way that it does with mine, right. Attend your block party, you know, meet your neighbors. I think that's a really, really important takeaway from this from this important lesson. And you know, I was going to ask you a little bit about how you thought this, this kind of set of effects might perpetuate in future elections. Do you think that we'd see this again and again, but you know, maybe maybe if people at mass are starting to do this kind of community engagement more often we'd be able to combat it? I don't know.

So I'd love to be like, no, it's going down. But I think just social media, I think is a big factor in why I don't think it's gonna go down. We just have so much access to so much information all the time. Sometimes incorrect information. But it's like, I think it's true. I read an article that said it's true. It must be true, even though if you, you know, if we dug into it, it may not be true. I think that kind of is making it much, much more difficult than maybe, you know, 30 years ago, when you maybe had the television and the newspaper and that was kind of it. And there have been studies that have shown that social media keeps fostering this, this animosity, and we, you know, both Republicans and Democrats, we get into our little bubbles, we only interact with people who share a worldview, and then we start to really have this negative affect towards the outgroup, so to speak. So I think it's probably going to get worse. But when we were talking, I was thinking about, I'm working with a colleague on another paper that's, well, it's not fully unrelated, but it's about abortion attitudes. And one of the things that came up is that when you give people, you tell people about abortion, they have very black and white views. But then if you give them a scenario, like a little story, or add more nuance, their views become much less black and white. And so thinking about social trust, and we didn't do a study on this, but you can think about, you know, you have this idea of the other group, and then you go to your block party, like you said, and you interact with people, and now you have a little more context. And so that might be one way that you're, can become a little less, we can become a little less polarized.

I like this, this juxtaposition, right? Either we can continue to doom scroll, which is obviously kind of a neologism that is capturing what you're describing, you know, spending hours upon hours of kind of just getting inundated with this really negative stuff out there in the in the social media realm, or we can, you know, put the phone down and go talk to our neighbors. I think that's, that's kind of where we are, perhaps in American society. And I'm really fascinated to think about the potential health consequences of those choices. I mean, really, really fascinating work. And I'm so glad that you, you know, raised this additional studies here to our attention. And I was also going to ask you a little bit about how you see some of this current research fitting into maybe some of the things you're doing in the future, right. What's kind of next for this research agenda?

Yeah, so um, I think I said this earlier, but like, a basic question or premise of my research is our social environment impacts our health. Great. So what? So I think this study actually made me think a lot about this idea of the political environment, both with how you think it feels but also like, laws and policies, how does that impact your life directly and indirectly through your health behaviors. So after this study, I did some work with immigrant women, specifically around thinking about the time around the election, which was had a lot of sort of anti-immigrant, xenophobic rhetoric, both during the election, but also in kind of the year leading up to it. And this was a qualitative study. And we found that it's still, even now because the study was conducted in 2021, people, immigrant women, particularly those who are undocumented, or who didn't have a permanent residency or citizenship, or some sort of permanent legal status in the country, are still being impacted by what happened then either because there's misinformation or it's just this chronic kind of stress that exists from from having this kind of precarious existence. So that's kind of the area I'm focused on now. And one of the things, so I'll give like a very specific example, because I had an email today and I was like, Oh, my God, my research in real life.

Please do I love that when that happens, right. You see some anecdotes resonate with what you're studying.

Yeah, so um, so this study we were looking at, well, a little bit of context. So if you don't have permanent residency or citizenship and you're in the US and you are a victim or survivor of domestic violence, immigration law has specific pathways that you can use to get permanent residency or citizenship. So one of them is you can apply to sponsor yourself. So you don't need your partner, your spouse or an employer. And you have to say like, here's what happened to me. Here's documentation of all these terrible things that happened to me, can I say, essentially. It's very dehumanizing, and that was...

That seems like a very pychologically difficult?

Yeah, it is, and, and then the second piece, it's not specifically for domestic violence, but it's for people who have been the victim of various types of crime, it's called the U Visa. And essentially, what you do is you're like, I'm cooperating with the police to prosecute XYZ person who committed this crime against me. So I'm being helpful to law enforcement. And therefore, there's like a special set of like visas that you can get that eventually you can get your green card. The problem with the U visa, which came out of the research was you only get 10,000 a year. And there's a lot more than 10,000 people who need it. So the email today was about a bill that's been introduced that is to remove that U visa cap, which was one of the recommendations from this paper, it's not published yet, otherwise I would give you the link. Uhm it was like, we need to change this U visa cap because this created this backlog and now it's I think it's like a nine year or eight year like waitlist time. So so this that's like a so what piece. So for me, it was like we've identified this problem, this is how we should change it. And so when I'm thinking about research going forward, I really want to focus on what recommendations can I make that are like tangible recommendations, as opposed to kind of the broader like, we need to think more about X versus like, if we changed X, this would happen. And I mentioned the abortion paper, I'm very much focused in women's health. So while I have done work in broader settings, like this one, or with children's health, a lot of the work is kind of thinking about women, immigrant women, women from sort of with multiply marginalized identities and how how their social environment impacts their health and decision making.

Wow, to hold the power of social science research, right? I mean, with these things we can actually do real, real good in the world, and that's fascinating, and really fantastic to hear that you're working on so many projects that hopefully will will bear fruit very, very soon. I can't wait to read them. And hopefully, we'll be able to have you back on to talk some more about your findings going forward. Before we let you go, I have one more question that I ask virtually everybody who comes on the podcast, and that is because we've got a lot of student listeners, to tell us a little bit about some advice that you might give to students who are maybe one day hoping to go pro, as I like to say, in the social sciences.

Um, wow, uhm I probably should have listened to more of the other episodes so I know what other people say.

It's all good, it's been a, it's been a huge variety of, you know, sometimes big pieces of advice, sometimes, like very specific things like, learn how to do a lit review, you know.

Oh definitely. I think one of the things that I realized, so I started doing research in undergrad as a research assistant, you know, and, and obviously, I liked it, because I'm still here, obviously, was the best researchers, in my opinion, are researching things that they have an intellectual interest in, but that they also have some sort of personal passion or interest in. And this has been controversial. You know, there's a school of thought that about objectivity and you shouldn't study things that you care about.

No, no, no doing me search, right?

Exactly. No, no, but in social epi, we're like, well, everything is me search because there's no objective there. In social sciences, there's no objective reality, we're gonna remember this entire podcast differently based on how we approach it. So you can be objective, but I think that just keeps you more motivated, especially for those who are, you know, going to go all the way, they're gonna get a PhD, which is long and lonely and hard. And at some point, you're gonna be like, I can't do this anymore. And I think if you care about it for more than just an academic pursuit, your research is richer, the questions you ask are better because you've been there. And I think I think that's really important. So for those if you're trying to go pro, and you're thinking about like, what am I going to go pro about? What do you care about? You know, what keeps you up at night? And I feel like that makes for really good social scientists.

Wow, what a fantastic callback. What keeps us up at night? Hopefully, it's dreams of really great research projects in the future and not partisan animosity. Dr. Sameera Nayak, thank you again, so much for coming on the show. Really engaging research, really interesting stuff, and I really appreciate you taking the time to talk to us today.

Thank you so much for having me.

Campus connections, campus connections, campus connections, campus connections.

Now it's time for Campus Connections. The part of the podcast where we connect today's featured content to the work of other scholars at UMBC. Our production assistant Alex has put together a fascinating connection, as always. What did you find Alex?

Thanks, Dr. Anson. This installment of Campus Connections, we'll be taking a look at another result of polarized politics, the handling of the COVID 19 pandemic. You used an example earlier describing the stress of election night in 2016. And I think that stress comes from a place of concern for the future of our nation. This article, "The Pndemic and Poor Health of America" was written by John Short, a professor from UMBC's Public Policy department. In it he details the flaws in our healthcare system that were highlighted by the pandemic as well as the clear political interference and undermining of the CDC's advice and protocol. While much of this information is still fresh in our minds, this in depth writing helps us to see the results of political polarization on a grand scale. That's all for this week's Campus Connection. Back to you, Dr. Anson.

Thanks, as always, Alex, for that interesting connection to Dr. Nayak's ongoing work. And thank you for tuning in. Once again. I hope that we can all remain calm in the lead up to the 2024 election, which will probably test our collective nerves a lot more than this year's election. But until then, practice deep breathing, get outside, and as always, keep questioning.

Retrieving the Social Sciences is a production of the UMBC Center for Social Science Scholarship. Our director is Dr. Christine Mallinson, our Associate Director is Dr. Felipe Filomeno, and our production intern is Alex Andrews. Our theme music was composed and recorded by D'Juan Moreland. Find out more about CS3 at socialscience@umbc.edu and make sure to follow us on Twitter, Facebook, Instagram, and YouTube, where you can find full video recordings of recent CS3 events. Until next time, keep questioning.