Perception of health information quality associated with likelihood of acceptance

Most residents (57%) in 22 states in the American Heartland say they won’t get the new COVID-19 vaccine this year.  This finding from 12 traditional Midwestern states and ten surrounding ones was significantly higher than the national average of 51%, in state and national surveys conducted this fall by Emerson College Polling.

The new study, commissioned by the Emerson Polling’s long-time health survey partners at the CUNY Graduate School of Public Health and Health Policy (CUNY SPH) was issued to mark the launch of a newly formed Council for Quality Health Communication, launched by the O’Neill Center for National and Global Health Law at Georgetown University Law Center and the Journal of Health Communication, which is housed at CUNY SPH.

“We found that American residents split down the middle, 51% to 49%, about getting the new COVID-19 shot, but likely acceptance dropped to 43% in our nation’s Heartland,” said Dr. Scott C. Ratzan, a founder of the new Council and distinguished lecturer on health communication and social change at CUNY SPH.

“Respondents in Minnesota, Colorado, Iowa, and Illinois align more closely with the national perception on COVID-19 boosters. Residents there are split evenly on whether they will get them,” he added, “but residents elsewhere in the Heartland are less supportive and their attitude towards the vaccine tracks closely with how they rate the quality of the government health information they receive.”

 According to Dr. Kenneth H. Rabin, a CUNY SPH senior scholar and coordinator of the new Council, “Over a third of residents (37%) from the Heartland states of Idaho and Wyoming gave the quality of government health information a ‘poor’ rating, followed respectively by those in West Virginia (32%), Arkansas (31%), Missouri (30%), and Michigan (30%).”

“While almost three Heartland residents in five (57%) say they are unlikely to get the new version of the COVID-19 vaccine, rejection rates of 74% in Wyoming and 68% in Idaho are particularly startling. These findings should be a wake-up call to health communicators, as we can no longer rely on mandates and must engage people in real conversations to encourage them to vaccinate themselves and their families,” Rabin continued.

“There is some good news here, however,” he noted.  “Residents who live in the 12 traditional Midwestern states do have a more positive perception of the overall quality of healthcare in their region compared to the rest of the country — 37% of traditional Midwesterners said healthcare is better in their area, compared to 32% of overall national respondents.”  

Of the 22 states studied, 38% of residents in West Virginia say that their healthcare is worse than other states, followed by residents in Wyoming (36%), Montana (28%), Kentucky (27%), and Arkansas (25%).


National: The Emerson College Polling national survey was conducted October 16-17, 2023. The sample of registered voters, n=1,578, has a credibility interval, similar to a poll’s margin of error (MOE), of +/- 2.4 percentage points. Data for the October national poll was collected by contacting an Interactive Voice Response (IVR) system of landlines and an online panel of voters. The data sets were weighted by gender, education, race, age, party affiliation, and region based on 2024 registration modeling. Turnout modeling is based on U.S. Census parameters, and U.S. voter registration data.

State Polling: Emerson College Polling conducted statewide surveys of residents in 22 states from October 1-4, 2023. Sample size varies by state, and each state’s sample can be found in the full results. Sample sizes ranged from n=451 to n=598, therefore carrying different margins of error, ranging from +/- 3.98 percent to +/- 4.6 percent. The data sets were weighted by gender, age, race, and education based on the general population-based data from the U.S. Census. Data was collected by contacting emails and landlines via Interactive Voice Response provided by Aristotle, along with an online panel of respondents provided by Alchemer.

It is important to remember that subsets based on demographics, such as gender, age, education, and race/ethnicity, carry with them higher credibility intervals, as the sample size is reduced. Survey results should be understood within the poll’s range of scores and that with a confidence interval of 95%, a poll will fall outside this range of scores once in 20 times.