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# Framing and Willingness to Pay for a Local Health Department: Evidence from a COVID-19 Contingent Valuation Experiment

## Details

**Authors** Orgill-Meyer et al.

**Year** 2026

**Publisher** Journal of Health Politics, Policy and Law

**Discipline** Public Policy

[Read it at the publisher](https://doi.org/10.1215/03616878-12757947) 
10.1215/03616878-12757947

## In authors' words

### Abstract

Context: Local health departments provide essential public health services, yet many counties lack them, and those that exist struggle with ongoing funding needs. The COVID-19 pandemic politicized public health, raising questions about how political framing affects public willingness to pay for these services. Methods: Participants in a contingent valuation experiment (N = 1,946) were recruited from Lancaster County in south-central Pennsylvania. They received information about local health department services and were randomized into conditions emphasizing either COVID-19 prevention or elevated blood lead level reduction–a less politically salient public health threat. Using interval regression, we estimate willingness to pay (WTP) for local health department services, identify its determinants, and examine treatment effects by party affiliation. Findings: Mean annual WTP for local health department services was 138.22 (95% CI:121.34, 139.73). Republicans showed a165.60 lower WTP to pay than Democrats (p < 0.001). We observed no statistical differences within political affiliations to issue framing. Conclusions: Partisan differences in support for local health departments persist, yet preferences remain stable across politicized frames. These findings suggest that polarization in public health attitudes reflects entrenched partisan identities more than frame-dependent views, underscoring the need for strategies that build durable cross-partisan trust and institutional legitimacy.

### What they found (results)

Republicans reported an average willingness to pay $165.60 less annually for local health department services than Democrats, while experimentally changing the message frame produced no significant effect within either political group.

## Commentary

### In short

The study tests whether willingness to pay is driven by message framing or by the observer's political perspective.

**Patterns it shows** R, P

**Added** 2026-08-05

**How to cite this** Orgill-Meyer et al. (2026). Framing and Willingness to Pay for a Local Health Department: Evidence from a COVID-19 Contingent Valuation Experiment. Journal of Health Politics, Policy and Law.