Updated Feb 23, 2023 - Politics & Policy

Axios-Ipsos poll: Republicans call opioids No. 1 health threat

What Americans say is the current greatest threat to U.S. public health
Data: Axios-Ipsos poll; Table: Simran Parwani/Axios

Republicans see fentanyl and other opioids as the biggest threat to Americans’ public health, while Democrats say it's guns, according to a new Axios-Ipsos survey.

Why it matters: The Axios-Ipsos American Health Index sheds light on how our partisan divisions — and our education levels — play into the wrangling over public health policies, and how they guide the parties' political messaging.

  • The survey also found that Americans overwhelmingly want private health insurance companies to cover weight-loss drugs and that they support capping out-of-pocket insulin costs at $35 per month.
  • Nearly half of Americans — 47% — say insurers should cover transgender-related medical care. That's a deeply partisan issue: 77% of Democrats favor it; just 16% of Republicans do.
  • "Like everything else, public health is a tale of two Americas — one red, one blue," said Cliff Young, president of Ipsos U.S. Public Affairs. "Governments must be nimble to talk about multiple public health issues at once."

The big picture: The national survey of 1,213 U.S. adults found that Americans' concerns over opioids — including fentanyl, a synthetic — vary by education level, not just by party.

  • Opioids were the top health concern of 32% of people with a high school diploma or less, compared to 25% of people with some college and 20% of those with a bachelor's degree or higher.
  • Concerns about obesity appear to correlate to education: Just 12% of Americans with no college — but 30% of those with a bachelor’s degree or higher — say it's the nation's biggest public health threat.
  • There's a big divide among those worried about guns, based on where they live: 22% of urban residents and 17% of suburban residents cited gun violence as their biggest concern, compared to just 8% of rural Americans.

Reality check: Heart disease and cancer actually were the two leading causes of death in the U.S. as of 2021, followed by COVID-19 and accidents, according to the Centers for Disease Control and Prevention (CDC).

  • But in the survey about Americans' health concerns, cancer ranked a distant fourth, with coronavirus, unsafe roads or driving, smoking and tobacco products, and alcohol abuse next in line.

Context: The findings square with the priorities lawmakers are pursuing on Capitol Hill. A House Energy and Commerce subcommittee kicked off the year under the new Republican majority with a hearing focused on fentanyl, while House Democrats have asked for a classified briefing on mass shootings.

  • Both sides are responding to grim statistics: The CDC estimates there were 107,477 drug overdose deaths in the 12 months ending in August 2022, while gun violence killed more than 44,000 Americans last year.
  • The survey also is a window into President Biden's thinking when he proposed limiting insulin costs to $35 a month, a popular plan roundly praised by Democrats in Congress — and criticized by Republicans.

By the numbers: 26% of Americans overall see opioids as the greatest current threat to U.S. public health — the largest share of any concern cited.

  • Republicans were more than twice as likely to say so as Democrats, with independents falling somewhere in the middle.
  • Obesity, at 21% among Americans overall, is seen as the second-largest threat. Republicans and independents are more concerned than Democrats about the issue.
  • Access to guns or firearms is seen as the third highest public health threat by Americans overall, at 17%, but that belies a gaping partisan disconnect: Democrats are nearly nine times as likely as Republicans to say it's the biggest threat.

Between the lines: Despite the differences in priorities, majorities of Americans said they support stricter requirements for guns, including majorities across the political spectrum and among gun owners.

  • 37% said they or someone in their household owns a gun.
  • The survey found that 87% of Americans support background checks for all gun sales, with 97% of Democrats, 79% of Republicans and 88% of independents endorsing the idea.

Likewise, 78% of Americans support red-flag laws to allow guns to be taken away from people who courts have determined to be dangerous, including 95% of Democrats, 63% of Republicans and 79% of independents.

And 84% of Americans — including 73% of gun owners — said they'd support requiring gun owners to keep their firearms stowed with trigger locks or in safes.

Methodology: This Axios/Ipsos Poll was conducted Feb. 17-21 by Ipsos' KnowledgePanel®. This poll is based on a nationally representative probability sample of 1,213 general population adults age 18 or older.

  • The margin of sampling error is ±3.0 percentage points at the 95% confidence level, for results based on the entire sample of adults.

Editor's note: This article was updated with a quote from Ipsos.

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