We hypothesize that in the presence of structural racism, a negative signal about one system will influence outcomes in the other. Our first experiment will elicit priors on experiences in the criminal justice system and the healthcare system, with a focus on understanding participant willingness to take up healthcare. We will then randomize respondents to either a treatment or control group. The treatment group will receive a series of statistics and a narrative on racial inequality in the criminal justice system, and the passive control will receive statistics and a narrative about lightning strikes (i.e. a placebo). The narrative vignettes related to discrimination in the criminal justice system will be informed by details of actual cases of discrimination and will be produced by the journalism production company The Invisible Institute.
After making salient racial disparities in the criminal justice system, we will again measure perceptions of racial discrimination in both the healthcare and criminal justice systems as well as other systems such as financial markets and education. In the absence of structural racism, and/or the absence of perceived structural racism, individuals in the first treatment group may only update regarding criminal justice; however, if the two systems are “correlated” due to structural racism and if individuals internalize this correlation, i.e., if a signal in one system is informative about the distribution of outcomes of another, then making discrimination in the criminal justice system more salient will have spillover effects on perceptions of the healthcare system. Individuals in this group may then be less willing to seek medical care.
In the second experiment, we will test the hypothesis that the updating process observed in Experiment 1 can be weakened by making salient the actions of medical professionals who denounce racial discrimination. In this experiment, individuals will again be randomized into one of four groups: first, they will be assigned to one of the two experimental arms from our first experiment, and then separately randomized into a second treatment: in this second treatment, the treatment group will be shown images and a narrative video of doctors protesting against police violence in the wake of the death of George Floyd. The control group will be shown unrelated images of doctors protesting climate change. We will then measure the effect of this second treatment on healthcare demand. We will measure self-reported health demand as in Experiment 1. We will also measure actual take-up of a coupon for telehealth services from a third-party provider, Plush Care. This telehealth provider is willing to create a signal of solidarity specific to their firm, linking the treatment to the same healthcare provider to which participants will be given subsidized access.