Income and education often rest at the root of racial and geographic inequities, and this is likely true in a pandemic. A few weeks ago, the second report in our series on the Living in Boston During COVID survey examined a series of measures capturing attitudes toward risk and social distancing guidelines, including perceived risks of infection, the importance of social distancing guidelines, mask-wearing, and belief that COVID-19 could be spread by asymptomatic individuals. We found that income did in fact matter, but that it revealed vulnerabilities on both ends of the socioeconomic spectrum—behaviors, and attitudes that might expose individuals and their communities to infection.
In a new report released this week, we have probed these and other findings more comprehensively with regression models, allowing us to evaluate which variables were most important in explaining people’s attitudes and beliefs pertaining to COVID-19. These analyses took into consideration, including sex, race, political ideology, being at high-risk for a severe infection, income, education level, and others. The reader should note that we analyzed these variables simultaneously, thereby evaluating the unique effect of each independent of all other factors. (We only discuss results that reach a traditional level of statistical significance (i.e., p-value < .05).)
Returning to our previous findings, we saw different types of vulnerability at the two ends of the socioeconomic spectrum. At the one end, those with higher income and greater education were more aware of asymptomatic spread. At the other end of the spectrum, the perception of risk, endorsement of guidelines, and tendency to wear masks in April were lowest in some—but not all—more affluent, majority-White neighborhoods. But it was unclear of all of these effects were driven by income itself.
The answer to whether income was the driving factor was “yes and no.” We found that income and education level both predicted the likelihood of believing in asymptomatic spread (see Figure 1). Note that these were independent effects, meaning that an individual was more likely to believe in asymptomatic spread than someone else with the same income but less education, or the same education level but less income.
Figure 1. The proportion of individuals who did not believe that asymptomatic individuals could spread COVID-19, by income level.
The other findings were less clear. Those with lower incomes were still more likely to wear masks in public in April. Unexpectedly, education level was related to mask-wearing as well. Those with an advanced degree (i.e., Masters, Doctorate) wore them significantly less often than others. Why this is true, however, is unclear. It may be a function of these individuals living in less densely populated neighborhoods, being less concerned because there have been fewer infections in their communities, or some other dynamic. Beyond that, however, neither income nor education predicted risk perception or the endorsement of guidelines when accounting for other factors.
In the second report in this series, we highlighted the different vulnerabilities experienced across communities and how these tracked with socioeconomic status. Some on the higher end of the spectrum were more ambivalent about risk and the importance of guidelines. On the lower end of the spectrum, there appeared to be less understanding about the science of the disease and the potential for asymptomatic spread. Here we have confirmed that some of these relationships, namely with the understanding of asymptomatic spread and mask-wearing, were directly associated with income and education. In contrast, it appears that differences in perceptions of risk and the importance of guidelines were a function of other factors, not of income or education themselves. This does not change the fact that communities on different ends of the economic spectrum have different types of vulnerability, but it does help us to understand the mechanisms needed to support each. Whereas we still need to learn more about why some more affluent neighborhoods are ambivalent, it is clear that we need to help those with lower levels of education to understand how COVID-19 can be spread via asymptomatic individuals.
The content of this post is drawn from the Living in Boston during COVID survey conducted by the Boston Area Research Initiative, the Center for Survey Research at UMass Boston, and the Boston Public Health Commission. It was funded by the National Science Foundation’s Human-Environment and Geographical Sciences (HEGS) program through a grant for rapid-response research (RAPID; Award #2032384). The results presented here were part of a longer report on “Lifestyle, Ideology, and Context Drive Attitudes“.
