{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:45:11Z","timestamp":1792424711305,"version":"4.5.0"},"reference-count":35,"publisher":"American Public Health Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Objectives. To assess how political polarization during COVID-19 compares with that in past disease outbreaks in the United States.<\/jats:p>\n                  <jats:p>Methods. Using random-effects meta-analyses and mixed-effects meta-regressions, we searched the Roper Center for Public Opinion Research and estimated the association between polarization during COVID-19 and during non\u2013COVID-19 disease outbreaks.<\/jats:p>\n                  <jats:p>Results. The study included 170 polls spanning 13 outbreaks over nearly 70 years. Polarization during COVID-19 was 5 and 12 times greater than in past disease outbreaks in terms of concern about infection and vaccine hesitancy, respectively. After we controlled for survey-level characteristics, COVID-19 was associated with 20.23 (95% confidence interval [CI]\u2009=\u200912.30, 28.17) and 25.89 (95% CI\u2009=\u20096.63, 45.16) additional percentage points of polarization regarding concern about infection and vaccine hesitancy, respectively\u2014far higher than historical trends would predict.<\/jats:p>\n                  <jats:p>Conclusions. In terms of concern about infection and vaccine hesitancy, polarization during COVID-19 was substantially higher than in any other disease outbreak in modern American history for which we have relevant data.<\/jats:p>\n                  <jats:p>Public Health Implications. High levels of polarization do not appear endemic to disease outbreaks, suggesting such division may be preventable in the future. ( Am J Public Health. 2026;116(1):124\u2013136. https:\/\/doi.org\/10.2105\/AJPH.2025.308226 )<\/jats:p>","DOI":"10.2105\/ajph.2025.308226","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T20:01:37Z","timestamp":1756411297000},"page":"124-136","source":"Crossref","is-referenced-by-count":3,"title":["Political Polarization During Disease Outbreaks: A Meta-Analysis of Archival Survey Data From Polio to COVID-19"],"prefix":"10.2105","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2617-7085","authenticated-orcid":false,"given":"Caitlin L.","family":"McMurtry","sequence":"first","affiliation":[{"name":"At the time of the study, Caitlin L. McMurtry and Rachana Cheu were with the Brown School, Washington University, St. Louis, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachana","family":"Cheu","sequence":"additional","affiliation":[{"name":"At the time of the study, Caitlin L. McMurtry and Rachana Cheu were with the Brown School, Washington University, St. Louis, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"bib1","first-page":"37","volume-title":"Political Negotiation: A Handbook.","author":"Barber M","year":"2016"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1515\/9781400837502-013"},{"key":"bib3","volume-title":"Polarization and Public Policy.","author":"McCarty NM","year":"2006"},{"key":"bib4","doi-asserted-by":"crossref","unstructured":"Rigby E, Wright GC.\n                      The Policy Consequences of Party Polarization: Evidence From American States.\n                      In: Thurber JA, Yoshinaka A, eds.\n                      American Gridlock.\n                      New York, NY:  Cambridge University Press; 2015:236\u2013255.","DOI":"10.1017\/CBO9781316287002.013"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-polisci-051117-073034"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.7208\/chicago\/9780226299358.001.0001"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0249596"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpubeco.2020.104254"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1007\/s11166-020-09336-3"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0250123"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jebo.2021.03.019"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.7758\/RSF.2022.8.8.10"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248334"},{"key":"bib14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00172-6"},{"key":"bib15","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2022.09.011"},{"key":"bib16","doi-asserted-by":"publisher","DOI":"10.1089\/bsp.2012.0048"},{"key":"bib17","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.12.020"},{"key":"bib18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.19499"},{"key":"bib19","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3539"},{"key":"bib20","volume-title":"Congress: A Political-Economic History of Roll Call Voting.","author":"Poole KT","year":"1997"},{"key":"bib21","volume-title":"The Disappearing Center: Engaged Citizens, Polarization, and American Democracy.","author":"Abramowitz A.","year":"2010"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.7208\/chicago\/9780226473673.001.0001"},{"key":"bib23","volume-title":"Unstable Majorities: Polarization, Party Sorting and Political Stalemate.","author":"Fiorina MP.","year":"2017"},{"key":"bib24","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.polisci.11.053106.153836"},{"key":"bib25","doi-asserted-by":"publisher","DOI":"10.1177\/0002764212463352"},{"key":"bib26","doi-asserted-by":"publisher","DOI":"10.1257\/jep.20.2.97"},{"key":"bib27","doi-asserted-by":"publisher","DOI":"10.1086\/590649"},{"key":"bib28","doi-asserted-by":"publisher","DOI":"10.1093\/poq\/nfv045"},{"key":"bib29","volume-title":"Introduction to Meta-Analysis.","author":"Borenstein M","year":"2011","edition":"2"},{"key":"bib30","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i03"},{"key":"bib31","doi-asserted-by":"publisher","DOI":"10.1093\/poq\/nfv017"},{"key":"bib32","doi-asserted-by":"publisher","DOI":"10.1257\/app.20220030"},{"key":"bib33","doi-asserted-by":"crossref","unstructured":"Langmuir AD, Nathanson N, Hall WJ.  The surveillance of poliomyelitis in the United States in 1955. CDC Report. November 9, 1955. Available at: https:\/\/stacks.cdc.gov\/view\/cdc\/48111. Accessed August 1, 2025.","DOI":"10.2105\/AJPH.46.1.75"},{"key":"bib34","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.polisci.9.070204.105138"},{"key":"bib35","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2022.01204"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2025.308226","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T21:01:53Z","timestamp":1765400513000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2025.308226"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.2105\/AJPH.2025.308226"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2025.308226","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}