Health Security for All? Racial Discourse in Presidential Health Speeches from Roosevelt to Biden

Area of Science:

• Health policy analysis
• Political science
• Sociology of race

Background:

• Racial inequality is a persistent issue in American health and healthcare.
• Presidential discourse significantly influences health politics and policy.
• Discussions of race in presidential health speeches are historically variable.

Purpose of the Study:

• To examine the prevalence and nature of racial discourse in 90 years of US presidential health speeches (Roosevelt to Biden).
• To address whether racial discourse in health policy speeches increased or decreased after the Civil Rights Era.

Main Methods:

• Quantitative content analysis of 1,359 presidential health speeches.
• Qualitative analysis of presidential health speeches from Roosevelt to Biden.

Main Results:

• Attention to race in health speeches was higher among Democrats than Republicans.
• Racial discourse peaked during the Civil Rights Era and COVID-19 pandemic, declining in between.
• Most presidents discussed race and health less than Civil Rights Era benchmarks (Johnson, Nixon).
• Presidents often used positive, sometimes paternalistic, racial discourse alongside universalist or technical language to mitigate backlash.

Conclusions:

• The study informs debates on the prominence, nature, and causes of racial discourse in policy-making.
• Demonstrates how presidents navigate balancing specific racial concerns with universal health messaging.