Public Opinion about the Health Care System

As with many other social issues, public opinion about health care systems, providers, plans, coverage, and benefits varies in response to a variety of personal, political, and economic forces. Personal experience and the experience of friends, family, and community opinion leaders (trusted sources of information such as members of the clergy, prominent physicians, and local business and civic leaders) exert powerful influences on public opinion. Health care marketing executives have known for years that the most potent advertising any hospital, medical group, or managed care plan can have is not a full-page newspaper advertisement or prime-time television ad campaign. It is positive word-of-mouth publicity.

The influence of the news media, advertising, and other attempts to sway health care consumers' attitudes and purchasing behaviors cannot be overlooked. A single story about a miraculous medical breakthrough or life-saving procedure can reflect favorably on an entire hospital or health care delivery system. Similarly, a lone mistake, an adverse reaction to a drug, or a misstep by a single health care practitioner can impugn (attack as lacking integrity) a hospital, managed care plan, or pharmaceutical company for months or even years, prompting intense media scrutiny of every action taken by the practitioner, facility, or organization.

Political events, the economy, and pending legislation can focus public attention on a particular health care concern, supplant one health-related issue with another, or eclipse health care from public view altogether. In 2005 Hurricanes Katrina and Rita focused attention on the U.S. public health and federal emergency management systems' capacities to effectively respond to disasters. At the same time, federal, state, and local government officials assessed disaster preparedness funding and plans for the possibility of an influenza pandemic arising from the H5N1 avian flu that had already swept through birds in parts of Asia and Europe and might arrive in the United States.

In Economic Anxiety Surges in Past Year (March 28, 2008, http://www.gallup.com/poll/105802/Economic-Anxiety-Surges-Past-Year.aspx), Lydia Saad of the Gallup Organization observes that the U.S. economy and health care were Americans' top concerns in the second quarter of 2008. Americans' concerns about the U.S. economy increased dramatically, from 39% in March 2007 to 60% in March 2008. (See Table 9.1.) The economic anxiety appears to have slightly dampened concerns about health care—during this same period the percentage of Americans naming health care as a major concern dropped from 63% of respondents to 58%.

In Kaiser Health Tracking Poll: Election 2008—June 2008 (June 25, 2008, http://kff.org/kaiserpolls/h08_posr062508pkg.cfm), the Henry J. Kaiser Family Foundation finds that rising health care costs continue to worry Americans, along with other economic concerns. Most (43%) respondents named paying for gas as a serious economic concern. Twenty-five percent of those polled said paying for health care and health insurance posed a serious problem, and about the same proportion (27%) was worried about getting a well-paying job. Nearly one out of five (19%) expressed concern about paying for food, and comparable percentages were worried about credit card or personal debt (16%), losing money in the stock market (15%), and rent or mortgage (14%).

According to Victoria Culver, in “Polls Show Health Care a Growing Concern” (San Francisco Chronicle, April 29, 2008), industry observers assert that the Kaiser poll underscores the fact that despite the mortgage crisis, rising gasoline prices, and growing economic uncertainty, health care remains high on the list of Americans' concerns. Observers also note that the Kaiser poll reveals the role of health care in lifestyle decisions. Culver indicates that 23% of survey respondents said they or a member of their household either switched or stuck with a job because of health benefits. Seven percent said health care coverage influenced their own or a household member's decision to marry during the past year.

AMERICANS ARE CONCERNED ABOUT HEALTH CARE COVERAGE, COSTS, AND QUALITY

In November 2007 the Gallup Organization found that 26% of Americans named health care insurance costs and 30% named access to care as the most pressing health problems facing the country. (See Table 9.2.) Twice as many survey participants named health care system problems, as opposed to specific diseases, as the nation's most urgent health problems. Fourteen percent of respondents said cancer was the most urgent health problem facing the country and 10% felt it was obesity.

Americans' assessment of the quality of health care they receive remains relatively unchanged from past years. In November 2007 just 17% rated U.S. health care as “excellent” and the same proportion (16%) described it as “poor.” (See Table 9.3.) Thirty-seven percent said it was “good,” whereas 29% said the quality of U.S. health care was “only fair.” Similarly, American's assessment of health care coverage has not changed in recent years. In November 2007 slightly more than a quarter of survey respondents felt that health care coverage in this country was “excellent” (6%) or “good” (21%), whereas 41% said it was “only fair” and 31% described it as “poor.” (See Table 9.4.)

Some industry observers believe health care providers, policy makers, biomedical technology and research firms, and academic medical centers have fanned the flames of

consumer dissatisfaction with the health care system by overselling the promise and the progress of modern medicine and the U.S. health care system. They fear that the overzealous promotion of every scientific discovery with a potential clinical application has created unrealistic expectations of modern medicine. Health care consumers who believe there should be “one pill for every ill” or feel all technology should be made widely available even before its efficacy has been demonstrated are more likely to be dissatisfied with the present health care system.

The national economy and the rate of increase of health care costs, especially out-of-pocket expenses, also play important roles in shaping public opinion. When unemployment rates are high, the proportion of people without insurance increases, workers fear losing their jobs and their health care coverage, and dissatisfaction with the present health care system grows. Many surveys show a direct relationship between rising out-of-pocket expenses and dissatisfaction with the health care system. The recent spike in health care costs, coupled with survey findings that employers intend to pass off some of the increasing costs to their employees, will likely inspire renewed interest in health care reform.

The overwhelming majority of Americans remain dissatisfied with the total cost of health care. In November 2007, 81% of respondents were dissatisfied with health care costs, the highest percentage since May 1993, when 90% of respondents expressed dissatisfaction with health care costs. (See Table 9.5.) Despite increasing health care costs and overall dissatisfaction with the total cost of health care, when the Gallup Organization queried Americans about their satisfaction with what they pay for their own health care, the majority (57%) was satisfied with the total cost of their own health care, and the percent that was dissatisfied had dropped three percentage points from the previous survey, from 42% to 39%. (See Figure 9.1.)

The November 2007 Gallup poll found that 83% of respondents were covered by some form of health insurance and 16% had no coverage. (See Table 9.6.) Of those covered by insurance, 57% were covered by private insurance and 31% by Medicare or Medicaid. (See Table 9.7.) These proportions have remained relatively stable since 2001, although the percentage of respondents with private insurance has declined over this period.

In November 2007, 64% of survey respondents shared the cost of their health insurance premiums with their employers, whereas 18% paid their own premiums and 15% reported their employers pay the total cost of their health insurance premiums. (See Table 9.8.) The percentage of respondents with employers that pay for all their health insurance premiums decreased, from 24% in 2001 to 15% in 2007. Similarly, the percentage of survey respondents that share costs with their employers rose, from 54% to 64% during this same period.

Among those respondents who pay for all or part of their health insurance premiums, 29% said their premiums had “gone up a lot” and 46% said their premiums had “gone up a little” when the Gallup Organization surveyed them in November 2006. (See Table 9.9.) Nineteen percent said their premiums were unchanged and 3% reported their premiums had “gone down a little.”

AMERICANS WANT TO REFORM THE HEALTH CARE SYSTEM

Most Americans feel the U.S. health care system is plagued by problems. In November 2007, 56% of Gallup poll survey respondents said they felt the health care system was beset by major problems, 24% felt there were minor problems, and 17% said the health care system was in a state of crisis. (See Table 9.10.) Just 2% of survey respondents said the current health care system “does not have any problems.”

Demographic changes, particularly the aging of the baby-boom generation (people born between 1946 and 1964) into Medicare eligibility, may also fuel concern and dissatisfaction with the health care system. If the health care futurists who have projected glaring deficiencies in the current system's capacity to meet the needs of the aging population are correct, this generation may become the largest and most vocal advocates for health care reform. In January 2008 a majority (72%) of Americans polled by Gallup were dissatisfied with the availability of affordable health care in the United States. (See Table 9.11.) Nearly two-thirds (64%) of Americans expressed dissatisfaction with Medicare and less than half (45%) said they were satisfied with the quality of medical care. (See Table 9.12.)

In November 2007 Americans were evenly divided about how to provide health care in the United States. Forty-one percent favored replacing the current U.S.health care delivery system and 48% felt the present system should be maintained. (See Table 9.13.) Eleven percent, the highest percentage in recent years, said they had no opinion or preference about replacing or maintaining the health care delivery system.

The November 2007 Gallup poll showed that 64% of Americans believed it is the responsibility of the federal government to ensure that they have health care coverage. (See Table 9.14.) One-third (33%) of survey respondents said it was not the federal government's responsibility to make sure all Americans have health care coverage. The proportion of Americans holding these views has remained relatively unchanged since 2000.

In anticipation of the 2008 presidential elections, in January 2008 the Gallup Organization asked Americans what kind of change they would like to see the next president of the United States bring about. The number-one change respondents called for was an end to the war in Iraq (26%), and the second-most frequent response was “healthcare reform” (19%). (See Table 9.15.)

AMERICANS FEEL THEIR OWN HEALTH CARE IS BETTER THAN THE U.S. HEALTH CARE SYSTEM

Most Americans give much higher ratings to the care they receive than to the larger U.S. health care system. Respondents to the November 2007 Gallup poll gave failing and mediocre grades to the overall quality of the U.S. health care system; however, when it came to rating their own personal health care quality and coverage, the survey respondents seemed much happier with their health plan. The majority, a full 83%, rated the quality of health care they receive as “excellent” (33%) or “good” (50%), and just 15% said their own care is “only fair.” (See Figure 9.2.) Similarly, 70% of respondents felt their health care coverage is “excellent” (25%) or “good” (45%).

MANY AMERICANS ARE CONCERNED ABOUT THEIR ABILITY TO PAY FOR HEALTH CARE

In view of escalating health care costs and increasing out-of-pocket expenses, it is understandable that Americans are extremely concerned about health care costs. Gallup surveys have repeatedly found that health care costs, which continue to rise much faster than inflation, top the list of health problems Americans believe beset the nation and are perceived as more urgent than threats of specific diseases.

In November 2007, 30% of Gallup survey respondents reported that they had put off some form of medical treatment because of concerns about costs. (See Table 9.16.) This percentage has risen since 2001. Among those who delayed or did not seek treatment, 15% said they put off treatment of a “very serious condition” and another 45% said they put off treatment for a “somewhat serious” condition. (See Table 9.17.)

Not unexpectedly, the Gallup Organization finds that wealthier Americans are less likely to postpone or defer seeking medical care because of cost. In Three in 10 Have Postponed Medical Treatment Due to Cost (December 14, 2007, http://www.gallup.com/poll/103261/Three-Postponed-Medical-Treatment-Due-Cost.aspx) Magali Rheault of the Gallup Organization observes that “Americans whose household incomes are

under $50,000 (39%) are more likely than those whose incomes are at least $50,000 (23%) to say that they or a family member put off treatment.” Similarly, younger survey respondents aged eighteen to forty-nine (37%) were more likely to report deferring care than those aged fifty and older (22%). Nearly twice as many respondents with children under age eighteen (40%) as those without children (24%) said they delayed seeking treatment because of cost considerations. (See Figure 9.3.)

AMERICANS UNCERTAIN ABOUT SOCIALIZED MEDICINE

The Harvard School of Public Health and Harris Interactive conducted a poll in January and February 2008 and reported the results in “Poll Finds Americans Split by Political Party over Whether Socialized Medicine Better or Worse Than Current System” (February 14, 2008, http://www.harrisinteractive.com/NEWS/allnewsbydate.asp?NewsID=1278). The poll reveals that even though two-thirds of respondents said they understood the term socialized medicine (publicly or government-administered health care delivery in which all health workers and facilities are paid by the government) “very well” (34%) or “somewhat well” (33%), respondents' understanding of the term varied widely. More than three-quarters (79%) correctly associated the term with the statement that in a socialized medicine system, “the government makes sure everyone has health insurance.” Seventy-three percent said they thought socialized medicine meant that the government would pay for all or most of the cost of health insurance and 32% of respondents opined that under socialized medicine the government “tells doctors what to do.”

Among those who claimed to understand the term, 45% asserted that instituting socialized medicine in the United States would improve care and 39% felt it would worsen health care delivery. Four percent of respondents felt it would not change the current health care system and 12% said they did not know how it would influence the current system.

The poll reveals marked differences by political party affiliation. Most Republicans (70%) contended that socialized medicine would be worse than the current system, whereas the same proportion of Democrats (70%) said a socialized medical system would be an improvement. Independents were divided on the issue—43% thought socialized medicine would be better and 38% felt it would be worse than the present system.

Most American Physicians Favor National Health Insurance

Physician support for national health insurance appears to be increasing. Aaron E. Carroll and Ronald T. Ackerman surveyed physicians in 2002 and again in 2007 to assess their support for government legislation to establish national health insurance and universal coverage. The results of their research were published in “Support for National Health Insurance among U.S. Physicians: 5 Years Later” (Annals of Internal Medicine, vol. 148, no. 7, April 1, 2008).

In 2002 the researchers found that about half (49%) of physicians surveyed supported national health insurance legislation. In 2007 overall support for national health insurance increased to 59%. Support for national health insurance was highest among psychiatrists (83%), pediatric subspecialists (71%), emergency medicine physicians (69%), general pediatricians (65%), general internists (64%), and family physicians (60%) More than half (55%) of general surgeons supported national health insurance, nearly twice as many as favored it in 2002.

CONSUMER SATISFACTION WITH HEALTH CARE FACILITIES

Despite the problems that continue to plague hospitals, such as shortages of nurses and other key personnel, diminished reimbursement, shorter inpatient lengths of stay, sicker patients, and excessively long waiting times for patients in emergency and other hospital departments, consumer satisfaction with hospital services has remained relatively high. In fact, Press Ganey Associates Inc. reports in Hospital Pulse Report: Patient Perspectives on American Health Care (2008, http://www.pressganey.com/galleries/default-file/2008_Hospital_Pulse_Report.pdf), which considers the experiences of nearly 2.8 million patients treated at 1,946 hospitals nationwide, that overall patient satisfaction with inpatient hospital care has steadily increased since 2003.

Patient satisfaction with hospital care was linked to the hospital's success in meeting patients' spiritual and emotional needs. This finding, that satisfaction is associated with patient-centered care and intangible qualities of the hospital experience such as sensitivity, attention, and responsiveness to emotional needs, concerns, and complaints, underscores the fact that many health care consumers assess the quality of service they receive in terms of the care and compassion displayed by hospital personnel.

Consistent with the findings that personal care and attention strongly influence satisfaction with hospital care, Press Ganey Associates finds that as the hospital size increases (in terms of number of beds) patient satisfaction decreases. Patient satisfaction was highest (87.5%) at hospitals with fifty or fewer beds, and satisfaction declined steadily to 83.4% in hospitals with six hundred or more beds. Presumably, this is because larger hospitals, and the health care workers they employ, find it more challenging to deliver the individual care and attention patients have come to associate with quality.

Other patient-related variables and hospital characteristics also influence satisfaction with care. Fewer patients admitted through the emergency department (82.5%) were satisfied, compared to those who did not have emergency admissions (85.2%). This difference may be attributed to the understandable stress and discomfort surrounding an emergency hospital admission, but it may also reflect dissatisfaction with specific hospital qualities such as long waits for admission.

Government Web Site Posts Patient Satisfaction Survey Data

In March 2008 the federal government posted the results of the Hospital Consumer Assessment of Health-care Providers and Systems (HCAHPS) survey on the Hospital Compare Web site (http://www.hospitalcompare.hhs.gov/), which enables consumers to compare up to three hospitals. Robert Pear reports in “Study Finds Many Patients Dissatisfied with Hospitals” (New York Times, March 29, 2008) that 63% of hospital patients were satisfied with the care they had received—giving their hospitals a 9 or 10 rating on a scale of 0 to 10. An even higher percentage (67%) said they would definitely recommend the facility where they received treatment to friends and relatives.

Pear notes that the study, which encompassed more than twenty-five hundred hospitals, included questions about hospital cleanliness and noise levels as well as issues such as being treated respectfully and whether health care providers listened to patient concerns. In “Medicare Adds Patient Opinions to Hospital Comparison Web Site” (March 31, 2008, http://www.ihealthbeat.org/articles/2008/3/31/Medicare-Adds-Patient-Opinions-to-Hospital-Comparison-Web-Site.aspx?topicID=55), the California HealthCare Foundation indicates that many patients felt health care providers did not treat them with respect. Others said they did not receive adequate pain management after surgery. A quarter of survey respondents said nurses did not communicate well, and 20% said they did not receive written information about follow-up care when they were discharged.

Pear explains that there was some variation in patient satisfaction based on geography. For example, in Alabama 73% of patients gave hospitals high scores, whereas in Hawaii just 57% of patients rated their hospitals as nines or tens. According to Kevin Freking, in “Patient Ratings of Local Hospitals Online/Federal Survey Results Offered in Plain English” (Associated Press, March 29, 2008), patients rated their experiences at rural hospitals better than those in urban settings for several satisfaction measures. Freking notes that Herb Kuhn, the acting deputy administrator at the Centers for Medicare and Medicaid Services, attributed this finding to the communities served rather than specific hospital characteristics, opining, “I think that has to do with rural hospitals being more of a fabric of the community.”

Consumer groups, employers, labor unions, and other government agencies applauded the dissemination of these data, asserting that it will help promote transparency and accountability. The California HealthCare Foundation notes that Gerry Shea of the AFL-CIO said, “It's a major step for consumers and not an easy step for hospitals. It puts them in the spotlight on how they are doing against the competition.” Carolyn Clancy, the director of the Agency for Healthcare Research and Quality, agreed that patient satisfaction data are an important measure of the quality of health care delivery.

Some industry leaders question the study design and results. According to the California HealthCare Foundation, in “Experts Question CMS Web Site's Patient Satisfaction Information” (April 8, 2008, http://www.ihealthbeat.org/articles/2008/4/8/Experts-Question-CMS-Web-Sites-Patient-Satisfaction-Information.aspx?topicID=89), Chip Kahn, the president of the Federation of American Hospitals, said the data are still preliminary, noting, “From an analytical standpoint, the numbers are not totally transparent.” He added that the findings call for greater review of the data characteristics. Deirdre Mylod, the vice president of public policy at Press Ganey Associates, said “the survey accounts for differences in patient populations but that no adjustments were made for hospitals' characteristics.” In “HCAHPS No Hiccup” (Modern Healthcare, vol. 38, no.15, April 14, 2008), Charles S. Lauer explains that Richard Umbdenstock, the president of the American Hospital Association, advises patients to consider a “variety of factors” when choosing a hospital and cautions them not to rely exclusively on the HCAHPS results.

A GROWING NUMBER LOOK FOR HEALTH INFORMATION ONLINE

Even though public trust in hospitals and personal physicians remains relatively high, and many people seek and receive health education from physicians, nurses, and other health professionals, a growing number of Americans are seeking health information online. Harris Poll researchers dub the millions of adults who seek information on the Internet about specific diseases or tips about how to maintain health “cyberchondriacs.”

In “Harris Poll Shows Number of 'Cyberchondriacs'—Adults Who Have Ever Gone Online for Health Information—Increases to an Estimated 160 Million Nationwide” (July 31, 2007, http://www.harrisinteractive.com/harris_poll/index.asp?PID=792), Harris Interactive indicates that nearly three-quarters (71%) of American adults sought health information online in 2007. Typically, cyberchondriacs searched the Internet for health information 5.7 times per month, up from 5.1 times per month in 2004 and 3 times per month in 2001. The vast majority (88%) of cyberchondriacs said they found the information they were seeking on the Internet.

Harris Interactive finds that in 2007, 86% of cyberchondriacs felt the information they obtained on the Internet was reliable, down from 90% in 2005. More than half (55%) reported using the Internet to obtain information following discussions with their physicians.

Rachael King explains in “Here Come the Cyberchondriacs” (BusinessWeek, August 2, 2007) that some industry analysts posit that the growing number of consumers choosing to research medical conditions online is in part motivated by escalating health care costs and the proliferation of high-deductible health plans, which motivate consumers to assume greater responsibility for their care. Cyberchondriacs not only seek information about medical problems but also want to know how much treatment should cost and whether their physician has a good track record treating specific conditions or performing specific procedures. Furthermore, industry observers feel online consumers are seeking greater control over health care decisions, which will serve to incrementally change the nature of relationships between patients and physicians.

MARKETING PRESCRIPTION DRUGS TO CONSUMERS

Even though health care consumers continue to receive much of their information from physicians, nurses, other health professionals, and the Internet, many also learn about health care services and products from reports in the news media and from advertising. Media advertising (the promotion of hospitals, health insurance, managed care plans, medical groups, and related health services and products) has been a mainstay of health care marketing efforts since the 1970s. During the early 1990s pharmaceutical companies made their first forays into advertising of prescription drugs directly to consumers. Before the 1990s pharmaceutical companies' promotion efforts had focused almost exclusively on physicians, the health professionals who prescribe their products.

Since the mid-1990s spending on prescription drugs has escalated and has become the fastest-growing segment of U.S. health care expenditures. In 1997 the U.S. Food and Drug Administration released guidelines governing direct-to-consumer advertising and seemingly opened a floodgate of print, radio, and television advertisements promoting prescription drugs. Industry observers wondered if this upsurge of direct-to-consumer advertising had resulted in more, and possibly inappropriate, prescribing and higher costs.

Is Direct-to-Consumer Advertising Effective?

It stands to reason that pharmaceutical companies must be receiving significant returns on their direct-to-consumer advertising investments to justify increasing budgets for consumer advertising, but it is difficult to measure the precise impact of consumer advertising on drug sales. In “Drugmakers Not Asleep When It Comes to Advertising” (Philadelphia Inquirer, June 2, 2006), Rob Waters notes that spending on direct-to-consumer prescription drug advertising increased by 7% to $4.8 billion in 2005, even though the pharmaceutical industry agreed to adhere to Pharmaceutical Research and Manufacturers of America guidelines urging the inclusion of information about the risks as well as the benefits of the drugs in direct-to-consumer advertising.

William E. Boden and George A. Diamond observe in “DTCA for PTCA—Crossing the Line in Consumer Health Education?” (New England Journal of Medicine, vol. 358, no. 21, May 22, 2008) that direct-to-consumer advertising results in a favorable return on investment for more than 90% of brand-name drugs, and that ten of the leading twelve brand-name drugs with direct-to-consumer advertising campaigns had sales of more than $1 billion annually. Nearly three-quarters of the brand-name drugs advertised generated “returns in excess of $1.50 for every $1.00 invested and 35% of which had returns in excess of $2.50 for every $1.00 invested.”

Is Direct-to-Consumer Advertising of Psychoactive Drugs Helpful or Harmful?

At what point does an understandable response to distressing life events become an indication for drug treatment—and a market opportunity?

—Barbara Mintzes, “Direct to Consumer Advertising Is Medical-ising Normal Human Experience” (British Medical Journal, vol. 324, no. 7342, April 13, 2002)

In the landmark report Mental Health: A Report of the Surgeon General, 1999 (1999, http://www.mentalhealth.samhsa.gov/features/surgeongeneralreport/home.asp), the U.S. surgeon general estimates that about 20% of Americans experience mental health problems and that nearly half of all Americans with severe mental illness do not seek treatment, often because they fear the social stigma and potential loss of employment or health insurance that a diagnosis of mental illness might precipitate. The Substance Abuse and Mental Health Services Administration finds in Results from the 2006 National Survey on Drug Use and Health: National Findings (September 2007, http://www.oas.samhsa.gov/nsduh/2k6nsduh/2k6results.pdf) that in 2006, 11.3% of all adults suffered from serious psychological distress (an overall indicator of past-year nonspecific psychological distress) and 15.8 million adults (7.2% of people aged eighteen and older) had suffered at least one major depressive episode (a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had symptoms that met the criteria for major depressive disorder) in the past year. Among adults aged eighteen and older who had a major depressive episode in the past year, 69.1% received treatment (i.e., saw or talked to a medical doctor or other professional or used prescription medication) for depression in the same time period.

Even though these studies rely primarily on self-report, they do suggest that the United States is in the throes of an epidemic of mental illness. However, some researchers argue that Americans' mental health is no worse than it was in past decades. They contend that the availability and aggressive marketing of psychopharmacological agents—prescription drugs aimed at mental health problems such as nervousness, anxiety, panic, and shyness—has prompted the overdiagnosis of mental health problems and conditions motivated primarily by the desire to increase drug sales.

There have been advocates and opponents of direct-to-consumer prescription drug advertising since its inception. According to Joel S. Weissman et al., in “Consumers' Reports on the Health Effects of Direct-to-Consumer Drug Advertising” (February 26, 2003, http://www.npcnow.org/resources/PDFs/W3-82Weissman.pdf), 35% of respondents discussed an advertised drug with their physician as a result of direct-to-consumer advertising, a finding that supports the contention that advertising exerts a significant influence on consumer preferences and behavior. Among patients prompted by consumer drug advertising to discuss a health problem with their physician, one-quarter received a new diagnosis and a new prescription. About four out of five patients who received a prescription drug and took it as prescribed reported they felt “much better” or “somewhat better” overall after taking the prescription medication. These findings were interpreted as supporting the premise that direct-to-consumer drug advertising increases awareness of specific health problems, provides reliable information, and encourages affected individuals to seek treatment.

Health care consumers favor advertisements for prescription drugs to treat mental health conditions. According to “The Public on Prescription Drugs and Pharmaceutical Companies” (March 2008, http://kff.org/kaiserpolls/upload/7748.pdf), a USA Today /Kaiser Family Foundation/Harvard School of Public Health survey that was conducted in January 2008, 60% of adults felt such advertisements “are mostly good because they improve understanding of these conditions and encourage people to seek treatment, whereas 36% think these ads are mostly bad because they encourage people without serious mental health conditions to think they need treatment.”

Opponents usually contend that direct-to-consumer advertising is primarily intended to drive sales and that it:

• Increases prescription drug costs
• Does not provide the impartial, objective information that would enable consumers to make informed health choices
• Increases risk because, unlike other consumer goods, prescription drugs, even when administered properly, may cause serious adverse reactions
• Takes unfair advantage of vulnerable people facing difficult treatment choices, especially people who suffer from mental illness
• Aims to increase awareness and utilization of newer products to gain market share and recoup development costs (new drugs are not necessarily safer or more effective but are usually costlier, and often little is known about long-term risks)
• Does not enhance consumer awareness or public health because there is no evidence that advertising helps patients to make better choices about prescription drug use
• May unduly influence physician-prescribing practices; physicians often rely on manufacturers for information about drugs, rather than on independent sources, and many studies show that the physicians most influenced by pharmaceutical advertising tend to prescribe less judiciously

Richard L. Kravitz et al. contend in “Influence of Patients' Requests for Direct-to-Consumer Advertised Antidepressants: A Randomized Controlled Trial” (Journal of the American Medical Association, vol. 293, no. 16, April 27, 2005) that the consequence of direct-to-consumer advertising is that the medicines that generate profits for drug companies are often overprescribed. During 2003 and 2004 Kravitz et al. sent actors posing as patients to the offices of 152 family physicians and internists practicing in California and New York. The actors scheduled appointments with the physicians during which some described symptoms of major depression, a long-lasting mood disorder that is often treated with antidepressant medications. Others complained of symptoms of a less serious mental health problem, called adjustment disorder with depressed mood. This condition generally disappears within months without medication.

Among the actors who posed as patients describing symptoms of major depression, one group did not specifically request an antidepressant, a second group mentioned that they had seen a television show about depression that had prompted them to seek drug treatment, and a third group said they had seen a television commercial that advertised paroxetine (one of several drugs often used to treat major depression) and they specifically asked for that drug. Of the first group, 31% were prescribed medication. For the second group of actors, 76% received a prescription. In both of these groups, about 6% of the actors posing as patients who received a prescription were given a prescription for paroxetine. Of the third group, more than half were prescribed the drug they requested.

Concerning the actors posing as patients who presented with symptoms of adjustment disorder and did not mention antidepressant drugs, just one out of ten received a prescription for any medication. However, when the actors asked for medication, nearly 50% were given prescriptions. Most of the actors who specifically requested paroxetine received a prescription for that drug, whereas those who simply asked for some sort of medication were prescribed another antidepressant. Kravitz et al. conclude that “patients' requests have a profound effect on physician prescribing in major depression and adjustment disorder. Direct-to-consumer advertising may have competing effects on quality, potentially both averting underuse and promoting overuse.”

Finally, critics of direct-to-consumer advertising, such as Elizabeth A. Almasi et al., in “What Are the Public Health Effects of Direct-to-Consumer Drug Advertising?” (PLoS Medicine, March 28, 2006), contend that the information in these advertisements is frequently biased and misleading and that direct-to-consumer advertising increases prescribing costs and has not demonstrated any evidence of health benefits. They also worry that the emphasis on advertisements for new drugs overshadows other vital public health messages about diet, exercise, addictions, social involvement, equity, pollution, climate change, and appropriate use of older drugs.

Still, many mental health professionals favor direct-to-consumer advertising, crediting it with informing consumers that there is effective treatment for potentially debilitating mental disorders and helping them to overcome reluctance to seek needed treatment. Anne McIlroy reports in “High Anxiety” (Globe and Mail, September 20, 2003) that Jaques Bradwejn, the chief of psychiatry at the Royal Ottawa Hospital, believes anxiety disorders remain underdiagnosed and claims he has never had a patient ask to be treated for an anxiety disorder who was not suffering from one.

According to Joel S. Weissman et al., in “Physicians Report on Patient Encounters Involving Direct-to-Consumer Advertising” (Health Affairs, April 28, 2004), a survey of 643 U.S. physicians, many physicians opine that pharmaceutical ads are a mixed blessing, simultaneously enhancing patient-physician communication and prompting patients to seek unnecessary treatment. Four-fifths of the survey respondents said direct-to-consumer advertising not only encourages patients to seek unnecessary treatments but also fails to fully convey the risks and potential adverse effects of drug treatment. Nearly three-quarters of the physicians surveyed said they thought direct-to-consumer ads inform people about medicines that might help them, and two-thirds of the doctors said ads stimulate dialogue. The physicians estimated that one-quarter of the ad-initiated patient-physician conversations lead to diagnoses of treatable problems that might have gone undetected.

Public Opinion About Space Exploration

We will build new ships to carry man forward into the universe, to gain a new foothold on the moon, and to prepare for new journeys to worlds beyond our own.

–President George W. Bush, January 14, 2004

How will a country at war and in deficit pay for such things?

–Harvard Independent Newsmagazine, February 12, 2004

Humans seem to have an inherent desire to surmount great obstacles and push into new frontiers. There have always been brave people willing to risk their lives on bold and dangerous journeys into uncharted territory. They have climbed Mount Everest, traversed wild jungles, crossed barren deserts, and sailed stormy seas. Successful explorers become popular heroes. Their achievements thrill and delight people who do not have the ability, resources, or courage to go themselves.

The U.S. space program taps into this spirit of adventure. Astronauts became the heroic explorers of the twentieth century. They opened new frontiers and set foot on the Moon. These successes were achieved at a high price. They cost the country human lives and billions of dollars that some critics say could have been spent feeding the poor, healing the sick, and housing the homeless. Was it worth it?

Space exploration is appealing on a psychological level. It is awesome, daring, and closely associated with American can-do optimism and patriotic pride. A robust space program also showcases and strengthens U.S. capabilities in science, engineering, and technology. These are powerful motivations to keep venturing out into space.

However, the United States faces a number of expensive problems: incurable diseases, crime, poverty, pollution, unemployment, and war. People concerned with poor social conditions resent the billions spent on exploring outer space. Within the scientific community many respected researchers would rather see scarce funds devoted to Earth-related research than space science. There are promising scientific and medical frontiers on this planet that still need to be explored.

In a democratic society the public gets to weigh the relative costs and benefits of national goals and decide which ones to pursue. Public opinion polls show that most Americans have an uneasy devotion to the nation’s space travel agenda. They love the idea, but hate paying the bill. Sometimes they wonder if money spent on space exploration might be better spent on Earth-based issues. It is a debate that has raged since the earliest days of space exploration and probably always will be a primary issue in space exploration.

IS SPACE EXPLORATION IMPORTANT TO SOCIETY?

In November 1999, as the century came to a close, Frank Newport, David W. Moore, and Lydia Saad of the Gallup Organization asked people to rank eighteen specific events of the twentieth century in order of importance and reported the results in The Most Important Events of the Century from the Viewpoint of the People (December 6, 1999, http://www.gallup.com/poll/3427/Most-Important-Events-Century-From-Viewpoint-People.aspx). Landing a man on the Moon ranked seventh in importance. (See Table 9.1.) This put it behind major events associated with World War I (1914–1918), World War II (1939–1945), and important social milestones that granted rights to women and minorities. Fifty percent of those asked believed that landing a man on the Moon was the most important event of the century.

A second space-travel milestone also made the top eighteen list. Ranked fourteenth was the launching of the Russian Sputnik satellites during the 1950s. (See Table 9.1.) Twenty-five percent of those asked rated this as one of the most important events of the century. Charles A. Lindbergh

Jr.’s (1902-1974) historic flight across the Atlantic in 1927 also made the list, coming in at number thirteen.

In Space: To Infinity and Beyond on a Budget (August 17, 2004, http://www.gallup.com/poll/12727/Space-Infinity-Beyond-Budget.aspx), Darren K. Carlson of the Gallup Organization reports on a poll conducted between June and July 2004, which found that a majority of people were interested in the space program: 24% were “very interested” and another 43% were “somewhat interested.” (See Figure 9.1.) Only 11% reported they were “not at all interested.” More men (34%) than women (15%) indicated they were “very interested” in the space program. Interest was also higher among respondents aged fifty to sixty-four years old. When provided with five possible reasons for space exploration, 29% chose that it is “human nature to explore.” (See Figure 9.2.) Another 21% believed that space exploration is primarily performed to help maintain the nation’s status as an international leader in space. Nearly as many respondents (18%) thought the main reason is to provide benefits on Earth. Small percentages believed that Americans explore space to ensure national security (12%) or inspire people and motivate children (10%).

SHOULD SPACE TRAVEL BE A NATIONAL PRIORITY?

History shows that space travel was a national priority during the 1960s. President John F. Kennedy (1917–

1963) and Vice President Lyndon B. Johnson (1908–1973) were convinced that putting a man on the Moon was vital to U.S. political interests during the cold war. They convinced Congress to devote billions of dollars to the effort. At the time, the public was not enthusiastic about the idea. According to the Gallup Organization, most polls it conducted during the 1960s showed that less than 50% of Americans considered the endeavor worth the cost.

In Where Do We Go from Here: Chaos or Community? (1967), the civil rights leader Martin Luther King Jr. (1929-1968) said, “Without denying the value of scientific endeavor, there is a striking absurdity in committing billions to reach the moon where no people live, while only a fraction of that amount is appropriated to service the densely populated slums.” King’s sentiment sums up a moral question that has plagued the space program since its inception. Is it right for a nation to spend its money on space travel while there are people suffering on Earth?

The National Aeronautics and Space Administration (NASA) would argue that its budget comprises only a tiny fraction of the nation’s total spending. Figure 2.1 in Chapter 2 shows that in 2007 NASA received less than 1% of the federal budget and has been near this level since the end of the Apollo program in 1972. Nevertheless, recent polls indicate that Americans do not favor

increasing NASA’s budget. Gallup polling conducted from 1984 to 2006 regarding government spending on NASA sheds some light on Americans’ opinions. In June 2006 nearly half (48%) of those asked said that NASA’s budget should remain at its present level. (See Table 9.2.) Another 28% believed the agency’s budget should be reduced. Only 17% thought NASA’s budget should be increased. Gallup has been asking this same poll question since 1984. The percentage of people wanting to increase NASA’s budget has varied between 9% and 27% over time. Consistently, the largest group of people (37% to 51%) advocated maintaining the agency’s budget at its existing level.

Two different polls conducted in 2006 and 2007 indicate that the American public assigns little value to government spending on the space program. The University of Chicago’s National Opinion Research Center conducts the annual poll General Social Survey (GSS). The GSS covers a variety of subjects, including the nation’s spending priorities. The 2006 GSS asked respondents to indicate their level of support for twenty-two national spending priorities. The list included specific programs, such as welfare and social security, and more generic priorities, such as environment, crime, health, and space exploration. The results of the polling were reported by Tom W. Smith in “Trends in National Spending Priorities, 1973-2006” (January 10, 2007, http://www.norc.org/). Smith notes that in 2006 space exploration ranked twenty-first out of the twenty-two categories. Only for-

eign aid received a lower spending priority. In “Closing the Budget Deficit: U.S. Adults Strongly Resist Raising Any Taxes Except ‘Sin Taxes’ or Cutting Major Programs” (April 10, 2007, http://www.harrisinteractive.com/harris_poll/index.asp?PID=746), HarrisInteractive reports on a March 2007 poll that it conducted. People were asked to choose two programs out of a list of eleven national programs that they would favor cutting if federal spending had to be cut to reduce the federal deficit. The space program received the largest percentage of votes with 51%. This compares to 28% favoring welfare spending cuts, 28% for defense spending cuts, 24% for cuts in farm subsidies, and 16% for cuts in environmental spending.

SHOULD SPACE TRAVEL BE A SCIENCE PRIORITY?

In the 1960s television show Star Trek, space was called “the final frontier.” While this may be true from a philosophical viewpoint, it does not apply as well to the realm of science. Geneticists, oceanographers, geologists, and biologists maintain that there are still many scientific and medical frontiers to be explored on Earth.

Since 1998 the marine biologist Sylvia Earle (1935-) has been an explorer-in-residence at the National Geographic Society. That same year Time magazine named her a “hero for the planet.” In “Mars Critics Wonder If Billions Aren’t Better Spent Elsewhere” (Associated Press, March 8, 2004), Joseph B. Verrengia asks Earle about NASA’s discovery that water once existed on Mars. Earle states that “the resources going into the investigation of our own planet and its oceans are trivial compared to investment looking for water elsewhere in the universe… Real oceans need scientific attention more than the dried-up remnants on Mars.” She states that she does not want to cut funding for space science, but notes that “we have better maps of Mars than our own ocean floor. That’s just not right.”

Verrengia notes that Amitai Etzioni (1929–), a sociologist at George Washington University and a long-time critic of the U.S. space program, believes that the scientific community should focus more attention on Earth’s oceans because of their potential to yield new energy and food sources or medical breakthroughs that would benefit humanity. Etzioni also criticizes the money spent looking for water on Mars and asks, “So what if there is water up there? What difference does it make to anyone’s life? Will it grow any more food? Cure a disease? This doesn’t even broaden our horizons.” Etzioni believes that any crewed space missions should be financed by private investors, not with taxpayers’ dollars.

CREWED VERSUS ROBOTIC MISSIONS?

In 1964 Etzioni published The Moon-Doggie, which questions the scientific value of putting astronauts on the Moon and criticizes NASA for favoring expensive manned missions over cheaper, more productive robotic missions. This complaint has been a common one in the scientific community since the 1960s.

It is extremely expensive to send explorers into space, particularly human ones. Robotic spacecraft can accomplish more for less money, but they lack the glam-our of human explorers. Machines do not give television interviews from space or get ticker tape parades when they return. Astronauts do. Human explorers inspire young people to be astronauts and encourage voters and politicians to keep funding space travel. NASA knows that machines simply do not reap the same public relations benefits as human astronauts.

James Van Allen (1914-2006) and Robert L. Park have been highly critical of the plan presented by President George W. Bush (1946–) in 2004 to send astronauts to the Moon and Mars. Van Allen, an astrophysicist, is credited with discovering the Van Allen radiation belts around Earth. Park is a physics professor at the University of Maryland.

In “Bush’s New Space Program Criticized over Costs & Nuclear Fears” (January 15, 2004, http://www.democracynow.org/2004/1/15/bushs_new_space_program_criticized_over), Allen explains his opinion of human spaceflight: “I’m a critic of it in terms of the yield of either scientific results or any results from the human space flight program that’s been very meager.” In “The Virtual Astronaut” (New Atlantis, no. 4, winter 2004), Park also advocates robotic space travel over astronauts. He speculates that Christopher Columbus (1451–1506) would have sent out a drone (an unmanned vessel) to search for the new world, if the technology had been available. Park maintains that “the great adventure worthy of the twenty-first century is to explore where no human can ever set foot.”

The Hubble Space Telescope Controversy

Astronomers and physicists fought throughout the 1970s and 1980s for large, sophisticated observatories to be put in space to gather data about solar and galactic phenomena. Time and again funding for their programs was slashed, because NASA needed more money for the Space Shuttle Program (SSP) and the International Space Station (ISS). However, NASA’s Great Observatories did eventually make it into orbit.

Even though these observatories are smaller and weaker than what scientists originally wanted, they are considered some of space science’s greatest triumphs. The Hubble Space Telescope (HST) alone has captured thousands of images of celestial objects and greatly advanced human understanding about the origins and workings of the universe.

However, in 2004 NASA announced it would let the HST fall out of orbit before the end of its useful life. The observatory needed an altitude boost that only a space shuttle mission could give it, but NASA was reluctant to risk astronaut lives for such a purpose. Since the 2003 space shuttle Columbia disaster the agency has shown heightened concern about shuttle safety issues. Also, NASA has switched its focus to President George W. Bush’s new space travel mandate. This plan calls for devoting shuttle missions to finishing the ISS as soon as possible and then retiring the shuttle fleet in 2010. Bush wants NASA to concentrate on developing new spacecraft for long-distance flights to the Moon and Mars.

The HST decision met with fierce disapproval from many astronomers and space scientists who were once again disappointed to see human missions given priority over robotic ones. In 2006 NASA relented to pressure and agreed to reinstate the HST servicing mission. However, as of March 2008 this mission had not taken place.

AMERICANS RATE NASA’S PERFORMANCE

In June 2006 Gallup asked Americans to rate NASA’s performance. Seventeen percent of those asked rated its performance as “excellent” and 40% said it was “good.” (See Table 9.3.) Nearly a third (30%) of those asked said that NASA’s performance was “only fair,” and 7% gave the agency a “poor” rating.

Gallup has asked this same question about NASA’s performance since July 1990. The highest approval (76%) was in November 1998, when 26% said it was “excellent” and 50% said it was “good.” (See Table 9.3.) This was shortly after John Glenn’s (1921–) flight aboard the space shuttle Discovery. The next three polls saw NASA’s rating slip dramatically, reaching 50% in September 2003, when 12% said it was “excellent” and 38% said it was “good.” This was a few months after the Columbia shuttle disaster. NASA’s image has improved slightly since then.

Mary Lynne Dittmar reports in “Engaging the 18-25 Generation: Educational Outreach, Interactive Technologies, and Space” (2006, http://www.dittmar-associates.com/Publications/Engaging%20the%2018-25%20Generation %20Update~web.pdf) that in 2006 young people aged eighteen to twenty-five were questioned about the relevance of NASA to their life. A majority (51%) of young adults deemed NASA “irrelevant or very irrelevant.” Less than a third (32%) of the respondents said NASA was “relevant or very relevant” to their life. Another 17% had neutral opinions on the subject. When pressed for more detail about their negative viewpoints, 39% of the young people agreed with the statement “nothing useful has come out of NASA.” A large majority (72%) felt that government spending on NASA should be diverted to other priorities, particularly employment and defense programs.

Focus on the SSP

NASA’s most horrific failures occurred in 1986 and 2003, when space shuttles were lost in accidents. Seven astronauts died each time. In Americans Want Space Shuttle Program to Go On (February 3, 2003, http://www.gallup.com/poll/7708/Americans-Want-Space-Shuttle-Program.aspx), Frank Newport of the Gallup Organization notes that days after each disaster the public’s confidence in NASA’s ability to avoid similar accidents in the future was assessed. Following the loss of Challenger in 1986, 79% (38% had “a great deal” and 41% had a “fair amount”) of respondents expressed confidence that another shuttle loss could be avoided. When the Columbia shuttle was destroyed during reentry in 2003, this confidence proved to be misplaced. Interestingly enough, the public’s confidence level actually increased to 82% (38% had “a great deal” and 44% had a “fair amount”) after the second accident. These polls suggest that Americans remain optimistic about NASA’s competency in regards to the SSP.

Jeffrey M. Jones of the Gallup Organization notes in Support for Space Program Funding High by Historical Standards (August 19, 2003, http://www.gallup.com/poll/9082/Support-Space-Program-Funding-High-Historical-Standards.aspx) that in August 2003 Gallup surveyed 1,003 adults regarding their expectations about the risks associated with the SSP. Most respondents (43%) believed that a fatal crash every one hundred missions was an “acceptable price to pay” to advance U.S. space exploration goals. In reality, the shuttle program has experienced two crashes during 120 missions. This is an average of one fatal crash every sixty missions.

Seventeen percent of those asked expressed the belief that a successful SSP should experience no fatal crashes at all. However, the vast majority (75%) accepted the loss of human lives as a regrettable, but expected, price to pay to advance the nation’s space program.

Recent polls show support may be waning for the SSP. For example, in Americans Express Confidence in NASA (July 11, 2005, http://www.gallup.com/poll/17224/Americans-Express-Confidence-NASA.aspx), Jeffrey M. Jones indicates that Gallup polled adults about their opinions on shuttle missions shortly after the Challenger and Columbia space shuttle disasters. More than 80% of the people asked in each poll thought the SSP should continue. The same question was asked in June 2005 (before the first return-to-flight mission). Nearly three-quarters (74%) of those asked said the SSP should continue, whereas 21% said the program should not continue.

In “Public up in Air on Shuttle” (CBS News, August 3, 2005), a poll that was conducted in August 2005 during the shuttle return-to-flight mission, support for the SSP was down compared to years past. The poll indicates that 59% of respondents thought the SSP was worth continuing. This value was down from 75% in 2003 and 72% in 1999.

A June 2006 poll conducted by Gallup found Americans evenly split on the financial worthiness of the SSP.

Forty-eight percent of those asked felt the program had been worth the cost, whereas an equal portion thought the money would have been better spent elsewhere. (See Figure 9.3.)

PUBLIC OPINION ABOUT FUTURE SPACE PROGRAMS TO THE MOON AND MARS

In January 2004 President Bush proposed a new agenda for the nation’s space program called the Vision for Space Exploration, which focuses on sending astronauts to the Moon and Mars. During the summer of 2004 Gallup polled Americans about their level of support for this new space exploration plan. The pollsters described the plan in general terms and noted that it was to be assumed that NASA’s budget would not exceed 1% of the total federal budget. A majority (26% “strongly support” and 42% “support”) of those asked supported the plan. (See Figure 9.4.) Another quarter (15% “oppose” and 9% “strongly oppose”) were opposed to the plan, and 6% expressed a neutral opinion.

However, a Gallup poll conducted later indicated that Americans provide somewhat different viewpoints when this question is phrased in a different manner. In Americans Express Confidence in NASA, Jones notes that a June 2005 poll asked people if they favored or opposed the United States “setting aside money” for a project to land an astronaut on Mars. He notes that 58% of those asked opposed the idea, whereas 40% were in favor of it.

The NASA administrator Michael D. Griffin (1949–) publicly criticized the wording of this poll question. In an interview televised on Meet the Press (July 31, 2005, http://www.nasa.gov/pdf/123993main_meet_the_press_trans.pdf), Griffin said the question should have been phrased to ask Americans how best to spend the budget that NASA was going to be allocated in future years. Griffin believed that, given a choice between shuttle missions in low Earth orbit and more adventuresome plans, Americans will choose the bolder undertaking.

Dittmar reports that in 2004, 55% of young people supported the Vision for Space Exploration, whereas 30% opposed it. Overall, young men were far more supportive than young women. By 2006 support for the plan had dropped among young people, with only 45% favoring the plan and 40% opposing it. Dittmar notes that when asked about specific measures within the plan, the respond-

ents showed greater enthusiasm for a crewed Moon mission (34% support) than for a crewed Mars mission (18% support). A large majority (77%) was opposed to sending astronauts to Mars because of its irrelevance, high costs, or other concerns. Young people were much more enthused about the prospects of commercial space travel and opportunities for space tourism offered by private companies. Sixty-one percent of the respondents said these endeavors were relevant to their life.

In Would Today’s Teens Take a Space Odyssey? (April 20, 2004, http://www.gallup.com/poll/11410/Would-Todays-Teens-Take-Space-Odyssey.aspx), Heather Mason Kiefer of the Gallup Organization reports on a poll that asked teenagers aged thirteen to seventeen about their desires to visit the Moon and Mars. A majority (59%) of teens indicated they would like to go to the Moon someday. (See Figure 9.5.) A smaller percentage (48%) wanted to be the first person to go to Mars. Mason Kiefer notes that responses varied widely by gender, with 74% of boys and only 43% of girls indicating a desire to go to the Moon. Likewise, 64% of boys and only 31% of girls wanted to be the first astronaut on Mars.

PRACTICAL BENEFITS OF SPACE TRAVEL

Even though it is widely acknowledged that space travel has psychological and scientific benefits to society, it is more difficult to point to everyday products that have directly resulted from the nation’s space program. Certainly satellites have brought about great changes in telecommunications, navigation, military operations, and weather prediction. All of these developments do affect American lives. The technologies associated with space exploration have advanced the fields of robotics, computer programming, and cryogenics (the physics of extremely cold temperatures). In addition, improvements based on NASA technologies have been incorporated into diverse products such as memory foam mattresses, medical imaging devices, eyeglass lenses, golf balls, baby food, pacemakers, and life rafts.

One of the mandates of the 1958 National Aeronautics and Space Administration Act is that the agency (and its contractors) must publicize any new developments significant to commercial industry. NASA accomplishes this through four publications: the newsletter Technology Innovation; a monthly magazine for engineers, managers, and scientists called NASA Tech Briefs that briefly describes new technologies; Technical Support Packages, which describe in detail the technologies presented in NASA Tech Briefs; and Spinoff, an annual publication describing successfully commercialized NASA technology.

In NASA Hits: Rewards from Space—How NASA Improves Our Quality of Life (2004, http://www.nasa.gov/extenalflash/hits2_flash/index_noaccess.html), NASA describes many practical benefits associated with its work in space flight, space science, Earth science, and aeronautical research and development, including:

• Communications satellite technology
• Medical monitoring systems used in intensive care units
• The Hazard Analysis and Critical Control Point system for ensuring food safety
• The NASTRAN software system for computerized design
• Space-based beacon locators used in satellite-based search-and-rescue systems
• Use of thin grooves in concrete airport runways and highways to improve drainage and reduce hydroplaning
• Advances in hydroponics (growing crops using water rather than soil to support plants)
• Improved hurricane forecasting and wildfire tracking using Earth-observing satellites
• Developments in microelectromechanical systems (extremely small devices and sensors about the diameter of a human hair)
• Combustion research that has improved the performance of jet engines
• Suspension techniques used by animal researchers
• A new light source now used to improve chemotherapy treatment for cancer patients
• Needle-based biopsies used in breast cancer diagnosis
• Bioreactors (devices used to turn cell cultures into functional tissue)
• Lifeshears (a hand-held shearing tool used by rescue workers to free people trapped in cars or underneath rubble)

NASA also discusses patents and Nobel prizes associated with NASA-funded research and development.

In 1988 NASA and the Space Foundation, a private organization, established the Space Technology Hall of Fame. Each year a handful of space-based technologies are selected for induction into the Hall of Fame. Inductees are honored at an annual conference held in Colorado Springs, Colorado, called the National Space Symposium. Previous Hall of Fame winners familiar to consumers include satellite radio technology and the DirecTV satellite system.

Douglas A. Comstock and Daniel Lockney of NASA trace in “NASA’s Legacy of Technology Transfer and Prospects for Future Benefits” (2007, http://www.ip.nasa.gov/documents/aiaa_space_2007.pdf) the development of NASA’s practices for sharing technology and describe significant commercial products that have resulted. These include Teflon-coated fiberglass, which was used in astronaut spacesuits in the 1970s. The product is now used extensively in roofing materials. Another spacesuit innovation—a liquid cooling system—is reportedly “one of the most widely used spinoffs in NASA history” with applications in a variety of medical devices. Another major NASA-developed technology in widespread use evolved from the light-weight breathing apparatuses created for astronauts. This technology has played a crucial role in the development of breathing apparatuses for fire-fighters. During the 1990s NASA techniques for the robotic servicing of spacecraft were adapted into robotic devices that perform laparoscopic surgery. In 2002 NASA technology led to the commercial development of innovative parachute systems capable of carrying small aircraft safely to the ground in the event of catastrophic engine failure while in the air.

The Public Speaks Out

Polls were conducted on the tenth, twenty-fifth, and thirtieth anniversaries of the Apollo 11 Moon landing to quiz the public regarding the benefits of the U.S. space program.

In Landing a Man on the Moon: The Public’s View (July 20, 1999, http://www.gallup.com/poll/3712/Landing-Man-Moon-Publics-View.aspx), Frank Newport explains that in each poll the participants were asked whether they

believe the space program has benefited the country enough to justify its costs. Newport notes that a 1979 poll conducted by NBC News and the Associated Press found that only 41% of respondents considered the benefits worth the costs. A majority (53%) thought the expense was not worth what was accomplished. In a 1994 Gallup poll Americans were evenly split on the issue, with 47% taking each side. By 1999 the space program had earned a bit more respect. Newport indicates that 55% of those asked believed the space program’s benefits justified its cost, whereas 40% did not.

In 2004 Gallup asked Americans whether they agreed or disagreed with the statement: “The quality of our daily lives has benefited from the knowledge and technology that have come from our nation’s space program.” (See Figure 9.6.) Sixty-eight percent of those asked agreed with this statement, whereas 16% disagreed. Another 16% were neutral on the subject.

NASA WOOS THE AMERICAN PUBLIC

NASA employs a number of public relations tools designed to interest and excite people about space travel. Since its inception the agency has recognized that public support is crucial to fostering a successful long-term space program.

Television

Throughout the space age NASA has used television as a publicity tool to try to spark greater interest in the space program. Television turned out to be one of the greatest public relations tools of the Apollo program. In 1968 the Apollo 7 astronauts conducted the first live television interview from space. All the remaining Apollo flights carried television cameras. The worldwide television audience for the Apollo 11 Moon landing was estimated at half a billion people.

Newport notes in Landing a Man on the Moon that in July 1999 Americans were polled about their memories of the first manned lunar landing by Apollo 11. The survey found that 76% of people aged thirty-five and over claimed to have watched the event on television as it happened.

NASA’s Web Site

NASA’s Web site (http://www.nasa.gov/) includes thousands of mission photographs and millions of documents related to the nation’s space endeavors. The Web site provides detailed information about NASA facilities, programs, and missions. There are a variety of multimedia features, including interactive displays, video and audio downloads, and spectacular images of Earth and space captured by NASA spacecraft. Furthermore, it provides access to historical archives that include documentation dating back to the earliest days of space travel.

According to NASA, the Web site is visited millions of times each day. The number of “hits” increases dramatically during highly publicized missions. For example, NASA reports in the press release “NASA Portal Makes a Little Bit of Mars Available to Everyone on Earth” (February 19, 2004, http://www.nasa.gov/home/hqnews/2004/feb/HQ_04064_portal.html) that it received over 6.5 billion hits between January 4 and February 19, 2004. This period coincides with the highly successful landings of the Mars Exploration rovers on Mars.

SIGHTING OPPORTUNITIES.

One of the ways that NASA tries to engage public interest in space travel is by posting sighting opportunities for its satellites, particularly the ISS and any ongoing shuttle missions. The NASA Web site instructs people how and where to look in the nighttime sky to see the spacecraft as it is passing overhead. Figure 9.7 shows a set of instructions for viewing the ISS at a particular location, assuming that skies are clear enough.

This listing identifies the exact date and time at which the ISS should become visible to observers on the ground and how long it will remain visible. It also gives information about the station’s location in the sky based on direction (north, south, east, or west) and angle of elevation compared to the horizon. A spacecraft flying directly overhead would be at 90-degree maximum elevation.

In the example shown, the ISS will appear in the west-southwest direction approximately 10 degrees above the horizon. (See Figure 9.7.) It will then climb o a maximum elevation of 66 degrees above the horizon and travel out of sight heading toward the northeast. It hould disappear from view about 31 degrees above the horizon.

In Sighting Opportunities (April 17, 2003, http://spaceflight.nasa.gov/realdata/sightings/help.html), NASA explains that a spacecraft looks like “a steady white pinpoint of light moving slowly across the sky.” Viewers are urged to observe spacecraft with the naked eye or through binoculars. The speed at which spacecraft move makes telescope viewing impractical.

NASA’s Web site provides links to sighting data for hundreds of cities around the world. People at locations not listed can use an applet (a small application program) called SkyWatch to enter their latitude and longitude and receive viewing information for numerous orbiting satellites.

NTV

NASA operates its own television network called NASA TV (NTV). NTV broadcasts via satellite and cable and is streamed over the Internet. It features live coverage of NASA activities and missions, video of events for the news media, and educational programming for teachers and students.

The show NASA Education Hour plays at 8:00 a.m. eastern standard time (EST) every weekday morning and is rebroadcast at regular intervals throughout the day and night. Hour-long coverage of the ISS mission is presented live at 11 a.m. EST daily.

Ham Radio

Ham radios vary in signal strength and capability. The strongest stations can reach operators on the other side of the world by bouncing signals off the upper atmosphere or using satellites.

In November 1983 the astronaut Owen K. Garriott (1930–) carried a small ham radio with him aboard the space shuttle Columbia. During his spare time he used the radio to contact fellow ham operators around the world. This was the first of more than twenty-four shuttle missions that carried ham radio equipment so astronauts could communicate with their families and other ham operators worldwide and perform interviews for school-children. The program was called the Space Amateur Radio Experiment (SAREX). The Soviet space agency operated a similar ham radio program for cosmonauts aboard the Mir space station.

In September 2000 the crew of the space shuttle Atlantis carried a ham radio to the ISS for use by Expedition crews. The SAREX program was given the new name of Amateur Radio on the International Space Station (ARISS). Under the ARISS program, ISS crewmembers can communicate with ham radio operators all over the world.

Educational Programs

NASA’s strategic plan says that one of the agency’s primary goals is to “inspire the next generation of explorers.” To accomplish this goal, NASA operates an extensive student education program designed to encourage young people to pursue studies in science, mathematics, technology, and engineering and careers in aeronautics and space science. NASA reports in National Aeronautics and Space Administration: FY 2008 Budget Estimates (February 5, 2007, http://www.nasa.gov/pdf/168653main_NASA_FY08_Budget_Summary.pdf) that the program’s proposed budget for 2008 was $153.7 million. NASA prides itself on its educational programs and the partnerships it establishes with schools, museums, libraries, and science centers around the nation to reach as many young people as possible.

NASA EXPLORER SCHOOLS.

The NASA Explorer School program was started in 2003 for educators teaching grades four through nine. Each year NASA selects fifty schools for the program and enters into a three-year partnership agreement with them. The schools are eligible for grants and summer training courses for science and mathematics teachers. The courses are provided at NASA centers around the country and present new teaching resources and tools to better educate students.

TEACHER RESOURCE CENTERS.

Teacher Resource Centers (TRCs) are offices maintained at NASA facilities around the country. The TRCs serve as libraries that loan educational materials including lesson plans, audio and video tapes, slides, and miscellaneous print publications to teachers.

ASTRONAUT INTERVIEWS VIA AMATEUR RADIO.

One of the most innovative ways that students can interact with astronauts in orbit is via ARISS, which is sponsored by NASA in conjunction with the American Radio Relay League and the Radio Amateur Satellite Corporation. Volunteers set up ham radio stations at schools so students can interview ISS crewmembers.

CURRICULUM DEVELOPMENT.

In 2004 NASA announced a new partnership with Pearson Scott Foresman (PSF), a leading publisher of educational products for elementary schools. The PSF will draw on publications in the NASA archives to create new science textbooks and other learning materials for the classroom. According to NASA, in “A Learning Adventure” (March 17, 2006, http://www.nasa.gov/audience/foreducators/informal/features/F_Zathura_Learning_Adventure.html), the goal of the program is to “spark student imagination, encourage interest in space exploration, and enhance elementary science curricula.”

Art Program

In 1962 the NASA administrator James Edwin Webb (1906-1992) established the NASA Art Program to encourage and collect works of art about aeronautics and space. As of 2008, the NASA art collection included over eight hundred works of art in a variety of media, including paintings, drawings, poems, and songs. NASA has donated more than two thousand of its art works (including a number by Norman Rockwell [1894-1978]) to the National Air and Space Museum in Washington, D.C. Other famous artists who have participated in the program include Annie Leibovitz (1949–), William Wegman (1942–), Andy Warhol (1927-1987), and Jamie Wyeth (1946–).

Over two hundred artists have provided art works to the program. Many of the pieces are displayed at art galleries and museums around the country. NASA centers, particularly the Kennedy Space Center in Florida, also display the art works in their visitor areas.

Astronauts

Astronauts have always been NASA’s greatest public relations agents. The early astronauts became instant heroes during the 1950s and 1960s. They were flooded with fan mail and held up by the media as sterling role models of what was great and daring about the United States. However, after the first Moon landing in 1969, public interest in the space program began to fade. The astronauts of later decades were still admired and respected, but they were not treated to the same level of hero worship as their predecessors.

During the early 1980s NASA decided to include a new type of astronaut on space shuttle flights to catch the public’s attention. The agency began the Educator in Space program. NASA hoped that sending a teacher into space would excite the nation’s schoolchildren and foster goodwill toward the space program. The schoolteacher Christa McAuliffe (1948-1986) was selected and trained for a mission aboard the space shuttle Challenger. She was killed with the other six crew members in 1986 when the shuttle exploded soon after liftoff.

NASA’s public relations experiment turned into a nightmare. The catastrophe brought harsh criticism of the agency. The shuttle program was found to have serious management and safety problems. The loss seemed even more poignant to the public because a teacher, an everyday kind of person, had been one of the victims. NASA decided that space travel was not routine enough to risk the lives of private citizens as goodwill ambassadors.

In 1998 NASA relented somewhat and allowed Glenn, a former Mercury astronaut, to ride aboard the space shuttle Discovery. At the time Glenn was a seventy-seven-year-old senator from Ohio. NASA said the mission would reveal new knowledge about the effects of weightlessness and bone loss in older people. Critics complained that it was nothing more than a publicity stunt. Whatever the motivation, the event did greatly improve NASA’s image. The public was entranced by the idea of an old hero traveling back into space.

Tourist Attractions

Many NASA facilities have become popular tourist attractions. This is particularly true for centers associated with the Apollo program and the SSP. Most NASA facilities operate their own visitor centers for which admission is free. The Johnson Space Center (Houston, Texas), the Kennedy Space Center (Cape Canaveral, Florida), and the Marshall Space Flight Center (Huntsville, Alabama) have privately operated tourist centers that charge a fee for admittance.

Contests and Gimmicks

One relatively new way that NASA engages the public in space travel is by holding spacecraft-naming contests. During the 1990s NASA held contests that chose the names for the Mars Pathfinder mission’s Sojourner rover and the Magellan spacecraft.

In 1998 the agency asked people to suggest names for an x-ray telescope to be launched as part of the Great Observatories Program. Each entry had to be supported by a short essay justifying why the name was appropriate. More than six thousand people entered the contest, representing every state in the country and sixty-one other nations. Two winning essays were selected. Both suggested the name Chandra, in honor of the Indian-American scientist Subrahmanyan Chandrasekhar (1910-1995). The winners were a high-school student from Laclede, Idaho, and a high-school teacher from Camarillo, California.

In 2001 a similar contest was held to name an infrared telescope intended for the Great Observatories Program. Over seven thousand entries were received from people around the world. NASA chose the name Spitzer in honor of the American physicist Lyman Spitzer Jr. (1914-1997). The winning essay came from a Canadian astronomy enthusiast.

In 2002 NASA held a contest for children to name the planned Mars rover craft. The contest was held in partnership with the Planetary Society and the Lego Company. A nine-year-old girl from Scottsdale, Arizona, wrote the winning essay, which suggested the names Spirit and Opportunity. Hers was one of nearly ten thousand entries in the contest.

Another public relations device used by NASA is to ask people to submit their names for inclusion on CDs or DVDs carried by spacecraft. Numerous NASA missions conducted since the 1990s have included electronic disks carrying the names of millions of people. In 1999 the Mars Polar Lander carried a CD containing the names of one million schoolchildren from around the world. The spacecraft was lost before it landed on Mars.

The highly successful Mars Explorer rovers Spirit and Opportunity carried mini-DVDs including the names of more than 3.5 million people. A DVD library has been compiled to fly aboard the Phoenix Mars Lander, which was scheduled for launch in 2008. The DVD includes a list of individual names, messages from space enthusiasts, and other works, including poems and stories.

PUBLIC KNOWLEDGE ABOUT SPACE TRAVEL

In Landing a Man on the Moon, Newport states that respondents were asked about the number of astronauts who have actually walked on the Moon. Only 5% of those asked correctly answered that twelve different men have walked on the Moon. (See Figure 9.8.) A vast majority (77%) of the respondents guessed too low. Another 11% guessed too high, and 7% had no opinion.

According to Newport, only 50% of the people asked correctly named Neil A. Armstrong (1930–) as the first person to walk on the Moon. (See Table 9.4.) Newport notes that young people aged eighteen to twenty-nine were the most likely to give the correct answer, despite the fact that the event occurred before they were born. Other astronauts receiving votes included Glenn, who received 13%; Alan B. Shepard Jr. (1923-1998), 4%; and Edwin E. (Buzz)

Aldrin Jr. (1930–), 2%. More than a quarter (28%) of the people asked could not come up with an answer.

Newport states that Gallup asked this same question back in July 1989, on the twentieth anniversary of the first human lunar landing. At that time only 39% of respondents gave the correct answer. The other 61% either did not know the answer or gave an incorrect answer.

Jeffrey M. Jones reports in Support for Space Program Funding High by Historical Standards (August 19, 2003, http://www.gallup.com/poll/9082/Support-Space-Program-Funding-High-Historical-Standards.aspx) that in August 2003, 534 adults were asked whether there were any U.S. astronauts in space at that time or not. Exactly half of the people said there were no U.S. astronauts in space at that time. Another 35% believed that U.S. astronauts were in space, and 15% had no opinion or did not know. In reality, there was one U.S. astronaut in space at the time: Edward Tsang Lu (1963–) was aboard the ISS. Since 2000 the ISS has been continually inhabited by at least one American astronaut.

According to Dittmar, in 2006 less than a third (32%) of respondents aged eighteen to twenty-five expressed “meaningful awareness” about the ISS. A much higher percentage (61%) indicated awareness of the Mars rover projects. Only 28% of the young people correctly answered “basic” questions about the ISS regarding where in space the station orbits and which countries are partnered with the United States on

the project. Amazingly, 32% of the respondents “were completely unaware that there is an ISS.”

OPINIONS ABOUT SPACE TOPICS EXTRATERRESTRIAL LIFE

In Life on Mars? (February 27, 2001, http://www.gallup.com/poll/1957/Life-Mars.aspx), Darren K. Carlson explains that Americans were surveyed in 1996 and 1999 about the possible existence of extraterrestrial (not Earth-related) life. Each time a strong majority of poll participants expressed the opinion that some form of life does exist on other planets in the universe. Belief in extraterrestrial life declined somewhat from 72% in 1996 to 61% in 1999.

Carlson notes that according to several Gallup polls conducted between 1973 and 1999, Americans are less convinced in the possibility of extraterrestrial human life. Only 38% to 51% of poll participants agreed that there could be “people somewhat like ourselves” living else-where in the universe. The latest poll, taken in 1999, reflects the greatest skepticism for the idea of extraterrestrial people. For the first time, a majority (54%) of those asked did not believe that such people exist.

According to Linda Lyons of the Gallup Organization, in Paranormal Beliefs Come (Super)Naturally to Some (November 1, 2005, http://www.gallup.com/poll/19558/PParanormal-Beliefs-Come-SuperNaturally-Some.aspx), in the summer of 2005 Gallup asked people in the United States, Canada, and Great Britain about their beliefs in various supernatural or paranormal phenomena. Twenty-four percent of the Americans polled believed that extraterrestrial beings have visited Earth at some time in the past. Slightly smaller percentages of Canadians (21%) and Britons (19%) held the same belief.

A Moon Hoax?

One of the most offbeat conspiracy theories of the space age is that the U.S. government faked the Apollo Moon landings. In 2001 the FOX television network broad-cast the show Conspiracy Theory: Did We Land on the Moon? Guests on the show claimed that the Apollo program never actually put a man on the Moon but faked the lunar landing for television cameras. The theory continues to be supported on various Web sites on the Internet.

Advocates of the hoax theory rely on several key points to support their position. Chief among these are:

• NASA’s Moon photographs do not show stars in the ackground behind the astronauts.
• The American flag supposedly planted on the Moon by Apollo 11 astronauts is rippling in a breeze, yet there is no atmosphere on the Moon.
• There is no blast crater beneath the lunar lander.
• Humans could not have survived exposure to the intense radiation of the Van Allen belts lying between Earth and the Moon.

In general, NASA ignores the hoax claims and does not address them publicly. However, the NASA Web site does include one article of rebuttal: “The Great Moon Hoax” (February 23, 2001, http://science.nasa.gov/headlines/y2001/ast23feb_2.htm). In it Tony Phillips addresses questions about Moon photographs and the rippling flag. He points out that the exposure on the Moon cameras had to be adjusted to tone down the dazzling brightness of the astronauts’ sunlit spacesuits. This caused the background stars to be too faint to appear in the photographs. The rippling flag is explained by the wire inserts built into the fabric and by the twisting motion the astronauts used to push the flagpole into the lunar ground.

Phillips notes that Moon rocks are the best evidence that astronauts visited the Moon. The astronauts brought back 841 pounds of these rocks, and these rocks have been investigated by researchers from all over the world. Moon rocks differ greatly in mineral and water content from any rocks found on Earth. They also contain isotopes created by long-term exposure to high-energy cosmic rays on the lunar surface.

In “Ask an Astrophysicist” (December 1, 2005, http://imagine.gsfc.nasa.gov/docs/ask_astro/answers/970630a.html), Laura Whitlock addresses the hoax issue concerning

the Van Allen radiation belts, which are regions of highly energized ionized particles trapped within the geomagnetic fields surrounding Earth. Whitlock explains that early NASA researchers were also worried about the radiation belts. Scientists at the Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee, devised experiments in which bacteria and blood cells were sent aboard unmanned probes into space and returned to Earth. Animal experiments were also performed. The ORNL used the resulting data to design special radiation shields for the Apollo spacecraft. The shields utilized materials left over from nuclear testing performed during the 1950s. Whitlock also notes that the Apollo spacecraft traveled so fast that the astronauts were exposed to Van Allen radiation for only a short time.

In a survey conducted in July 1999, Gallup asked poll participants their view about a possible Moon-landing hoax. The vast majority (89%) of those interviewed did not believe that the government staged the Apollo Moon landing. (See Table 9.5.) Only 6% agreed that the landing was a hoax. Another 5% had no opinion. The results closely match those of a poll taken in 1995 by Time, CNN, and Yankelovich Partners, Inc. That poll also found that 6% of the respondents believed the Moon landing was staged. Most people (83%) did not.

However, Dittmar notes that in 2006, 27% of eighteen-to twenty-five-year-olds were doubtful to some degree that astronauts had traveled to the Moon. Ten percent of the young people indicated that it was “highly unlikely” that the Moon landings occurred at all.

Public Opinion

I. IntroductionW. Phillips Davison

BIBLIOGRAPHY

II. Political OpinionAvery Leiserson

BIBLIOGRAPHY

I INTRODUCTION

There is no generally accepted definition of “public opinion.” Nevertheless, the term has been employed with increasing frequency since it came into popular usage at the time of the French Revolution, when Louis xvi’s finance minister, Jacques Necker, referred to public opinion as governing the behavior of investors in the Paris money market. Later efforts to define the term precisely have led to such expressions of frustration as: “Public opinion is not the name of a something, but a classification of a number of somethings.” (See Childs 1965, pp. 12-28, for some fifty different definitions.)

In spite of differences in definition, students of public opinion generally agree at least that it is a collection of individual opinions on an issue of public interest, and they usually note that these opinions can exercise influence over individual behavior, group behavior, and government policy. Because public opinion is acknowledged to play a role in several diverse areas, leading writers on the subject have included sociologists (Tonnies 1887; Lazarsfeld et al. 1944; Albig 1956), political theorists (Bryce 1888; Lasswell 1927; Lippmann 1922), social psychologists (Allport 1937; Cantril 1966), and historians (Bauer 1929). Those who are engaged in manipulating public opinion have also made important contributions: for example, politicians (Lenin 1929) and public-relations specialists (Bernays 1923). Differences in definition and approach can be accounted for largely by the differing interests of various categories of students and practitioners.

The principal approaches to the study of public opinion may be divided into four partially overlapping categories: quantitative measurement of opinion distributions; investigation of the internal relationships among the individual opinions that make up public opinion on an issue; description or analysis of the political role of public opinion; and study both of the communication media that disseminate the ideas on which opinions are based and of the uses that propagandists and other manipulators make of these media.

Some researchers have simultaneously contributed to knowledge in several of these categories. An investigation in Erie County, Ohio, of the 1940 U.S. presidential election campaign not only provided statistical measurements of voting intentions over time but also explored the influence of group membership on individual opinions and evaluated the impact of mass communications on the outcome of the election (Lazarsfeld et al. 1944). Another example may be taken from a study of Norwegian opinions on a number of foreign policy issues between 1959 and 1964 (Galtung 1964). In this case the researcher was able to contribute to the body of theory regarding political behavior in a democracy by analyzing the relationship between foreign policy attitudes and social position while also taking into account the role of group affiliation and the communication structure of the society.

Quantitative measurement of opinions

A definition offered by a specialist in polling is suggestive of the approach to public-opinion research of those who are primarily interested in measurement: “Public opinion consists of people’s reactions to definitely worded statements and questions under interview conditions” (Warner 1939, p. 377). Those focusing on measurement usually investigate such questions as the following: How widely (and, sometimes, how intensely) is a given opinion held? In which geographic, religious, ethnic, or socioeconomic sectors is the opinion encountered most frequently? With what other opinions is it most closely associated?

Measurement of opinions based on polling representative samples of larger populations came into prominence in the United States following the presidential election of 1936. At that time George Gallup, Elmo Roper, and Archibald Crossley, then the most prominent exponents of the sample-survey method, correctly predicted the outcome, while the Literary Digest, relying on nearly 2.5 million unrepresentative straw ballots, was off by nearly twenty percentage points. Use of the sample-survey method spread rapidly thereafter and was scarcely affected by the failure of the principal polling organizations to pick the winner in the presidential election of 1948. This failure did, however, lead to important improvements in polling methods. (For a succinct description of polling procedures in recent election surveys, see Perry 1960.)

By 1965 public-opinion polling had spread throughout the world. The World Association for Public Opinion Research had members from more than forty countries, and numerous polling organizations were reported to be working in communist and other countries that were not represented in the association’s membership. The New York-based International Research Associates, headed by Elmo C. Wilson, had branch offices or affiliates in 34 countries, and the Gallup poll counted 32 affiliates and conducted frequent polls in nearly fifty countries. In the United States several hundred survey organizations existed on a national, state, or local level, with university research bureaus accounting for a substantial number of these.

Data gathered in the course of numerous surveys throughout the world are centralized in a number of “data banks,” the oldest of which is the Roper Public Opinion Research Center at Williams College. The Council of Social Science Data Archives, a cooperative organization of American university and non-profit research groups, helps to promote the exchange of these basic data for purposes of secondary analysis. Columbia University’s Bureau of Applied Social Research serves as a secretariat for the council. A selection of poll results from the United States appears in each issue of the Public Opinion Quarterly, and selected results from throughout the world are carried in Polls, a magazine published by Systemen Keesing in Amsterdam.

Quantitative studies have led to numerous generalizations about public opinion, most of which, however, do not hold for every time and place. One is that large numbers of people pay surprisingly little attention to political personalities and issues, even when these are featured by the mass media. For instance, in 1964 one out of four adult Americans did not know that there was a communist government on mainland China (Michigan, University of …1964). Polls taken since World War II in the United States have consistently shown that large proportions of the respondents were unaware of such crises as those of 1959 and 1961 in Berlin, or of 1955 in the Formosa Straits. As of 1959, 22 per cent of adult Americans said that they had not heard or read anything about Fidel Castro (Erskine 1963, pp. 661-662). Surveys conducted in western European countries have disclosed similar results: more people are familiar with the names of leading sports and entertainment figures than with all but the most prominent politicians. As of 1961, 95 per cent of rural Brazilians were unable to identify the president of the United States (Institute for International Social Research 1961, p. 3).

Stating the same proposition in another way, one can say that relatively small numbers of people regularly show a serious concern for public affairs. This has led some students to distinguish between the “general public,” the “attentive public” (which is at least aware of important issues), and the “informed public,” which participates in discussion of the issues (Almond [1950] 1960, p. 138). It has also led to the polling of “elites,” which are variously defined as being composed of those with a high degree of wealth, education, prominence, or influence. For example, numerous polls have been conducted using samples of legislators, businessmen, or those listed in Who’s Who.

The other side of the coin is that people are likely to be most concerned with matters that they see as affecting them directly. A survey of the principal worries of adult Americans found that 80 per cent of the respondents answered solely in terms of personal and family problems; only 6 to 8 per cent mentioned national or world problems, including war, as being among the things they worried about most, in spite of the fact that the survey was conducted during a period when there was an active atomic-arms race with the Soviet Union (Stouffer 1955). Another study, using cross sections in more than twenty countries throughout the world—including several commun^Jst countries and developing countries—found a similar pattern of concerns, although with important national variations (Cantril 1966).

Nor is it a simple matter to raise the level of information about public issues (Hyman & Sheats-ley 1947). Repeated experiments and observations in several countries have indicated that people have a remarkable ability to ignore easily available facts when these facts are of little interest to them. Merely increasing the amount of information available will not necessarily increase public knowledge, although this generalization probably will not hold true in developing areas where there is a strong unfulfilled demand for more mass media. What seems to be the case is that a proportion of each population, ranging from a very small group up to about two-thirds of the adults, experiences a need for at least some information on matters of public concern. Once the needs of these people have been satisfied, further information flows over the population like water over a saturated sponge.

Opinion measurement has also disclosed strong correlations between educational, religious, geographic, socioeconomic, and ethnic factors, on the one hand, and the opinions that people hold on political subjects, on the other. Indeed, in several areas of the United States it has been found that a person’s voting behavior can be predicted with considerable reliabihty if information is available about his socioeconomic status, his place of residence (urban or rural), and his religious or ethnic background (Lazarsfeld et al. 1944, p. 26). In general, political interest and activity are greater among upper socioeconomic and educational levels, men, middle-aged groups, and urban residents than among lower socioeconomic and educational levels, women, older and younger adults, and rural residents (ibid., pp. 42-51). A number of surveys have also found a relationship between political opinions and personality factors—although this relationship has usually been weaker and more difficult to document satisfactorily.

A final example of the kind of generalization that can be developed through quantitative measurement is that people tend to adjust their opinions to conform to the situation in which they find themselves. During racial integration of schools in the United States, for instance, public opinion in the areas affected tended to become more favorable toward integration following, rather than before, the action of school authorities to admit Negroes to formerly all-white schools (Hyman & Sheatsley 1964). Similarly, the attitudes that the people of two nations have toward each other are likely to result from the state of relations between their governments, as well as being a cause of good or bad relations (Buchanan & Cantril 1953).

The use of public-opinion studies

The rapid spread of public-opinion measurement around the world is a reflection of the number of uses to which it can be put. Governments have increasingly found surveys to be useful tools for guiding their public-information and propaganda programs and occasionally for helping in the formulation of other kinds of policies. The U.S. Department of Agriculture was one of the first government agencies to sponsor systematic and large-scale surveys. It was followed by many other federal bodies, including the U.S. Information Agency, which has conducted opinion research in all parts of the world in which such activities are permitted. Public-opinion studies made abroad following the orbiting of the first Soviet satellite contributed to the decision of the United States to speed up its own space program. Similarly, governments of many other countries now either commission polls on questions of domestic and foreign policy or pay close attention to surveys made under private auspices. France, West Germany, and Japan are among the most frequent users of this kind of research, and there are few major countries that have not commissioned one or more surveys for policy purposes. India and Indonesia are among the newer nations that have occasionally turned to opinion measurement (Free 1967).

Individual politicians, as well as governments, have found polls useful. Opinion surveys can give them a rough estimate of their chances of election and can also help them gauge the salience of various issues with the voters and evaluate the effectiveness of their campaign propaganda. Once in office they can use polls to keep in touch with opinion trends in their constituencies. As of 1953, 48 members of the U.S. House of Representatives were known to be sponsoring opinion surveys, and 14 more said they intended to do so; significantly, most lawmakers in question were in the younger age groups, a fact that suggests that more congressmen may be using polls at the present time (Hawver 1954, p. 125). Politicians and political parties in western European countries are known to have shown similar interests in survey research.

Private businesses and associations have made even more frequent use of polling techniques. Most of the surveys done for business come under the heading of market rather than opinion research and are primarily concerned with product preferences, but large numbers are concerned with public issues, such as government regulation, the economic outlook, or community relations. There are also numerous studies of the public image of individual enterprises or whole industries. Such studies fall somewhere between market and opinion research, and many of them are commissioned by public-relations counsel working on behalf of the business or industry concerned. Labor unions, churches, and professional bodies have also used polls on occasion; the medical profession has been especially active in this regard. Innumerable small polls (and some large ones) have been conducted by academic researchers working with students. Indeed, it has been said that more is known about the opinions of American college sophomores than about the opinions of any other group in the world.

A very different but equally important use of measurement is made by those who are primarily interested in other approaches to public-opinion research. Quantitative studies have provided many of the building blocks for those who study the internal relationships among opinions on public issues, the political role of public opinion, and the impact of communications. Measurement techniques have thus contributed importantly to the formation of theories and hypotheses in all branches of public-opinion research.

Public opinion as a form of organization

Long before techniques for systematically measuring opinions were developed, it was noted that public opinion seemed to have qualities that made it something more than the sum of individual opinions on an issue. It was presumed to have a force and vitality unconnected with any specific individual. The German poet Wieland (1799) spoke of it as “an opinion that without being noticed takes possession of most heads,” and the sociologist Ferdinand Tonnies ([1887] 1957, p. 256) observed that “whatever may come to be considered a public opinion, it confronts the individual with an opinion which is in part an extraneous power.” Some scholars postulated the existence of a “group mind” with a will of its own, and observation of crowd behavior seemed to confirm the existence of some psychic entity that could seize hold of many individuals at once and lead them to behave in ways that no one of them would have behaved under other circumstances [SeeCollective Behavior].

The concept of a group mind was soon discarded, since no empirical referent for it could be found, but the search continued for an explanation of the way public opinion differed from a simple summation of individual opinions. One explanation that has been advanced by a number of twentieth-century social scientists is that individual opinions are sometimes related to each other in such a way as to form a kind of organization. Charles Horton Cooley described public opinion as “no mere aggregate of separate individual judgments, but an organization, a cooperative product of communication and reciprocal influence” ([1909] 1956, p. 121). Ideas such as these have resulted in the abandonment of the search for an entity or content labeled “public opinion” that can be discovered and then analyzed; emphasis has been placed instead on the study of multi-individual situations and of the relationships among the opinions held by various people in these situations (Allport 1937, p. 23).

If public opinion is viewed as a species of organization or as a bundle of relationships, questions arise as to what the nature of these relationships is, how they are formed, how they persist, and why they dissolve. The relationship most frequently examined is that between leaders and followers— that is, between political influentials and the mass of the people. A number of writers have analyzed the techniques by which politicians and statesmen are able to develop a common will among masses of disparate individuals by manipulating concepts and symbols (Lippmann 1922; Lasswell 1927; 1935). Woodrow Wilson, for instance, used his Fourteen Points to mobilize a common opinion out of the wide varieties of opinions churned up by World War I. Later investigations have found that opinion leaders, or those who are influential in determining what others think about current issues, are not concentrated only at the top of the social and political pyramids but can be found throughout the population. Each socioeconomic group has its own opinion leaders, who play an important part in determining the attitudes of other members of their group. The same leaders are not necessarily influential in all subject areas, however; one may be considered an authority on political questions, another on economic questions, and so on (Katz & Lazarsfeld 1955). Studies of the way in which group membership influences individual opinions have contributed substantially to understanding the relationships involved in public opinion. For example, researchers have found that soldiers transferred from one unit to another during World War II adopted attitudes prevalent in the unit to which they had been transferred (M. B. Smith 1949).

Knowledge about the internal structure of public opinions, nevertheless, is still limited and lags far behind measurement. This is largely because of the difficulties involved in this type of research, both in conducting experiments that enable the investigator to make systematic observations of the relationships among those holding individual opinions and in quantifying such observations as can be made about these relationships in real-life situations, outside the laboratory. Despite the relatively undeveloped state of our knowledge about the internal relationships among opinions, some of the implications of this approach have found recognition among practitioners engaged in trying to influence popular thinking. It is common for public-relations specialists or propagandists to compile lists of “influentials,” often on the basis of sociological criteria, on the assumption that ideas reaching people on these lists will spread to a wider public. Some public-relations practitioners have spoken of their task as the “crystallization” of public opinion —that is, the transformation of individual attitudes into a collectivity that can exert influence (Bernays 1923).

People concerned with building viable democratic polities in new nations may also find it useful to think of public opinion as a form of organization. Students of developing areas have noted that private citizens who take an interest in political questions in emerging nations are frequently out of touch with each other and unable to interact constructively (Shils 1963). There is thus no infrastructure of private organizations and public opinion between the government and the population masses, and this lack tends to facilitate sudden and radical shifts in governments and policies. These shifts, it is hypothesized, would be less extreme if a way could be found to engage all those with political interests, both in and out of government, in a dialogue that would lead to an increasing degree of consensus on important national issues. The problem is thus to relate individual opinions to each other in such a way that fairly stable bodies of opinion, capable of exerting political influence on each other and on the government, will be formed.

The political role of public opinion

Political scientists and historians have been most interested in the part that public opinion has played and is playing in political life. Accordingly, they have looked upon it primarily as an expression of opinion from the public that reaches the government and that the government finds prudent to heed (Speier 1950; Key 1961, p. 14). Some students have added the concept of latent public opinion, that is, public opinion that governmental officials expect will form if they do or do not do something and that thus influences their actions even though it has not yet taken shape (Truman 1951, pp. 511-512). This approach may bypass such questions as how opinions are distributed and what kinds of relationships they have with each other, but it does not necessarily do so. Numerous political thinkers have been interested in the measurement and organizational structure of public opinion.

Although the term “public opinion” was not used prior to the eighteenth century, historians have identified phenomena very much like it in both ancient and medieval civilizations (Bauer 1929), and the relationship between government and mass opinion receives attention in the work of Plato, Aristotle, and other classical as well as medieval writers. Following the Protestant Reformation and the Renaissance in Europe, both of which resulted in more widespread and intensive discussion of competing beliefs and ideas, popular opinion was increasingly seen as playing a part in governmental decisions. Machiavelli believed that princes should take this opinion into account as one element in their calculations, and by the seventeenth and eighteenth centuries leading political philosophers were paying tribute to its power. Rousseau held that all laws were ultimately based on public opinion and regarded the free expression of it as a major safeguard against despotism. Bentham stressed that the legislator could not ignore it (Palmer 1936).

By the nineteenth century the concept of public opinion had entered into the mainstream of political theory. In Europe it was frequently seen as a weapon of the middle class against the old order. Friedrich J. Stahl, a Prussian conservative, described public opinion as the “will of the middle class” and believed that with the aid of the press the middle class would prevail over the crown. Johann Kaspar Bluntschli, the Swiss legal scholar, wrote that public opinion was “predominantly the opinion of the middle classes, which form their own judgments and express these in unison” (Lenz 1956, p. 60). James Bryce saw public opinion in western Europe as being substantially the opinion of the class that “wears black coats and lives in good houses” (1888, p. 260 in 1891 edition). Observers of the United States held that public opinion there rested on a far wider population base. Bryce, writing in the 1880s, described the American system as government by public opinion and believed that popular attitudes were expressed primarily by the press, political parties, and elections. Half a century earlier Tocqueville had likewise considered the mass basis of American public opinion, and he saw in its influence a threat to independence of thought: “In America, the majority raises formidable barriers around the liberty of opinion” (1835, p. 117 in 1956 edition); “I am not the more disposed to pass beneath the yoke because it is held out to me by the arms of a million of men” (ibid., p. 149).

The current concerns of those who are primarily interested in the interplay between public opinion and government center on questions defined in the previous century, but the discussion of these questions customarily draws upon quantitative data from opinion polls, content analyses, or other sources. A large portion of this literature consists of arranging and analyzing poll data in order to disclose the content and characteristics of opinions with which governments are or should be concerned (Key 1961). Thus, one can find a substantial number of studies that deal with public opinion and foreign policy, public opinion and social legislation, or public opinion and economic issues. Many of these studies focus on population subgroups of presumed political significance.

Closely related to analyses of public opinion on political issues are studies that are concerned with the ways in which public opinion influences government. In addition to using poll data, these studies usually describe the activities of pressure groups and political parties and the techniques of individuals who attempt to affect government policy (for a selective bibliography, see Childs 1965, pp. 257-260). Included in this group are analyses of mail reaching executive or legislative officials. Although most such treatments have dealt with the United States, there is a growing body of literature both on pressure groups in other countries and on efforts by individuals in other countries to participate in official decisions. A recent study compared citizens’ attitudes toward their own ability to influence governmental policy in West Germany, Italy, Mexico, and the United States (Almond & Verba 1963).

The weakness of most studies dealing with the influence of public opinion on government policy is that they cannot trace the effectiveness of the attempts that are made to exert influence. The equation of activity with effectiveness is simply assumed. Nevertheless, there are some notable exceptions. For example, the West Coast fishing industry was found to play a major part in the negotiation of a settlement with Japan following World War II (Cohen 1957).

The other side of the coin—government efforts to influence public opinion—has also been dealt with extensively. Tools most frequently used by governments for this purpose include publicity, propaganda, censorship, and a number of techniques of news management (Childs 1965, pp. 305-308). Although the manipulative attempts of government in the United States have received the lion’s share of the attention of scholars, the rulers of totalitarian states have been most active in trying to mold public opinion. Efforts of the Nazi government to control public attitudes in Germany were notorious, and Soviet domestic propaganda has also received fairly extensive attention (Inkeles 1950). More recently, scholars have begun to focus on the activities of Communist China in this field (Yu 1964). As with studies of popular efforts to influence governments, treatments of governmental efforts to manipulate opinion have ordinarily been unable to show a clear connection between cause and effect. A possible exception is the case of the Soviet Union, where even anticommunist citizens appear to have adopted many of the principal categories of thought prescribed for them by the government.

Cutting across all these aspects of the relationship between government and public opinion are studies of voting behavior. These have registered the distribution of opinions on a wide variety of issues, have explored the impact of special interest groups on election outcomes, and have contributed to our knowledge about the effects of government propaganda and policy. Since voting is the method by which the largest numbers of citizens of any democracy participate in policy, analysis of the behavior of potential voters during and between election campaigns contributes fundamentally to an understanding of the democratic process. Those who believe in democracy often find the results of such studies discouraging, in that they may show widespread prejudice and ignorance or little popular appreciation of important issues, but the results are rarely irrelevant.

To generalize about the effects of the enormous amount of theorizing, philosophizing, and research that has been done on the relationship between public opinion and government is a difficult task. It seems safe to assume that the behavior of some political leaders has been influenced by political theories that are based in part on thinking about public opinion. It can also be argued that public-opinion research has enhanced the prospects for democratic government by helping to acquaint major groups in the population with each other’s attitudes and values. When, however, one looks for specific examples of ways in which the study of public opinion has affected the political process, the examples one finds are likely to be relatively minor and to involve measurement rather than theory. For instance, officials have sometimes been able to discount the importance of what they hear from pressure groups when they have learned about the distribution of the opinions of the population as a whole on the same issues. It is also probable that both governmental manipulators of public opinion and private groups seeking to influence official policy have been able to conduct their activities with greater sophistication because of increased knowledge about the nature of the relationship between the government and the public.

Communication research

The task of communication research has been defined by Lasswell as that of answering the question: who says what to whom through what channel and with what effect? ([1948] 1964, p. 37). Thus, communication researchers who follow this formula have not focused their attention directly on opinions regarding public issues, but they have made a number of important indirect contributions to the understanding of public opinion. In particular, studies of symbol manipulators (those who speak), audiences (those who are exposed to communications), the role of the mass media, and the effects of the ideas that are communicated are relevant to such questions as how opinions take hold among large numbers of people, why they are distributed as they are, how they are related to each other, and how they change.

Those who are concerned with the ways in which ideas are spread have studied the activities of government spokesmen, private publicists, and propaganda and news organizations as well as the relationships between communications and policy. Few adequate generalizations have been made about propagandists. One analysis found them to have abnormally strong cravings for power, highly extroverted personalities, unreasoning intolerance for rivals, and a gift for organization and management when these are related to self-aggrandizement (B. L. Smith et al. 1946). This unflattering characterization was, however, based in large part on attention to Nazi, Fascist, and Communist spokesmen. Modern propaganda organizations are characterized by elaborate mechanisms for setting policy, operating media, studying audiences, and evaluating effectiveness (Davison 1965). The task of coordinating the output of such vast organizations with the policy of the sponsoring group (usually a government) has frequently led to clashes between propagandists and policy makers.

Studies of news media have indicated that they, too, tend to structure opinions, even though usually unintentionally. One way this is done is by giving large numbers of people a common focus of attention. An operating definition of news used by most journalists is that a subject is newsworthy if it is already in the headlines. Thus, there tends to be a circular reinforcing process, in that a subject is featured if it is already being given attention and it is given more attention because it is featured (Cohen 1963). News media also help to assure cohesion among members of major population groups. In many nations there is a “prestige paper” that is read by a large proportion of influential persons and that keeps members of this group of influentials informed about what others in the group are thinking. It also serves as a forum for exchange of ideas among them. In 1961, for example, a survey found that the New York Times was subscribed to by 60 per cent of American news editors, 46 per cent of utility executives, 30 per cent of college presidents, and 28 per cent of bank officers throughout the country (Kraft 1961). Newspapers such as he Monde, Pravda, and The Times of London may occupy an even more central position.

Propagandists and the mass media do not, however, have it all their own way. Audience studies have shown that people give their attention selectively to the communications that are available to them and that they frequently derive meanings from these that are quite different from the ones intended. Even very intensive publicity drives have failed to increase knowledge about given subjects when people have no interest in acquiring more information. This was found to be the case in Cincinnati shortly after World War n, when civic organizations and mass media experimented with a campaign to stimulate interest in the UN; in spite of the fact that the entire population was deluged with information about the world body, those who were uninformed prior to the campaign remained uninformed (Star & Hughes 1950). Conversely, news of events that are not given extensive publicity can circulate with amazing rapidity by word of mouth. Attention seems to be governed primarily by two factors: habit, in that people grow accustomed to relying on certain sources for information, and interest, in that people tend to look for information that they think will help them satisfy their wants or needs [SeeCommunication, Mass, article onEffects].

As far as the effects of communications on opinions are concerned, a major finding of researchers has been that well-formed attitudes are highly resistant to change. Even the most skillful propaganda or advertising is unlikely to bring about shifts in attitudes that are firmly based on a person’s own experience or that are shared by those with whom he comes in frequent and close contact. On the other hand, casual attitudes can be changed fairly easily. In nonpartisan local elections, where the candidates are not well known, even a small amount of information or an endorsement by a respected newspaper can sway a substantial number of votes. Similarly, the editorial stand of a newspaper can sometimes tip the scales for or against an issue in a community where opinions are fairly evenly divided and feelings do not run high. Communications can also reinforce existing attitudes and activate latent ones. Agitators frequently make use of activating and reinforcing communications in order to whip up enthusiasm for an idea and bring people to the point where they are willing to vote, demonstrate, or take some other action. Such effects may also be achieved unintentionally. During 1955, when a number of West German newspapers started to publicize crimes committed by American military personnel in West Germany, largely as a circulation-building device, they whipped up latent emotions to a point where at least one town council requested the withdrawal of American forces from the area. It later turned out that the “crime wave” represented no more than the usual number of violations with which American and West German authorities were customarily plagued and that the press had not intended to stimulate political action.

Insights from communication research are used in both the political and the commercial realms. Political uses are made most frequently by those concerned with propaganda and psychological warfare. In democratic elections, for instance, the political propagandist frequently tries to find an issue that is favorable to his side or unfavorable to the opposition and about which there are widespread latent attitudes; he then tries to activate these attitudes by means of emphasizing the issue in the public media. The psychological-warfare specialist often seeks the “marginal man,” one who is in the opponent’s camp without being firmly dedicated to it, and makes him the principal target for propaganda. In the commercial world, communication research makes it possible for the advertiser to select media that are already being given attention by the audience he wishes to reach and also to test the effectiveness of varying advertising appeals. The same principles of selection and testing can be used by those who are merchandising political ideas.

One of the most important applications of communication research is in connection with national development. The mass media play a critical role in turning traditional societies into modern ones by preparing people psychologically for life in an industrial society, by helping to build new political institutions engaging in mass education, and by providing information that is necessary for economic development (Lerner 1958; Conference on Communication …1963). Accordingly, modernizing nations have been advised to examine the channels for the flow of information within their borders and to plan for the growth of the mass media in phase with the growth in other sectors. The mass media are necessary for development not only because they link people with government and disseminate information that is needed in educational and economic programs but also because they draw diverse people together around common national problems and interests and make it possible for them to participate in public affairs (Schramm 1964).

Future prospects

Although there is little agreement on a precise definition of “public opinion,” and many of its facets remain hazy, constantly increasing use of the term during the past two centuries testifies to its utility. As societies have become more complicated and ever larger masses of people have become involved in political and economic life, students have felt a growing need for some concept that refers to collectivities failing between the undifferentiated mass, on the one hand, and primary groups and formal organizations, on the other. In modern society people do not behave like isolated individuals, but neither can their behavior be explained exclusively in terms of their organizational and group membership. This became abundantly apparent just prior to and during the French Revolution, when the middle class began acting much as though it were an organized force, even though no principle of organization was immediately apparent. True, the middle class had its salons and coffeehouses, where information and ideas were exchanged, and sometimes its newspapers, but were these communication facilities alone sufficient to threaten the stability of the ancien regime“? The ferment of the times could be explained only in terms of some greater force, and this force was labeled public opinion.

As a result of increases in literacy and proliferation of communication media, public opinion soon ceased to be exclusively a middle-class phenomenon in the principal industrialized areas of the world. Less-advantaged members of the community have also been able to achieve a consensus on some issues, although less frequently and intensely than those at higher socioeconomic levels. The civil rights movement in the United States has succeeded in mobilizing public opinion far beyond the middle class. It is probable that public opinion in the developing countries will evolve in similar fashion but will take less time to do so.

Public opinion has played a smaller role in communist countries than in the democracies. The efforts of the state to control the principal channels of public communication and to prevent nonoffi-cial links among the citizenry have made it more difficult for individual opinions to become related and for consensuses to develop. Nevertheless, this has occurred in some instances, either because independent-minded artists and writers have given expression to widely shared ideas or because it has been made possible by word-of-mouth communication. Both rebellious writers and interpersonal channels seem to have played a role in the growth of public opinion that led to the antiregime uprising in Hungary in 1956. Communist spokesmen occasionally assert that public opinion does exist in countries having a totalitarian-socialist form of government but that it is a common opinion in which the entire population shares and is adequately expressed in single-list elections and mass demonstrations. It is improbable that such asseverations are made seriously, especially since public-opinion studies that recognize important differences among individuals and population groups have been reported from eastern Europe and the Soviet Union with increasing frequency.

Our understanding of the role that public opinion plays in political, economic, cultural, and other areas can be expected to increase during the coming years as research and thinking at all levels is pursued throughout the world. Further comparisons of public-opinion processes in various societies would be especially helpful. Even more important would be empirical and theoretical studies linking together the four approaches described above, so that each would contribute to an interlocking and mutually reinforcing whole. Only when this integration has been achieved will a coherent theory of public opinion be possible.

W. Phillips Davison

[See alsoAttitudes; Census; Communication, Mass;Communication, Political; Diffusion, article on

INTERPERSONAL INFLUENCE; Mass Society; Propaganda; Public Relations; Reference Groups; and the biographies of Bryce; Cooley; Dicey; Machiavelli; Tocqueville].

BIBLIOGRAPHY

Albig, William 1956 Modern Public Opinion. New York: McGraw-Hill.

Allport, Floyd H. 1937 Toward a Science of Public Opinion. Public Opinion Quarterly 1:7-23.

Almond, Gabriel A. (1950) 1960 The American People and Foreign Policy. New York: Praeger.

Almond, Gabriel A.; and Verba, Sidney 1963 The Civic Culture: Political Attitudes and Democracy in Five Nations. Princeton Univ. Press.

Bauer, Wilhelm 1929 Die bffentliche Meinung in der Weltgeschichte. Potsdam (Germany): Akademische Verlagsgesellschaft Athenaion.

Bernays, Edward L. 1923 Crystallizing Public Opinion. New York: Boni & Liveright.

Bryce, James (1888) 1931-1933 The American Commonwealth. 3d ed. 2 vols. New York and London: Macmillan. → An abridged edition was published in 1959 by Putnam.

Buchanan, William; and Cantril, Hadley 1953 How Nations See Each Other: A Study in Public Opinion. Urbana: Univ. of Illinois Press.

Bureau Of Social Science Research, Washington, D.C. 1956 International Communication and Political Opinion: A Guide to the Literature, by Bruce L. Smith and Chitra M. Smith. Princeton Univ. Press.

Cantril, Hadley 1966 The Pattern of Human Concerns. New Brunswick, N.J.: Rutgers Univ. Press.

Childs, Harwood L. 1965 Public Opinion: Nature, Formation and Role. Princeton, N.J.: Van Nostrand.

Cohen, Bernard C. 1957 The Political Process and Foreign Policy: The Making of the Japanese Peace Settlement. Princeton Univ. Press.

Cohen, Bernard C. 1963 The Press and Foreign Policy. Princeton Univ. Press.

Conference On Communication And Political Development, Dobbs Ferry, N.Y., 1961 1963 Communications and Political Development. Edited by Lucian W. Pye. Princeton Univ. Press.

Cooley, Charles H. (1909) 1956 Social Organization: A Study of the Larger Mind. In Charles H. Cooley, Two Major Works: Social Organization and Human Nature and the Social Order. Glencoe, 111.: Free Press. → Each title reprinted with individual title page and

pagination. Separate paperback editions were published in 1962 by Schocken.

Davison, W. Phillips 1965 International Political Communication. Published for the Council on Foreign Relations. New York: Praeger.

Erskine, Hazel G. 1963 The Polls: Exposure to International Information. Public Opinion Quarterly 27: 658-662.

Free, Lloyd A. 1967 The Role of Public Opinion in International Relations. Unpublished manuscript.

Galtung, Johan 1964 Foreign Policy Opinion as a Function of Social Position. Journal of Peace Research 1:206-231.

Hawver, Carl 1954 The Congressman and His Public Opinion Poll. Public Opinion Quarterly 18:123-129.

Hyman, Herbert H.; and Sheatsley, Paul B. 1947 Some Reasons Why Information Campaigns Fail. Public Opinion Quarterly 11:412-423.

Hyman, Herbert H.; and Sheatsley, Paul B. 1964 Attitudes Toward Desegregation. Scientific American 211, July: 16-23.

Inkeles, Alex (1950) 1958 Public Opinion in Soviet Russia: A Study in Mass Persuasion. 3d printing, enl. Russian Research Center Studies, No. 1. Cambridge, Mass.: Harvard Univ. Press.

Institute For International Social Research 1961 Some International Implications of the Political Psychology of Brazilians. Princeton, N.J.: The Institute

Katz, Elihu; and Lazarsfeld, Paul F. 1955 Personal Influence: The Part Played by People in the Flow of Mass Communications. Glencoe, 111.: Free Press.

Key, V. O. Jr. 1961 Public Opinion and American Democracy. New York: Knopf.

Klapper, Joseph T. 1960 The Effects of Mass Communication. Glencoe, 111.: Free Press.

Kraft, Joseph 1961 The Future of the New York Times. Esquire 55, no. 4:121-122.

Lasswell, Harold D. (1927) 1938 Propaganda Technique in the World War. New York: Smith.

Lasswell, Harold D. 1935 World Politics and Personal Insecurity. New York and London: McGraw-Hill. → A paperback edition was published in 1965 by the Free Press.

Lasswell, Harold D. (1948) 1964 The Structure and Function of Communication in Society. Pages 37-51 in Institute for Religious and Social Studies, Jewish Theological Seminary of America, The Communication of Ideas: A Series of Addresses. Edited by Lyman Bryson. New York: Cooper Square.

Lazarsfeld, Paul F.; Berelson, Bernard; and Gaudet, Hazel (1944) 1960 The People’s Choice: How the Voter Makes Up His Mind in a Presidential Campaign. 2d ed. New York: Columbia Univ. Press.

Lenin, V. I. 1929 Agitation und Propaganda. Berlin: Verlag fur Literatur und Politik. → Published posthumously. Contains a collection of Lenin’s earlier writings on the subject first published in Russian.

Lenz, Friedrich 1956 Werden und Wesen der bffent-lichen Meinung. Munich: Pohl.

Lerner, Daniel 1958 The Passing of Traditional Society: Modernizing the Middle East. New York: Free Press. → A paperback edition was published in 1964.

Lippmann, Walter (1922) 1944 Public Opinion. New York: Macmillan. -* A paperback edition was published in 1965 by the Free Press.

Maletzke, Gerhard 1963 Psychologie der Massenkom-munikation: Theorie und Systematik. Hamburg (Germany): Verlag Hans Bredow-Institut.

Michigan, University Of, Survey Research Center 1964 The American Public’s View of U.S. Policy Toward China: A Report. New York: Council on Foreign Relations.

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Schkamm, Wilbur L. 1964 Mass Media and National Development: The Role of Information in the Developing Countries. Stanford Univ. Press.

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Yu, Te-chi 1964 Mass Persuasion in Communist China. New York: Praeger.

II POLITICAL OPINION

“Political opinion” is a convenient term for referring to the context of authoritative decision, governmental and nongovernmental, in which persons in petitions of discretionary authority anticipate or respond to estimates of the community’s demands, expectations, or requirements. As the sampie survey and other instruments of social science research add precision to the concept of public opinion—defined as the distribution of personal opinions on public objects in the population outside the government—it becomes increasingly apparent that the opinion process is not identical with or completely determinative of the judgments of persons in a position to formulate and shape public policy. The concept of political opinion is thus a shorthand expression for the relation or sets of relations between the opinion-forming and policy-making processes in society. In empirical terms, it leads to the following question: which opinions and views, held by which persons outside the government, are heeded by which persons who make authoritative policy decisions? Philosophically, it also raises the question of meaning: what function does public opinion play in the political process? Public opinion is sometimes considered to be a sanction (legitimizing symbol), sometimes an instrument (data), and sometimes a generative force (directive and limit) in the policy process. Clearly, then, normative assertions about “government by public opinion” do not accurately describe the processes by which opinions are actually utilized by the makers of public policy.

Opinion in the public context

In order to understand the many ways in which public opinion actually functions in the political process, it is necessary to clarify the meaning of “opinion” and “public.” “Opinion” includes the whole range of personal and private sentiments, beliefs, and systematic views, felt and expressed, rational and nonrational, that both affect the legitimacy and stability of the social order and political system and condition the feasibility and acceptability of public policies. In a political setting, the relevant criterion is not the truth or falsity or the Tightness or wrongness of opinions but their significance for the electoral success or failure of officeholders and candidates, for the degree of popular support for existing and proposed policies aimed at the security and prosperity of the community, and ultimately for the viability of the constitutional and political system.

Insofar as opinions are expressed, it is useful to distinguish two categories of opinion statements:

(1) those of preference, which include expressions of individual feeling, conviction, and value; and

(2) those of fact, which purport to describe transpersonal reality in objective terms of verifiable evidence. The important characteristic of opinion statements, as distinct from postulates of knowledge, mystical or religious faith, and matters of belief beyond discussion (e.g., incest), is that they are recognized as expressing controversial, conflicting ideas, capable of being accepted by rational minds, and hence are appropriate for discussion among individuals and groups. Discussion can lead to agreement and can settle differences of opinion; only violence, authority, or an appeal to a metaphysical or a divine source can resolve differences in objects of faith and belief, which are literally nondebatable and thus fall outside the sphere of opinion.

There is a notable tradition in the history of normative thought about the relation of the public and the private in matters of opinion. Milton’s Areopagitica, Locke’s Letter Concerning Toleration, and Mill’s On Liberty are classic statements of the moral and political problems posed by the personal freedoms of religious belief, thought, and expression; by a press that is not owned or controlled by the government; and by the respective rights of the majority and of minorities.

Through most of the nineteenth century the dominant tradition assumed that the public sphere was defined by the legally coercive acts of government officials acting in the name of the monarch or representing the people organized as a political community. The work of Marx, James, and Freud, coupled with the rise of the “culture” concept in anthropology, shifted the focus of attention to the economic and social-psychological determinants of opinion, almost to the point of obliterating the distinction between “public” and “private.” Some writers treated the public and political aspects of opinion as logical derivatives of class or status ideologies; others, as by-products of the personality-forming processes by which individuals are adjusted to society. The term “public” was given the sense of “interpersonal relations.” For example, Charles Cooley saw public opinion as the product of social communication and reciprocal influence; John Dewey, as the consequences of interpersonal acts upon persons other than those directly involved in transactions. But these concepts turned out to be virtually identical with the notion “group,” measured by “the extent and complexity of interpersonal relations among the members of specified aggregates, …which under specified conditions exhibit organization of varying kinds and degrees” (Lass-well & Kaplan 1950). Hence “public” had to be differentiated by specifying the requirement of a more inclusive consensus, within which various opinion aggregates could coexist.

These theoretical developments emphasized the roots of public opinion in private and group experience and demonstrated the futility of absolute differentiations between “individual,” “group,” and “public.” However, the conception of the public as a simple extension of interpersonal contact and communication remains unsatisfactory. First, it is not clear that an opinion consensus is a necessary or sufficient condition for a public to exist. Second, the problem of coercion is ignored. Finally, the linkages and adjustments connecting group opinions with the formulation of public policy are vaguely referred to under the heading “pressures” or “compromise.” Models of the political process that explicitly recognize the ambiguous relation between conflicting opinion preferences and actual policy decisions are still required.

Theories of political opinion

The range of individual and group opinions taken into account by political rulers, representatives, and public officials varies widely among political societies, historical and contemporary. In primitive communities and in feudal, caste, or closed-class social systems, the range of political communication seems to have been narrowly confined within limits set by ritual, custom, and social structure. In fractionalized, transitional cultures the ruling group often restricts sharply the scope and subjects of public discussion and indeed controls more or less completely the channels of mass communication. Since World War i it has become fashionable for all governments to claim to be democratic, in the sense that a high degree of correspondence is imputed to exist between the acts of government officials and the majority opinion. However, we may draw a preliminary, fundamental distinction between “constitutional” and “people’s” democracies, in terms of the degree of nongovernmental control of the instruments of opinion formation and the relation that is asserted to exist between public opinion and governmental decision making.

Under constitutional governments, public officials operate through prescribed, legal procedures for issuing and validating statements of public policy. Nongovernmental institutions of public information and discussion are allowed ample opportunity, before, during, and after the official process, to formulate the issues and to develop a patterned distribution of individual responses from “the country.” All this goes on in an atmosphere free from military or private violence, and individuals and groups are free to criticize and respond to governmental programs of information and persuasion. In this context the acts of public officials are interpreted as symbolic, authoritative expressions of the public interest, legally enforceable until amended or rescinded by proper constitutional procedures after a period of public reaction, political agitation, and response.

Contrariwise, in so-called people’s democracies it is held that the will of the “people,” the “masses,” the “nation,” or the Volk is known or available only to the ruler or the party; this “will” is embodied in the ruler’s or the party’s acts, and only such information and views as are found necessary or appropriate are legitimate matters for public knowledge and discussion. To this end, the channels of public communication and conditions of group association are rigorously limited and controlled by governmental and party officials.

Speculative theories of political opinion can be grouped into five classes; each has affinities to one of the two basic types above but may also resemble the other in some features.

Elitist theories

Perhaps the oldest theory of political opinion is that of the elite, or ruling class, according to which society is horizontally divided into leaders and followers and vertically divided into hierarchies of racial, functional, socioeconomic, or demographic groups. The ruling class is composed of the leaders of the several vertical-group hierarchies. The consensual foundations of political community, according to elitist theorists, lie in ethnic ties, qualities of the people, ancient customs, glorious historical events, and symbolic documents embodying self-limiting agreements between the nominal ruler and the elite leaders. In the elitist conception of political opinion, the status and opinion leaders outside government are seen as occupying a hierarchical position above the points of official decision, so that the lower-status governmental officials, by definition, simply execute the decisions made by the ruling class. Representative of this approach is the work of Gaetano Mosca [SeeMosca].

Absolute-sovereignty theories

A second class of theories of political opinion includes those absolutist doctrines of sovereignty, both monarchic and popular, that view society as an abstract mass of individuals. In the absence of rulers, the people are able to act only chaotically or in compulsive unanimity, for example, as a mob. The abstract “people,” therefore, find it necessary to abdicate power to a no less abstract absolute ruler, monarch, leader, or party. These entities alone are capable of knowing and expressing the mystical, unifying will variously named volonte generate, Volksgeist, sovereign people, and mass proletariat. Interpreters of Hobbes, Rousseau, and Hegel can point to paragraphs and sections showing that these thinkers were aware that the social structure and opinion processes of society are more complex than the simple dichotomy of people and ruler; nonetheless, in answer to the question of where the source of supreme power in the political community is located, each postulated an unlimited governing authority, either in the mass-majoritarian consensus of the people or in the moral and political responsibilities of the state-ruler. None of the Leninist-Stalinist theories (or their adaptations by Mao Tse-tung) about the relations of the party to the masses overcomes the difficulty of the people-state dilemma. [SeeSovereignty].

Manipulative theories

Closely associated historically with the concept of popular sovereignty is the idea that people have to be educated, guided, induced, or persuaded. In practical terms, this has led to the notion that issues can be created and that new cleavages and changes in the mass distribution of opinion can be brought about by events and adroit acts of opinion leaders, politicians, prestige figures, or persons who control the content of the mass media. War propaganda during World War i, the tremendous increase in commercial advertising and public relations activities thereafter, the deliberate use of propaganda and agitation by totalitarian and revolutionary mass movements, and the conscious development of psychological warfare in World War n, all highlighted what may be called the mass-manipulation theory of political opinion. During the interwar period there was a tendency to overstate the degree to which modern “mass society” can be controlled without legal and political monopolies over the press and other mass media. However, there was also a clear realization that social forces and public opinion are not independent, exogenous variables in the opinion-policy process but are affected by, and indeed are sometimes produced by, leaders and events. [See, for example,Lippmann].

Constitutional-democratic theories

The fourth category of political opinion models contains those theories of representative democracy which postulate the idea of a covenant or agreement among people who, by giving up their prepolitical freedom of action, are enabled to establish a government of limited powers in order to secure certain values (union and independence, security of life and property, justice and liberty, the common welfare) that individuals without government cannot obtain by themselves. [See The Federalist; see alsoLocke; Social Contract]. The metaphorical notion of an “agency” contract allows the imposition of substantive and procedural restraints upon the legitimacy of discretionary acts by elective representatives and public officials. It also provides guarantees of personal and private rights, requirements for insuring conformity between governmental acts and majority opinion (free elections, freedom of speech and of the press, and the right of assembly and of petition), and a prescribed procedure for amending and revising governmental structures, procedures, and powers. Such widely varying theories of political organization as monarchy, minority or restricted majority rule, and populist democracy have been reconciled with representative-democratic forms, when they admitted prior legitimacy and loyalty to a political order based on the principles of limited powers and the consent of the governed [SeeLindsay].

Rationalist-idealist theories

The fifth category, the rationalist-idealist model of political opinion, was perhaps best formulated by A. L. Lowell and R. M. Maclver, who sought to identify the conditions necessary for individuals and groups to participate rationally in public affairs [SeeLowellandMaciver]. The specified conditions were (1) that the people be politically organized and act as a community rather than as a mass or crowd; (2) that the right of minorities to hold their opinions and to organize politically for peaceful opposition be recognized but that the minority submit to and obey majority decisions; (3) that majorities and minorities alike accept and abide by the structure and processes of governmental decision, including the rules for amendment and change; (4) that the members of the political community have access to the facts reasonably necessary to arrive at a rational decision on a given issue; (5) that they engage actively in discussion and participate in public affairs, so as to be capable of assessing political realities; and (6) that they explicitly adjust their votes and other political acts to their conception of the common good and public interest. Lowell’s criteria may raise doubt that any human government can be wholly democratic, but they perform the important task of clarifying the qualities of individual and group action needed if the members of a community are to act as a public.

Speculative versus empirical theories

The division between speculative and empirical theories is not precise, nor are the two mutually exclusive. Generally speaking, speculative models implicitly or explicitly incorporate the observer’s preferences into his conceptual system and attempt to describe and classify human behavior and institutions directly in terms of a priori, complex categories that defy quantitative expression. Empirical or analytical models extrapolate from individual behavior a minimum number of elemental, conceptual variables, supposedly identifiable by standard observational procedures independent of the observer’s or respondent’s preferences, and attempt to explain behavior indirectly by inferring (predicting or generalizing) the probable covariation between two or more such variables.

Certain obstacles confront all empirical theories of political opinion. One is the obvious methodological problem of systematically gaining access to persons in positions of public authority or private influence for purposes of observation. More important, conceptually, is the problem of variations in the setting in which the opinion-policy relation occurs. The two-way relation between opinion and policy formation, can be studied on the level of, and within, the individual personality; in the interactions of two or more persons in small groups; in leader-follower behavior within large groups, whether or not they possess formal structure and bureaucratic organization; and in the complex relationships between key individuals in the multi-group process of public, official policy making. Intensive studies of the conditions under which changes can be induced in individual opinion, personality, and behavior have great potential value for research in more inclusive contexts, but the variations of scale and setting often seem to reduce the applicability of concepts employed in personality and small-group studies to analogies and metaphors on the level of political and societal behavior.

Empirical research

On the macroscopic level of political society, studies of public opinion and policy formation do not agree about the analytical terminology for the different aspects of the opinion-policy relation, nor have they integrated the conceptual tools available. Past approaches to the study of political opinion can be grouped into four categories with respect to the focus of analytical attention: (1) the formal sanctions that justify and limit the exercise of power within the process of public opinion and policy formation; (2) the initiating sources and the environmental conditions that galvanize or inhibit the process in action; (3) the critical decision-making components in policy determination; (4) the total opinion-policy process or system, through which opinions are transmitted, policy decisions reached, and behavioral adjustments effected on the part of the members of the political society. Among the social sciences political science has been largely preoccupied with (1) and (3), sociology with (2) and (4), psychology and economics with (3) and (4), and cultural anthropology with (1) and (4). Since 1945, however, interdisciplinary communication, especially in the United States, has been steadily breaking through such conceptual jurisdictions.

Political opinion—role as sanction

The location, organization, and exercise of formal, legal sanctions over the process of public opinion and policy formation has long been a central concern of conventional political theory, comparative government, and constitutional law and history. Not until the distinction between legal and political sovereignty was recognized, however, could public opinion become a respectable subject of academic research, and then new methods, concepts, and even disciplines became necessary.

Evidence of the role of political opinion as sanction has been found in (1) the demonstration of widely held faith among the population in the legitimacy of the structures and processes by which public policy decisions are reached; (2) the measurement of divisions of the electorate into organized parties and groups which provide support for, criticism of, or opposition to official government policies; (3) the estimates of the degree of popular satisfaction with the performance of the regime or party in power in promoting the security and prosperity of the political community; (4) the discovery of norms of behavior and procedure expected from public officials in promulgating and enforcing public policies; and (5) the analysis of the moods and qualities of opinion to which policy makers have to adjust their thinking and public behavior.

The concept of political opinion has stimulated inquiries into the distinctive calling (vocation) of the politician—the specialist in organizing political controversy, in formulating and discussing issues, in making decisions and taking protective policy positions in public, in return for which he obtains influence over or access to elective office. Opinion research has provided objective data on the variability of popular moods, demands, expectations; on the scope for choice, error, and misjudgment in policy making; and on career opportunities and the rewards and dangers involved in estimating opinion distributions and trends. Finally, research has documented the conception of government by public opinion as a process of identifying, investigating, and adjusting the differences between mass, interest-group, professionally political, and technically expert conceptions of the public interest, as opposed to the old-fashioned method of elaborating the distinction between the “partial” interests of groups and the “common” interests of the public or community as a whole.

Political opinion as articulation of interests

Of all research into political opinion, studies of social structure and mobility, group organization and activity, and processes of interpersonal and mass communication and their effects upon opinion formation and change have made the greatest advances in precision and sophistication since 1925. However, even in these areas such research has contributed more to an understanding of the sources of public policy formation and of society’s responses to the policy than to an understanding of the operation of the whole process.

Major contributions have been made toward

(1) discriminating the different kinds of opinion aggregates that arouse political controversy (the mass-attention group, the reference group, the attentive public, the opinion-making public, etc.);

(2) isolating and measuring the determinants of opinion by correlating self-identified group opinions with those classified by objective measures of sociopolitical stratification (multivariate analysis);

(3) extending our cognitive “maps” of policy making in organizations that recruit opinion makers who articulate group interests throughout the whole field of cultural, economic, and political activity; (4) specifying the conditions under which individual and mass attitudes and behavior can be modified, distorted, or transformed by organization, leadership, and manipulation; (5) measuring the content and audience exposure of communications; and (6) analyzing the behavior of voters, consumers, buyers, and members of other functional groups in the making up and changing of their minds as the result of exposure to various forms of communication.

The sample survey has been a major vehicle of this progress, but for studying the personal transmission of opinions, the impersonal processes of organizational communication, and the relations between opinion leaders and policy makers, technicians have found it necessary to supplement the sample survey with sociometric, intensive-interview, and other observational methods. The sample survey technique has not yet enabled social scientists to construct a satisfactory general model of how social structure and group organization activate, permeate, and respond to the policy process. It has, however, enormously enhanced their ability to verify, at points of time before, during, and after the process of public decision, the extent to which information, attention, and other attributes of opinion distributions conform to hypothesized statements, however derived. It may be conjectured that the next major advance in our knowledge of the opinion-policy relation will emerge from developments in the fields of organizational theory and decision-making behavior, where sharper concepts of interaction analysis are being developed.

Dimension of decision makers’ behavior

Another large body of empirical inquiry into the opinion-policy process centers upon the behavior of persons in positions to make authoritative decisions that bind or control the acts of others. The study of leadership and organizational behavior falls partially into this category, as do case studies of policy formation, analyses of voting behavior of legislative, administrative, and judicial officials, and studies of the personal contacts and the quantity and content of communication coming to decision makers’ attention. No more than in the previous categories has one single, unifying conceptual framework emerged. It is, therefore, necessary to resort to a paradigmatic presentation of the significant factors which affect decision makers’ judgments and acts.

Decision-making theory does not specifically utilize the concept of public opinion but incorporates data on public opinions and policy communications into indexes of perceptual and informational influences upon the perspective of the decision maker. In decision-making vocabulary, “public opinion” means those links or channels of communication with the external setting of the system that are available to the policy maker and the effective rules which define the source and content of communications that are authoritative for him.

“Basic” techniques for analyzing communications linkages and rules (networks) for policy makers are still rudimentary, and to describe the role of public opinion in decision making, we still resort to common-sense terms derived from the “applied” skills of intelligence, propaganda, and public relations. Studies of the impact of public opinion on public policy makers have been focused on the following: (1) policy makers’ perceptions of whether a policy proposal or issue would be regarded by the public as necessary, would be tolerated, would be controversial, or would be overwhelmingly unpopular, and the extent to which awareness of such attitudes leads to modifications of policies; (2) policy makers’ estimates or anticipations of shifts or changes in public opinion that might result if certain “engineered” events took place, if issues and decisions were presented in certain ways at a certain time, if they were presented by certain prestige or authority figures in ways and by means recommended by the opinion specialist or public relations consultant (the first category is generally regarded as the specialty of the researcher, the second of the policy adviser on planned programs of “opinion preparation”); and (3) policy makers’ acceptance or sharing of the legal and ethical norms held by the majority or at least by substantial numbers of the public.

Policy makers’ perceptions of their opinion climate may be rendered more objective by sample surveys. Their estimates of public reactions may be refined by intelligence operations (military, commercial, or political) and employment of the skills of advertising and public relations agencies. Political biographers, journalists, literary artists, and psychological experts have explored the internalized conflicts produced by motivational drives embodying strong compulsions to violate or to conform to societal norms. Whether the context of application be literary, scientific, or practical, empirical analysis supports the assumption of normative theory that public opinion is not a single source of authoritative command; rather, it has at least three different functions: (1) it provides generalized support for the authority and policy-making system; (2) it articulates group interests; and (3) it is a factor in the judgment of individual policy makers.

Political opinion and public policy

The most pervasive issue dividing theories of the opinion-policy relation bears a striking resemblance to the problem of monism-pluralism in the history of philosophy. The controversy deals with the question of whether the structure of sociopolitical action should be viewed as a more or less centralized process of acts and decisions by a class of key leaders, representing integrated hierarchies of influence in society (“establishment”), or whether it is more accurately envisaged as several sets of relatively autonomous opinion-and-infiuence groups (based on wealth, votes, prestige, beliefs, or violence), interacting with representative decision makers in an official structure of differentiated (elective, judicial, bureaucratic) governmental authority. The former assumption interprets individual, group, and official action as part of a single system and reduces politics and governmental policies to a derivative of three basic analytical terms: society (social differentiation), culture (norms of expected behavior), and personality (internalized drives and modes of adaptive behavior by leaders). The pluralistic assumption retains the familiar dualism between society (the interpersonal affinities of interest, loyalty, and opinion exhibited in spontaneous groupings and voluntary associations outside of government) and the state (the official role structures of government, based upon the institutionalized control of violence and bureaucratic performance of public duties). This approach elevates to the central focus of attention the political patterns of communication (superior force, bargaining, competition, coalition, etc.) between leaders of societal groupings and the hierarchies of official policy determination. The monistic assumption is theoretically simpler and more easily verified, particularly in static, rural, local communities. The pluralistic model is more flexible, in that it allows for variations in the configuration of power, depending upon the nature of the issue, and accounts for more of the facts of urban, industrialized, technologically developed national states. Under either assumption, public policy is an end product of different patterns of communication between representative leaders of societal and of governmental opinion.

Avery Leiserson

[Directly related are the entries Communication, Political; Cross Pressure; Decision Making; International Relations, article on Psychological Aspects; Political Process; and the biographies of Key; Lippmann; Stouffer].

BIBLIOGRAPHY

Almond, Gabriel A. (1950) 1960 The American People and Foreign Policy. New York: Praeger.

Back, Kurt W. 1961 Power, Influence and Pattern of Communication. Pages 137-164 in Luigi Petrullo and Bernard M. Bass (editors), Leadership and Interpersonal Behavior. New York: Holt.

Bendix, Reinhard 1961 Social Stratification and the Political Community. Archives europeennes de soci-ologie 1:181-210.

Berelson, Bernard (1948) 1960 Communications and Public Opinion. Pages 527-543 in Wilbur L. Schramm (editor), Mass Communications: A Book of Readings. 2d ed. Urbana: Univ. of Illinois Press.

Cater, Douglass 1959 The Fourth Branch of Government. Boston: Houghton Mifflin.

Dahl, Robert A. (1955) 1956 Hierarchy, Democracy, and Bargaining in Politics and Economics. Pages 83-89 in Heinz Eulau, S. J. Eldersveld, and Morris Janowitz (editors), Political Behavior: A Reader in Theory and Research. Glencoe, 111.: Free Press.

Doob, Leonard W. 1948 Public Opinion and Propaganda. New York: Holt.

Katz, Elihu; and Lazarsfeld, Paul F. (1955) 1964 Personal Influence: The Part Played by People in the Flow of Mass Communications. New York: Free Press.

Key, V. O. Jr. 1961 Public Opinion and American Democracy. New York: Knopf.

Kris, Ernst; and Leites, Nathan C. (1947) 1966 Trends in Twentieth Century Propaganda. Pages 267-277 in Bernard Berelson and Morris Janowitz (editors), Reader in Public Opinion and Communication. 2d ed. New York: Free Press.

Lane, Robert E. 1959 Political Life: Why People Get Involved in Politics. Glencoe, 111.: Free Press. → A paperback edition was published in 1965.

Lassweix, Harold D.; and Kaplan, Abraham 1950 Power and Society: A Framework for Political Inquiry. Yale Law School Studies, Vol. 2. New Haven: Yale Univ. Press. -* A paperback edition was published in 1963.

Likert, Rensis 1961 An Emerging Theory of Organization, Leadership, and Management. Pages 290-354 in Luigi Petrullo and Bernard M. Bass (editors), Leadership and Interpersonal Behavior. New York: Holt.

Lipset, Seymour M. 1960 Political Man: The Social Bases of Politics. Garden City, N.Y.: Doubleday.

Petrullo, Luigi; and Bass, Bernard M. (editors) 1961 Leadership and Interpersonal Behavior. New York: Holt.

Polsby, Nelson W.; Dentler, R. A.; and Smith, P. A. (editors) 1963 Politics and Social Life: An Introduction to Political Behavior. Boston: Houghton Mifflin.

Rosenau, James N. 1961 Public Opinion and Foreign Policy: An Operational Formula. New York: Random House.

Shils, Edward; and Janowitz, Morris (1948) 1966 Cohesion and Disintegration in the Wehrmacht in World War II. Pages 402-417 in Bernard Berelson and Morris Janowitz (editors), Reader in Public Opinion and Communication. 2d ed. New York: Free Press. → First published in Volume 12 of the Public Opinion Quarterly.

Snyder, Richard C. (1957) 1964 A Decision-making Approach to the Study of Political Phenomena. Pages 3-38 in Roland A. Young (editor), Approaches to the Study of Politics. Evanston, 111.: Northwestern Univ. Press.

Society For The Psychological Study Of Social Issues (1954) 1960 Public Opinion and Propaganda: A Book of Readings, by D. Katz et al. New York: Holt. → See especially pages 1-84, ’The Nature and Function of Public Opinion,” and pages 381-459, “Group Processes: Interaction, Communication and Influence, Social Reinforcement.”

Speier, Hans 1950 Historical Development of Public Opinion. American Journal of Sociology 55:376-388.

Truman, David B. (1951) 1962 The Governmental Process: Political Interests and Public Opinion. New York: Knopf.

Public Opinion

Melvin Small

The public's role in the American foreign policy process is a controversial subject. Generations of diplomats, political theorists, and historians have argued about the nature of the elusive opinion policy relationship. They have been concerned about the abilities of American leaders to operate according to democratic precepts in a pluralistic international system often dominated by autocratic powers.

In arguing for greater authority in foreign affairs for the proposed new Senate in the Federalist Papers, Alexander Hamilton saw the senior house of the U.S. Congress as serving as a defense to the people against their own temporary errors and delusions. Striking a similar theme almost a half-century later, that perceptive observer of the American scene Alexis de Tocqueville was not very sanguine about the prospects for a democratic foreign policy. Writing during a period when the diplomatic activities of the United States were relatively unimportant, he explained:

Foreign politics demand scarcely any of those qualities which a democracy possesses; and they require, on the contrary, the perfect use of almost all of those faculties in which it is deficient…. [A] democracy is unable to regulate the details of an important undertaking, to persevere in a design, and to work out its execution in the presence of serious obstacles. It cannot combine measures with secrecy, and it will not await their consequences with patience…. [D]emocracies…obey the impulse of passion rather than the suggestions of prudence and…abandon a mature design for the gratification of a momentary caprice.

According to Tocqueville and other so-called realists, diplomacy should be the province of a small group of cosmopolitan professionals who perform their duties in secret and with dispatch. Leaders must not encourage their constituents to mix in heady matters of state because the uninformed and unsophisticated mass public is unable to comprehend the subtle rules of the game of nations. Democratic leaders are severely handicapped in diplomatic jousts with authoritarian rulers who are able to contain the foreign policy process within chancellery walls.

Defenders of popular participation in international politics maintain that despite the clumsiness and inefficiency inherent in open diplomacy, the alternative is worse. Leaders who employ devious means to defend a democratic system will, in the long run, pervert or transform that system. At the least, the public and its representatives must have as much influence in the making and execution of foreign policy as they have in domestic policy. A foreign policy constructed and controlled by the people is stronger than one that rests upon a narrow popular base. The victory of the United States in the Cold War can be offered to support that contention.

Historians are just as contentious as political theorists. Despite an enormous amount of rhetoric, speculation, and research, very little is known about the actual relationship between public opinion and foreign policy. Since the late 1940s, survey researchers have explored the dimensions of public opinion while political scientists have considered the ways in which decision makers perceive opinion. Nevertheless, a broad consensus about the nature of the opinion-policy nexus has yet to emerge.

Many studies describe the power of the public and how it has forced presidents into wars and crises against their better judgments. The journalist Walter Lippmann, among others, felt that Tocqueville's prophecies have been fulfilled:

The people have imposed a veto upon the judgements of informed and responsible officials. They have compelled the governments, which usually knew what would have been wiser, or was necessary, or was more expedient, to be too late with too little, or too long with too much, too pacifist in peace and too bellicose in war, too neutralist or appeasing in negotiation or too intransigent. Mass opinion has acquired mounting power in this century. It has shown itself to be a dangerous master of decisions when the stakes are life and death.

Lippmann's position is supported by a host of historical legends: that congressional war hawks, responding to popular jingoism, compelled James Madison to ask for war in 1812, during a period of improving British-American relations; that a spirit of manifest destiny swept James K. Polk along in its wake into the Mexican War of 1846; that expansionist fervor and humanitarian impulses created by an irresponsible yellow press propelled William McKinley into war against hapless Spain in 1898; that myopic popular isolationism restrained Franklin D. Roosevelt's realistic anti-Axis program in the late 1930s; that antiwar protesters humbled the once-omnipotent Lyndon Johnson in 1968 and forced both his withdrawal from public life and his de-escalation of the war in Southeast Asia; and that the bitter memories of that war made it difficult for presidents to intervene militarily in the Third World during the last quarter of the twentieth century. All of these examples lend credence to the principle that the public is sovereign in the United States, even when it comes to matters of weltpolitik.

But all of those historical cases have been interpreted in a very different fashion. Many reputable historians contend that war hawks were not elected in 1810 and that an unimaginative Madison merely lost control and mindlessly drifted into war in 1812; that Polk was the prime instigator of jingoism in 1845 and 1846 with his blunt messages to Great Britain about the Oregon dispute and his provocative movement of troops into an area claimed by Mexico; that McKinley, who exercised weak leadership in 1897 and early 1898, created a serious political problem for the Republicans—a problem whose solution depended upon a declaration of war against Spain; that Roosevelt underestimated his ability to move the nation and, in any event, was more of an isolationist than an internationalist; that Johnson backtracked in Vietnam because the military policies he had pursued for four years had failed on the battlefield; and that when necessary, as in Grenada in 1983 and the Persian Gulf in 1991, presidents had little trouble convincing their constituents to accept their interventions.

To be sure, there is a certain degree of truth in both sorts of interpretations; but, in the last analysis, a careful reading of American history reveals few clear-cut situations in which public opinion has forced presidents to adopt important foreign policies that they themselves opposed. Furthermore, in most diplomatic confrontations, American decision makers were able to act in secrecy and with dispatch to meet challenges from rivals representing authoritarian systems. Indeed, during his administration, the secretive Richard Nixon may have exercised more personal control over his nation's foreign policy than did his counterpart, Leonid Brezhnev, the ruler of the totalitarian Soviet Union. At the least, there was more genuine debate in his Politburo than in Nixon's National Security Council.

Historians, political scientists, and even the participants themselves report that American decision makers pay little direct attention to public preferences, especially in a crisis. Presidents have maintained that it would be unseemly to worry about the public's often uninformed views, and thus their own political futures, when the nation's security is threatened. All the same, fear of outraged public opinion undoubtedly serves as an implicit veto against such extreme options as the preemptive bombing of North Korean nuclear facilities or unilateral disarmament. Moreover, popularly elected statesmen are loath to adopt policies that could lead to a loss of personal prestige. Thus, with their votes U.S. citizens allegedly hold the ultimate club over the heads of their representatives.

Nevertheless, despite the occasional case of a Robert Kennedy who worried openly about popular reactions to a sneak attack on Cuba in the fall of 1962, most decision makers do not consciously consider public opinion when they discuss responses to external threats. As for that ultimate club, foreign policy has rarely figured prominently in national or local elections. The personalities of the candidates, party loyalties, and domestic politics have obscured such major electoral issues as imperialism in 1900, the League of Nations in 1920, the escalation of the war in Vietnam in 1964, and the apparent renewal of the Cold War in 1984.

It is true, however, that although elections may not frequently turn on foreign policy issues, foreign policy sometimes turns on electoral politics. Beginning in October 1968, Americans became aware of the "October Surprise," a dramatic diplomatic or military démarche in the weeks before an election that appeared to have been orchestrated to affect that election. That year, Lyndon Johnson announced a breakthrough in peace talks with the communists in Vietnam a week before what was going to be a very close election. Four years later, the shoe was on the other foot when Richard Nixon's national security adviser, Henry Kissinger, announced a breakthrough in his peace talks with the North Vietnamese in late October.

Other nations may also "participate" in U.S. elections. The Russian leader Nikita S. Khrushchev claimed he helped elect John F. Kennedy by refusing to release U.S. flyers who had been shot down and captured by the Soviets until Kennedy, and not his opponent Nixon, was elected. In 1988, as Vice President George H. W. Bush genuflected toward the anticommunists in his party during his run for the president, he sent a message to the Soviet premier Mikhail Gorbachev to not pay much attention to his campaign rhetoric about U.S.–Soviet relations.

THE PUBLIC AS GOAL SETTER

The lack of compelling evidence for direct popular influence in diplomatic interaction does not necessarily make American foreign policy undemocratic. On the contrary, theorists see the public as sovereign, because it establishes parameters for action and sets goals for presidents and their agents. Broad national policy is said to originate with the people. For example, during the Cold War, the public's foreign policy mandate was clear. It included the desires to defend U.S. interests around the world against the onslaughts of communism and anti-Americanism, to refrain from direct involvement in unnecessary wars, and to engage in diplomatic conduct becoming to a great democratic power. Theoretically, such a mandate was implemented by policymakers who developed shorter-term tactical programs. This widely accepted view is not without its logical and evidential flaws.

In the first place, because of their preeminent roles in the opinion-making process, presidents generally define the relationship of the United States to international events. Consequently, they can make almost any of their actions appear to defend the national interest and to be within the bounds of decorous democratic foreign policy. Further, the limits that the public ostensibly sets for them are remarkably flexible. They can be expanded because of the exigencies of a changing international climate that, according to the policymaker, demand new approaches. In early 1946, for example, Americans looked forward to a long period of normalcy and nonentanglement. Apparently, joining the United Nations was all the internationalism they desired. At the time, few would have approved of the permanent stationing of military units in Europe, nor would they have accepted giving away millions of dollars to foreign friends. By 1948, however, the impact of events—events interpreted by the foreign policy establishment—convinced a majority of citizens that unprecedented interventionist activities were needed to maintain national security. The limits that restrained American diplomats in 1946 were expanded by 1948 through a combination of events and propaganda.

The view is also inadequate when analyzed from the bottom up. The abstract differentiation between the public's task of defining strategic interests and the government's task of developing tactical policies is difficult to make operational. During the early 1960s most Americans supported their government's general attempt to stop "communism" in Southeast Asia. Yet, the bombing of North Vietnam, putatively a tactical policy decision implemented to achieve that goal, became a matter for widespread public debate. Both hawks and doves refused to leave the bombing issue to the planners in the Pentagon. And rightly so, for most major military policies are fraught with serious political implications.

In sum, despite widespread scholarly agreement about its basic outlines, the dominant paradigm delineating the public's role is faulty. The suggestion that the public sets goals and limits while the president executes policy does not adequately describe the opinion-policy relationship in American diplomatic history.

The public and the policymaker do interact in a more fundamental way. Historic periods are marked by unique climates of opinion. From time to time, Americans have been more isolationist than expansionist, more tolerant than intolerant, or more pessimistic than optimistic. Such general moods, which develop as a result of a concatenation of social, economic, and, to some degree, psychological factors, cannot be rapidly changed through elite manipulation.

Those who challenge the notion that national mood is impervious to sudden transformation point to the Spanish-American War and the manner in which the yellow press supposedly created mass interventionist hysteria. Interestingly, many of the explosive elements present during the crisis of 1895–1898 were also present during the Cuban Revolution of 1868–1878. However, the earlier stories of atrocities, gun running, assaults on American honor, and the struggle for Cuban freedom did not arouse a population recovering from its tragic and bloody Civil War. During the 1890s, a different generation of Americans was receptive to the inflammatory accounts in the newspapers of William Randolph Hearst and Joseph Pulitzer. The "psychic crisis" of the Gilded Age produced an audience primed for jingoist journalists and politicians.

Similarly, Richard Nixon, the architect of détente with the People's Republic of China in 1972, could not have proposed such a démarche in 1956. According to most indicators of public opinion, American citizens then would not have been willing to consider such a drastic reorientation of national policy. No one could have been elected to a position of power in 1956 who talked openly about sitting down with Mao Zedong, the "aggressor" in the Korean War. Five years later, President John F. Kennedy, a Democrat from the party that "lost" China in 1949, believed it impossible to alter U.S. policy in Asia. A majority of Americans would first have to unlearn the propaganda lessons of the early 1950s before such a dramatic program could be safely broached by a national leader.

In the years after the Vietnam War, the American public was in no mood to intervene in other distant struggles in the Third World. It is possible that had the public not felt so strongly about this issue, Ronald Reagan would have intervened with U.S. troops in El Salvador in 1981. And while Americans had apparently licked their so-called Vietnam syndrome by 1991, when George H. W. Bush led the nation into war in the Persian Gulf, Bush was convinced he had to terminate the war before marching on Baghdad because he feared his constituents would not support a longer war or more GI casualties. Bush's chair of the Joint Chiefs of Staff, General Colin Powell, supported that decision with what came to be called the Powell Doctrine. The United States could not again participate in a lengthy, Vietnam-style war unless the public expressed enthusiasm about such a venture at the outset.

PRESIDENTIAL POWERS

Aside from participating in the development of a climate of opinion and possessing a latent electoral veto over major foreign policy decisions—two not insignificant functions—the public's direct influence in the making of foreign policy is minimal. Here, more than in domestic affairs, presidents are dominant over both Congress and the mass public. Their ability to create opinion and dominate the opposition assures them a relatively free hand in planning and executing foreign policies.

Because of the vast information-gathering and information-disseminating facilities at their disposal and because they are the only truly national spokespersons, presidents are the most important source of information on foreign affairs. Through their public attention to specific international problems, they can go a long way toward determining the agenda of the national foreign policy debate. Although congressional committees and the mass media have developed their own informational and promotional capabilities, until recently they have not commanded the resources available to the president. It was only during the last decade of the twentieth century that round-the-clock cable television news and Internet sources, available everywhere around the world, began to level the information and propaganda playing fields.

The president's ability to conduct day-to-day diplomacy, free from public pressures, rests on the fact that most Americans are not very interested in esoteric international issues. Naturally, some obscure policies that the public does not care to monitor eventually become major issues. One such example was the unpublicized U.S. assistance to forces opposing Salvador Allende's socialist regime in Chile during the early 1970s.

If presidents' freedom of action in the development of foreign policy depends in good measure upon public inattention, their power in a crisis depends upon public helplessness. During sudden crises citizens must accept their accounts of fast-breaking events or risk further loss of American lives. In May 1846, Americans had no option but to accept President Polk's misleading account of the way American blood had been shed on American soil by Mexican soldiers. Given the apparent need for immediate retaliation and Polk's relative credibility, the public rallied behind his policies and asked questions later. In similar situations Americans supported their leaders during the Korean crisis in the summer of 1950 and the Gulf of Tonkin incident in August 1964. Surprisingly, the public does not always withdraw its support when crisis diplomacy or military intervention fails. After the Bay of Pigs fiasco in April 1961, John F. Kennedy's popularity rose in the polls, as did Jimmy Carter's after the failed rescue mission in Iran in April 1980.

In noncrisis periods the president can develop support for a program by selectively suppressing or releasing secret information. Madison published letters from a turncoat British spy in an attempt to demonstrate that Federalists who challenged his British policies had been conspiring with the enemy. More than a century later, Woodrow Wilson's release of the purloined Zimmermann telegram contributed to the onrushing torrent of anti-German sentiment on the eve of American entry into World War I.

As for the suppression of important information, Harry S. Truman decided to withhold General Albert C. Wedemeyer's 1947 report on China because it was potentially offensive to Jiang Jie-shī (Chiang Kai-shek). More important, its conclusions ran counter to official policies. From 1970 to 1973, Richard Nixon suppressed information on the bombing of Cambodia while some of his aides participated in a cover-up that involved falsification of military records. In one of the most celebrated cases of all, Franklin D. Roosevelt concealed the extent of his involvement as a silent partner in the Allied effort in World War II for fear that such revelations might lead to his electoral defeat and a change in the direction of national policy. His defenders contend that the president and his advisers had a better grasp of what constituted national security than did the well-meaning but untutored public. Like the doctor who tells his patient that the bitter but vitally important medicine tastes good, Roosevelt obscured the issues and misled the people for their own alleged best interests.

Such a position might seem tenable in the light of the times, but its acceptance as a legitimate procedure for all presidents is unlikely. Many of those sympathizing with Roosevelt's position were displeased when Lyndon Johnson was not entirely forthcoming with the electorate about his plans for the war in Vietnam during the 1964 election campaign. Yet both presidents later cited national security in defense of their tactics.

Conceivably, an alert, crusading press can counterbalance the awesome power of the president to mold foreign policy opinions. However, editors move with caution when it comes to printing material potentially detrimental to national security. The New York Times learned of the 1961 Bay of Pigs operation on the eve of the attack. After conferring with the White House, its editors decided not to run the story because they were convinced that the success of that covert operation was a matter of the highest national interest. In a related vein, when columnist Jack Anderson published excerpts from the minutes of the National Security Council during the Bangladesh war of 1971, many reporters joined with the government to criticize his "impropriety." Nixon's aides went beyond mere criticism as they contemplated ways to do away with the columnist who told Americans that contrary to what the White House was saying, the administration was supporting the rapists of West Pakistan against the freedom fighters in East Pakistan.

In general, the press has been far more circumspect in printing diplomatic than domestic exclusives. For journalists, it is one thing to uncover scandals and quite another to publish material that could render aid and comfort to a foreign enemy. Since the 1990s, however, unaffiliated investigative reporters on the Internet have not been so circumspect.

Despite their general mastery of the opinion problem, American leaders have traditionally claimed that the people are important to them as a source of support and inspiration. Since the Jacksonian period, most have probably believed that they were duty-bound to heed the people. Thus, they have constantly attempted to assess public opinion, or at least the opinions of relevant publics. Of course, the opinion evaluated and used by decision makers does not always meet the social scientists' definition of public opinion.

Public officials have traditionally relied heavily upon newspapers and other mass media to discover what people are thinking about. The media, however, are better indicators of the topics in the current foreign policy debate than of the range of opinions on those topics. Despite charges about the biases of the "liberal press," most U.S. newspapers have been owned by Republicans who fill their editorial pages with materials that do not always represent majority opinion in their communities.

Many leaders consider newspaper and magazine columnists to be peers whose approval they covet. Occasionally, they use friendly journalists to float trial balloons for them, so that they can test the political waters before committing themselves to a new course. In some cases columnists may become directly enmeshed in the policy process. In the fall of 1962, Walter Lippmann proposed the dismantling of U.S. missile bases in Turkey as a quid pro quo for the dismantling of Russian bases in Cuba. Nikita Khrushchev mistakenly interpreted the trade-off presented by America's most distinguished columnist as a cue from the White House. This misunderstanding about the nature of Lippmann's relationship to the inner circles of the Kennedy administration contributed to the tension during the Cuban missile crisis. Moscow may have been confused by the fact that the Americans were using John Scali, a television journalist, as an unofficial go-between with one of their diplomats during the affair.

Congress has been the policymakers' second most important source for public opinion. Primarily, they are concerned about the activities of committees with interests in foreign affairs, but they also view senators and representatives as reflecting constituents' interests. From time to time such an interpretation of opinion on Capitol Hill has affected policy outcomes. During the late 1930s, President Roosevelt may have underestimated the public's interventionist sentiment when he treated congressional isolationism as an accurate reflection of the national mood. Today, social scientists suggest that though legislators may reflect the majority opinion in their respective districts on domestic issues, they frequently support foreign policies that run counter to their constituents' preferences. In part, they tend to vote their consciences or party lines on international issues because foreign policy is not important to their constituents. In most cases, members of Congress will be neither rewarded nor punished for their endeavors in the international sphere.

Even when they attempt to reflect faithfully their districts' foreign policy attitudes, the aggregation of their views is not always an accurate reflection of national public opinion. After all, there is no guarantee that national opinion leaders, to whom the president looks for guidance, will share the opinions of local leaders to whom legislators may listen.

During the first twenty years of the Cold War, the handful of congressional critics of presidential foreign policy on both sides of the aisle was not influential. The concept of bipartisanship meant that the opposition was expected to approve executive programs while the president went through the motions of prior consultation. As a product in part of the Vietnam War, in the late 1960s, Congress began to flex its long-atrophied muscles and offer programs and ideas independent of the president and, to some degree, more representative of the range of opinions in the country.

Since the 1930s, policymakers have employed polls as a third indicator of opinion. Even the best of them, however, are not always reliable, especially when they attempt to elicit opinions on foreign affairs. Survey instruments do not lend themselves to sophisticated treatment of such questions and, moreover, rarely cover enough contingencies to be of immediate use to decision makers. During the months before the attack on Pearl Harbor, a majority of those polled thought that the United States would go to war in the near future and recommended such a course if it appeared that England was about to go under. But up to December 1941, only a very small minority told interviewers that they favored an immediate declaration of war. It is impossible to determine on the basis of these data how Americans would have responded to a presidential request for war in the absence of a direct attack on U.S. territory. In addition, some polls are worded so ambiguously that antagonists derive support from the same poll. So it was during the 1960s, when hawks and doves often utilized the same poll to prove that they spoke for the majority concerning the Vietnam involvement. During the last decade of the twentieth century, particularly during the administration of Bill Clinton, policymakers used their own sophisticated polling techniques and focus groups to see how various foreign initiatives might be received by the public. This reliance on first trying out foreign policies on focus groups drew a good deal of criticism during the presidential campaign in 2000 from those who argued that presidents must do what they think is right without checking the nation's pulse and then lead the public to accept their policies.

Phone calls, mail and e-mail, telegrams, and faxes received by the White House and other executive branches represent a fourth source of information about public opinion for the president. Modern administrations keep careful count of the weekly "scores" on specific issues, paying attention to communication that does not appear to be mass-produced by a lobby or political organization. Presidents view significant changes in the direction of opinion or in the number of complaints or commendations on an issue as possibly representing shifts in national public opinion, even though they understand that their sample is very small and hardly a random one. When the mail flow is going their way, presidents often trumpet the news, hoping to affect those who did not write in to climb aboard the bandwagon. Richard Nixon took this part of the activity so seriously that he organized secret Republican operatives around the country to send in supportive letters and telegrams on demand after a speech or a foreign policy initiative.

Last, and most important, politicians claim they have developed finely tuned antennae that enable them to "sense" public opinion. Through an unscientific sampling of opinion from newspapers, Congress, and the polls, and from talking to family members, friends, advisers, and influential leaders, they contend that they can accurately read public opinion on any major issue. Harry Truman told his friends that the polls were wrong in 1948. As he traveled across the nation, he sensed a swing to the Democrats that did not show up in the polls.

To some degree Truman's faith in his political intuition was warranted. Social scientists report that leaders of small groups are better able to assess the range of opinion in their groups than other members are, and, in fact, their rise to leadership status may relate to their superior ability to assess group opinion.

Nevertheless, the politicians' antennae sometimes pick up only opinions that conform to their preconceived notions. Thus, when William McKinley toured the country in 1898 to determine what Americans thought of expansion, he apparently saw and heard only those who favored acquisition of the Philippines. In a slightly different case in the fall of 1937, Franklin D. Roosevelt publicly proposed that the United States begin to take a more active role in curbing expansionists in Asia and Europe. According to most opinion indicators available today, a majority of Americans supported his bold quarantine speech. However, before the fact, the president had convinced himself that his remarks would launch a storm of isolationist protest. Consequently, after scanning the newspapers, telegrams, and letters, he found more opposition than was merited by the empirical data. It is irrelevant to students of the foreign policy process that presidents and their advisers often assess public opinion in an unscientific manner and confuse opinions stated publicly with public opinion. When officials act on the basis of an inaccurate reading of opinion, the opinions they hear represent effective public opinion. Naturally, this might indicate that they use public opinion to rationalize or justify a course already decided upon.

The public is usually most important to the decision maker after a major policy has been implemented. At that point, dissenters who challenge both the legitimacy of the policy and presidential authority may be heard. In most cases, presidents have been able to cope with those who oppose their foreign programs. When they are confronted with some negative and little positive reaction to a policy, they can argue that the absence of widespread dissent is the same as tacit support—the silent majority assents by remaining silent. When the ranks of the dissenters swell in Congress and in the media, presidents can dismiss them as partisans who sacrifice national security for political gain. When, as in the 1960s, hundreds of thousands of dissenters march on Washington and support moratoriums, presidents can call attention to the 250 million who stay home. Most citizens would never think of protesting publicly or marching in open opposition to an official foreign policy. Such behavior appears unpatriotic, especially when it is confounded by officials and the media, sometimes purposely, with the scattered violence and revolutionary rhetoric present on the fringes of contemporary mass protests.

In general, presidents can secure their positions by assailing critics for their irresponsibility—they do not know what the presidents know, nor do they have access to the intelligence reports that flow across a president's desk. Furthermore, critics lack knowledge of the intricate linkages between all diplomatic activities from Asia to Latin America. However, this line of argumentation lost some of its power after the 1970s. Many of the more sensational revelations contained in the Pentagon Papers merely documented rumors and leaks that perceptive citizens gleaned from fragmentary accounts in the media during the 1960s. The spirited public debates over the wisdom of intervention in Vietnam demonstrated that critics in the opposition often have as accurate intelligence and knowledge about the issues as those in the White House.

In the last analysis, presidents can usually contain their critics because they hold the office of president, the most visible symbol of the American nation. Many who may privately express skepticism about certain foreign policies are reluctant to speak up for fear of insulting the dignity of the presidency and, perhaps, the prestige of the United States in the international arena.

The power of the president to mold opinion has been enhanced in the twentieth century by electronic media. During much of American history, national leaders encountered difficulties when they tried to appeal to the mass public. In the 1840s, James K. Polk threatened to "go to the people" whenever Congress challenged him. His threat, however, lacked credibility because he did not possess the physical means to reach them. Almost seventy-five years later, Woodrow Wilson might have succeeded in developing irresistible public pressure for his League of Nations had national radio hookups been available.

In the 1920s radio began to play an important role in the political life of the nation. Franklin D. Roosevelt, a consummate master of the new medium, increased his popular support through frequent direct contact with the public. Television, in the right hands, is an even more powerful tool than radio. During the period following World War II, Americans began to suffer from information overload, a condition brought on by constant bombardment with all sorts of material on complex problems. This condition can produce both frustration and confusion. It is only natural, therefore, that Americans turn to the president for relief; he appears on television as a reassuring father figure to simplify reality and ease anxiety. During most of the post–World War II era, contemporary presidents enjoyed easy access to the airwaves. Even when network executives were skeptical about the importance of a presidential speech or a press conference, they could not resist White House demands for free airtime. According to the journalist Tom Wicker, writing in October 1974:

This is a Presidential "power" that no one wrote into the Constitution, or even "implied" in that document…. It is the power to command a vast audience almost at will, and to appear before that audience in all the impressive roles a President can play—from manager of the economy to Commander in Chief…. This "power"…gives a President an enormous advantage over his political opposition, as well as over the other branches of government, in molding opinion. It magnifies a thousandfold what Theodore Roosevelt, long before television, called the "bully pulpit" of the Presidency.

Naturally, after presidents lose credibility, even the cleverest television and media experts are unable to help them regain their audiences. And with the advent of cable television, which meant that Americans could view scores of stations, the major networks began to refuse to carry many presidential appearances, arguing that interested viewers could always find the president on a public-service channel.

Presidents have been assisted by agencies and departments of the executive branch in their dealings with the public. The Department of State has assumed the major responsibility in foreign affairs. Through the years it has been more interested in information and lobbying functions than in survey research. In 1909, Secretary of State Philander C. Knox established the Division of Information, which was responsible for placing news releases into newspapers and other information channels. In 1934 the department became especially active when it launched a lobbying campaign to assist passage of Secretary of State Cordell Hull's Reciprocal Trade Agreements Act. During World War II, the department began systematically to survey the press and to provide opinion studies to foreign service officers. In 1944 all of its information functions were placed under an assistant secretary for public affairs. During the Cold War, the promotional aspects of the department's work with the public were expanded through liaison with such influential private foreign policy groups as the Council on Foreign Relations and the Foreign Policy Association.

The government has had one unfortunate experience with a formal propaganda agency. The Committee on Public Information (also known as the Creel Committee), operating during World War I, angered legislators and other influential leaders because of the methods it used to sell the war effort to Americans. When the Office of War Information was established during World War II, Congress explicitly prohibited domestic propaganda work. The United States Information Agency and the Voice of America are similarly banned from operating in the United States.

WHO IS THE PUBLIC?

No matter how we assess the public's role in the foreign policymaking process, Americans do have opinions on international affairs. The range of their attitudes, knowledge, and interest is wide. As there are many opinions, so are there many publics.

At the apex of the pyramidal structure often used to depict the American polity is a small group of opinion makers: business leaders, politicians, statesmen, publishers, journalists, intellectuals, and organizational spokespersons. There are four basic types of opinion makers. In descending order of importance, they are national multi-issue opinion makers, such as senators; national single-issue opinion makers, such as presidents of corporations with defense contracts; local multi-issue opinion makers, such as the president of a large bank; and local single-issue opinion makers, such as a professor of Islamic studies at a local university.

This elite, which is involved with international affairs in its daily professional capacities, constitutes the policymakers' primary constituency. Many members of this foreign policy establishment periodically serve in either official or advisory government positions. As opinion makers they transmit their ideas through the media to the rest of the population. In their ancillary role as opinion submitters, they present their policy preferences to those in power. These opinion makers influence, articulate, and represent mass opinion. In such relatively low-profile areas as tariff and trade policies (except for such issues as the North American Free Trade Agreement and the World Trade Organization), they may be the only interested public. Consequently, they can exercise a good deal of influence in the policymaking process. Through their lobbies, pressure groups, and informal contacts with decision makers, they are often able to ensure that national policy serves their needs.

Through most of American history a disproportionate number of opinion makers lived along the eastern seaboard. By the mid-twentieth century, however, they were more widely dispersed throughout the country. Although New York City still maintained its hegemony as the national media and financial capital, new opinion makers in regional power centers like Atlanta and Los Angeles began to play leading roles in the foreign policymaking process.

Below this rarefied group of powerful individuals is a segment of the population, perhaps as large as 10 percent, that has been labeled "the attentive public." This well-educated group, whose composition can shift from issue to issue, is informed about foreign affairs and may be mobilized for some form of political activism. These members of the middle and upper-middle class read intellectual magazines and books, belong to organizations and pressure groups with continuing interests in problems in the international sphere, and are likely to be among those who sign petitions and write letters to politicians. The attentive public helps to transmit ideas and information from opinion makers to the rest of the population through interpersonal communications. Much of the foreign policy debate takes place within the ranks of the attentive public, the primary audience for the opinion makers on most issues.

The remainder of the population, a vast and generally silent majority, is basically disinterested in most diplomatic events and uninformed about the nature of the international system. Wars and crises that result in banner headlines or preemption of popular television shows will arouse them, but they ignore the day-to-day operation of the foreign policy machine. Furthermore, they rarely contemplate the broad strategic concerns that define the American national interest.

The mass public is latently powerful. On occasion it can be persuaded to exert pressure upon the directors of the nation's foreign policy, or even to counterbalance more articulate critics among opinion makers and the attentive public. When Lyndon Johnson and Richard Nixon began to lose the backing of the foreign policy establishment, they appealed to the silent majority for support of their Vietnam policies.

The static pyramidal structure masks some of the behavioral interaction among the three groups. One of the leading students of the issue, James N. Rosenau, proposes the analogy of a gigantic theater featuring daily dramas of international intrigue on its stage. Seated in a disproportionately large and distant balcony, the mass public is unable to see and hear much of the action and, consequently, becomes involved only when the actors reach dramatic peaks. The attentive public, in the much smaller orchestra section, follows the performance closely and even helps those from the balcony whom it meets during intermissions. The players or opinion makers on stage variously direct their attentions to other actors, to specific groups in the orchestra, and, occasionally, to those in the balcony. From time to time, almost everyone within the theater is engaged in activities simultaneously, although the majority in the balcony only rarely applauds or boos.

The American public's ignorance of and disinterest in international affairs is not unique. Surveys tell us that most people in most countries are little concerned with diplomacy. Nevertheless, when compared with their peers in western Europe, Americans tend to score lower on questions demanding knowledge of the outside world.

This situation appalls many observers. Americans are better-educated and more literate today than they have ever been. Print and electronic mass media provide their audiences with more essential information than was available to the decision makers themselves in the nineteenth and early twentieth centuries. Nonetheless, the public is still woefully uninformed about foreign affairs. As late as 1964, more than one-quarter of those polled in a national survey did not know that a communist regime, which had been in power since 1949, ruled on the mainland of China. During the same period, only a handful of Americans could distinguish among Prince Souvanna Phouma, General Phoumi Nosavan, and Prince Souphanouvong, the three rival leaders contending for power in Laos, a country to which millions of dollars and some U.S. military personnel had been committed. In 1997, only 5 percent of the population could name one European nation that was a candidate for membership in NATO. Paradoxically, in earlier days, despite primitive means of communication, the average American probably was better-informed about foreign affairs than he or she is now. Then, boundary disputes and tariff imbroglios not only were diplomatic problems but also dominated the domestic political debate and determined the health of the economy. Of course, the U.S. role in the international system was not very complicated during the first century and a half of American history.

According to several influential scholars, the widespread disinterest in many political issues is not necessarily an undesirable feature of contemporary American democracy. As long as the majority of the uninformed and noncosmopolitan mass public is disinterested, leaders do not have to worry about irrational inputs into the foreign policy process. Indeed, some theorists contend that democracy in a large polity depends upon mass apathy in order to function effectively. If all Americans were to become interested, informed, and active in the political process, decision makers would be subject to constant crosscutting pressures that would render them incapable of performing their duties. Such a model of the civic culture in the United States disturbs some commentators. They call attention, among other things, to a period in the early 1960s when, insulated from public opinion, the government made decisions about political and military commitments to South Vietnam that had tragic consequences for Americans and Vietnamese alike. Had more Americans been aware of the covert and, at the time, relatively obscure programs, the ensuing ventilation of the issues might have led to the development of alternate policies for South Vietnam. The mass public is not always correct in its assessment of prudent foreign policies, but it can monitor and challenge decision makers who may be moving along dangerous pathways.

THE MEDIA AND THE PUBLIC

The American public's lack of interest in and information about foreign affairs is intimately related to the relative lack of interest displayed in such topics by their news and informational organs. Except for a handful of cosmopolitan dailies, few newspapers maintain a staff of foreign correspondents or offer many column inches of international news. Most rely upon one of the major wire services for whatever foreign news they see fit to print. By 2000, the Associated Press, which had come to dominate the wire services in the United States, was used by 1,700 U.S. newspapers and 5,000 U.S. radio and television outlets. The most influential shapers of media presentations of international problems may be the handful of journalists who produce the daily news budgets for the wire services. The New York Times plays a comparable role, particularly for the editors of the television networks' nightly newscasts, who, like most journalists and politicians, consider its judgment about what is important foreign news preeminent among all newspapers.

Electronic media bring foreign news to Americans over regularly scheduled news broadcasts and special programs. For the most part, however, their treatments lack the continuity and background material that would enable their audience to make sense out of a one-minute report on a riot in Nigeria or a thirty-second reference to the fall of the Euro. Television time is so expensive, and the time allocated to news so limited, that viewers are afforded only fleeting, disjointed glimpses of complex international events. News of body counts, bombings, and inflammatory rhetoric are treated without concern for the historical processes in which they are embedded. Only when there is a major crisis do some networks, particularly the cable news networks, offer sustained treatment of an international problem that goes beyond the brief snapshot of the sensational happening. And even then, most viewers, except "news junkies," quickly begin to surf other channels to find lighter programming.

Publishers and editors are convinced that, except in times of crisis, foreign news does not attract large enough audiences to satisfy the demands of their cost accountants. Although they probably are correct in their judgment, a feedback process is at work here. The directors of the mass media perceive their audience as uninterested in most stories with international datelines. Consequently, they offer a skimpy diet of such materials. Presented with such fare, the audience will never become either informed about or interested in international affairs. Whatever the explanation for public and media disinterest in such news, the situation is unlikely to change radically in the foreseeable future. The increasingly complicated diplomatic arena, with its numerous international organizations and nations no longer operating in a simpler bipolar world, makes the task of understanding foreign policy more difficult than it has ever been and, perhaps, not worth the effort for most Americans. After all, to become competent in international affairs in the 1990s, one had to know something about the history of the Balkans, the nature of Islamic fundamentalism, and the social structure of the Peruvian peasantry. In the 2000 election campaign, many Americans sympathized with the Republican presidential candidate George W. Bush, who not only had a difficult time pronouncing "foreign" names but often could not remember them at all. This lack of interest in learning about the world intensified after the Cold War ended and the international system became a less dangerous but also far more complicated place for most citizens.

SOURCES OF THE PUBLIC'S OPINIONS

Although the vast majority of Americans do not closely follow foreign affairs, they do express opinions about foreign countries and problems of peace and war. These opinions, as well as their underlying attitudinal and value structures, are developed in various ways from a variety of sources. Quite often people form attitudes about public affairs because of factors that may have nothing to do with the merits of a case.

An individual's attitude toward foreign policy is determined in part by his or her educational experiences, religious affiliation, age, place of residence, and even sex. Citizens belonging to the same cohorts tend to share similar foreign policy attitudes. College graduates are more likely to be internationalists than people with a high-school education; Catholics are more likely to be hostile to socialist nations than non-Catholics; young people in the 1990s were more friendly to the Japanese than those who remembered Pearl Harbor; midwesterners are usually more isolationist than easterners and westerners; and women tend to be less militaristic than men. All of these rather simplistic dichotomous generalizations are more complicated than they appear at first glance. For example, midwesterners may be isolationist because they live hundreds of miles from the coasts, or because farmers are more isolationist than city dwellers, or for several other reasons. Young people may be relatively friendly to Japanese because they are more tolerant of Asians in general, or because they have learned to understand the Japanese point of view in 1941, or because they harbor guilt feelings about the atomic bombings of Hiroshima and Nagasaki in 1945.

The groups to which an individual belongs are not the only predictors of foreign policy attitudes. Psychological and personality factors also influence, and may even determine, political attitudes. In one of the most famous explorations in this area, researchers discovered that those who score high on the "F" or authoritarian scale are often xenophobic and militaristic, while those with low scores are more tolerant of foreigners and more pacific. The authoritarian and other specific personality types are affected by the pattern of the individuals' relationship to their parents, their sexual experiences, and their career development. In one study of the impact of personality on foreign policy attitudes, psychologists theorized that a subject was pro-Russian during the 1950s because his mother had been an oppressively dominant factor during his childhood. At the other end of the political spectrum, a subject's violent Russo phobia was attributed to his need to display the courage and toughness that he lacked as a youth. Interestingly, it is likely that the more important a public issue is for an individual, the more his or her attitudes will be determined by such psychological factors.

Regardless of the social or personality group to which one belongs, people the world over are generally suspicious of outsiders, whether those outsiders represent a different church, community, or country. Such suspicions increase in inverse proportion to knowledge. Since many Americans lack knowledge of other nations, they often view foreigners both in negative and in stereotypical terms. Stereotypes that simplify a complicated world are most comforting when the individual who relies upon them is not exposed to dissonant information.

For many Americans, and a good many Europeans, Latins are lazy, Jews are shrewd, and Arabs are terrorists. Not all stereotypes are negative. The smaller and less threatening the country, the more likely Americans are to admire its people. Charming and peaceful countries like the Denmark of Hans Christian Andersen and the Switzerland of hardy democrats have long had pleasant images in the United States. Stereotypes for larger and more powerful states are usually more ambiguous. Depending upon the specific historical situation, the positive or negative components of those stereotypes may be dominant. Although at times Americans have been attracted to the polite and clever Chinese seen in the Charlie Chan character, they have at other times been fearful of the fiendish Mandarin Fu Manchu. Germans have been esteemed for their efficiency and cleanliness but also despised for their arrogance and brutality. During the 1940s, Russians went from godless communist conspirators to partisan freedom fighters and then back to godless communist conspirators in a matter of eight years.

In some cases, Americans have confused a country's foreign policy with its nationals. However, when asked about this distinction, they respond that they have nothing against ordinary folk in a rival state, only the ruling class. Indeed, they express sympathy for those who live under dictatorial regimes. All too often Americans have assumed that such benighted people must be hostile to their overlords. This sort of analysis led some to conclude, during the early years of the war in Vietnam, that the North Vietnamese and Vietcong performed so well in the field because they were either drugged or chained to their weapons. Similarly, in the 1990s many Americans believed that the people of Iraq could not wait to overthrow their evil dictator, Saddam Hussein.

The Soviet-American relationship during the Cold War produced the intriguing hypothesis that the antagonists tended to view each other in terms of a mirror image. That is, each side saw its rival as its polar opposite. Russians viewed themselves as defensive and conciliatory and Americans as offensive and refractory, while Americans reversed these images. Such an interpretation is supported by the general psychological principle of projection, in which individuals project their own character flaws onto those whom they dislike. As they emerged from the crushing Vietnam experience in the 1970s, Americans became more self-critical and began to see themselves as others saw them. The mirror-image phenomenon of the 1950s was replaced by a more realistic view of America's role and actions in the international system, at least for a while. Such realistic introspection did not sit well with many citizens who rallied to their old vision of national superiority under the administration of Ronald Reagan.

Although American images of foreign countries may shift from generation to generation, groups organized around their ethnic origins often constitute permanent lobbies for their homelands. Such Americans have been active throughout American diplomatic history. The mythical melting pot has failed to create a new American; even to the fourth and fifth generations, many citizens cling to their original nationality. In diplomatic and military disputes that do not directly involve the United States, German Americans, Polish Americans, and Arab Americans, among others, tend to support their homelands. Often this support is given without regard to the national interest of their adopted country. Fenians of Irish origin tried to bring England and the United States to war in the 1860s. During World War I, German Americans vigorously contested Woodrow Wilson's drift toward the British and ultimately his decision for war. Throughout much of the post–World War II era, Jewish Americans exercised a powerful influence, if not a veto, over U.S. Middle East policy. Cuban Americans played a similar role in affecting the nature of U.S. policy toward Cuba under Fidel Castro.

The ethnically based lobby is only one type of mass pressure group. Other segments of the public can be mobilized because of shared economic interests. In the months before the outbreak of the War of 1812, midwestern farmers agitated for war against England because they blamed their depressed condition on the British Navigation Acts. In the late twentieth century, New England fishermen pressured the State Department to support measures that would keep Russian and other competitors away from their traditional fishing grounds, while most corporate leaders pressured Washington to break down tariff barriers through free-trade and other international organizations.

Ideology can also arouse citizens to action. During the 1930s, many American Catholics worked to prevent the administration of Franklin D. Roosevelt from permitting arms sales to the Republican government of Spain. Conversely, many college students who saw the Spanish Republicans as heroic antifascists attempted to force Roosevelt to relax the arms embargo. During the 1950s, the conservative Committee of One Million was a powerful voice in the debate over America's China policy. Two decades later, a comparable anticommunist group, the Committee on the Present Danger, exercised great influence within the Republican Party in destroying support for Nixon and Ford's policy of détente with the Soviet Union.

Although, from time to time, special interest groups have been able to play powerful roles in American diplomatic history, they have not been as influential in the shaping of foreign policy as they have been in domestic policy. For the most part, American diplomats have been able either to ignore them or to play them off against one another.

CONCLUSION

Wherever we probe in our study of public opinion and foreign policy, we encounter frustrating complexities and ambiguities. Political theorists and historians disagree about the ways the public ought to influence foreign policy and the dimensions of the actual nature of the relationship in American history. Most contend that presidents are somehow constrained by a public that defines broad national goals and sets parameters for action. Yet the presidents' preeminence in the opinion-making process guarantees them almost as much freedom in the international arena as leaders from less democratic systems. The public itself is not monolithic. Several publics possess varying degrees of knowledge of, interest in, and influence on foreign policy. Individuals develop foreign policy attitudes because of exposure to events and as a result of socioeconomic status and personality development.

The wealth of sophisticated research produced by social scientists since World War II underscores the gaps in knowledge about the opinion-policy relationship. Although we know much more about the origins of foreign policy attitudes, as well as the world of the decision maker, the precise nature of the opinion-policy nexus still eludes us. Because of the questions raised about the meaning of the Vietnam experience for the American democratic system, scholars and statesmen began reexamining the public's impact on foreign policy. As might have been expected, considering the earlier debates over this complicated and contentious issue during the life of the republic, they have failed to reach a clear consensus on this most important and often troubling aspect of their unique political system.

BIBLIOGRAPHY

Almond, Gabriel A. The American People and Foreign Policy. New York, 1950. A path breaking effort by a social scientist, now rather dated.

Bailey, Thomas A. The Man in the Street: The Impact of American Public Opinion on Foreign Policy. New York, 1948. The classic impressionistic and wonderfully anecdotal treatment by a dean of diplomatic historians.

Barnet, Richard J. The Rocket's Red Glare: When America Goes to War—The Presidents and the People. New York, 1990.

Benson, Lee. "An Approach to the Scientific Study of Past Public Opinion." Public Opinion Quarterly 30, no 4. (1967–1968): 522–567.

Cohen, Bernard C. The Public's Impact on Foreign Policy. Boston, 1973. One of the soundest treatments of the subject, especially the introductory chapter on the state of the art.

Foster, H. Schuyler. Activism Replaces Isolationism: U.S. Public Attitudes, 1940–1975. Washington, D.C., 1983.

Foyle, Douglas C. Counting the Public In: Presidents, Public Opinion, and Foreign Policy. New York, 1999. An interesting attempt by a political scientist to categorize the approaches of recent presidents.

Graber, Doris A. Public Opinion, the President, and Foreign Policy: Four Case Studies from the Formative Years. New York, 1968.

Hilderbrand, Robert C. Power and the People: Executive Management of Public Opinion in Foreign Affairs, 1897–1921. Chapel Hill, N.C., 1981.

Holsti, Ole R. Public Opinion and American Foreign Policy. Ann Arbor, Mich., 1996.

Kegley, Charles W., Jr., and Eugene R. Wittkopf, eds. The Domestic Sources of American Foreign Policy: Insights and Evidence. New York, 1988. Several useful contemporary studies in this political science volume.

Levering, Ralph B. The Public and American Foreign Policy, 1918–1978. New York, 1978. A valuable brief survey by a leading specialist in the field.

Lippmann, Walter. Public Opinion. New York, 1922. Still a thought-provoking treatise.

——. Essays in the Public Philosophy. Boston, 1955. A critique of democratic leaders' pandering to the emotional masses.

May, Ernest R. "An American Tradition in Foreign Policy: The Role of Public Opinion." In William H. Nelson, ed. Theory and Practice in American Politics. Chicago, 1964, pp. 101–222.

Mueller, John E. War, Presidents, and Public Opinion. New York, 1973. An influential work by a political scientist concentrating on the Korean and Vietnam wars.

Newsom, David D. The Public Dimension of Foreign Policy. Bloomington, Ind., 1996. A practitioner takes a look at the problem.

Rosenau, James N. Public Opinion and Foreign Policy: An Operational Formulation. New York, 1961. A still-important study of the various publics and their relationships to the policymakers.

Shapiro, Robert Y., and Benjamin I. Page. "Foreign Policy and Public Opinion." In David A. Deese, ed. The New Politics of American Foreign Policy. New York, 1994.

Small, Melvin. "Historians Look at Public Opinion." In Melvin Small, ed. Public Opinion and Historians: Interdisciplinary Perspectives. Detroit, Mich., 1970. An analysis of the shortcomings of traditional historical approaches to the subject.

——. Johnson, Nixon, and the Doves. New Brunswick, N.J., 1988. An attempt by a historian to evaluate the influence of the antiwar movement on presidential decision making.

——. Democracy and Diplomacy: The Impact of Domestic Politics on U.S. Foreign Policy, 1789–1994. Baltimore, 1996.

See also Department of State; Dissent in War; The National Interest; Presidential Power; The Press; Race and Ethnicity; Realism and Idealism; Television; The Vietnam War .

NIXON AND THE VIETNAM WAR

When Richard Nixon became president in 1969, he vowed not to make the mistakes his predecessor, Lyndon Johnson, had made in conducting foreign policy. In particular, he was most concerned with the way some elements in the public had affected Johnson's policies in Southeast Asia through telegenic mass demonstrations and other dissenting actions of their anti–Vietnam War movement. Foreign policy should not be made in the street, he and his national security adviser, Henry Kissinger, insisted. They wanted to demonstrate that they could operate just as their foes did in the communist bloc, unencumbered by domestic opinion.

On 15 July 1969, Nixon sent the North Vietnamese leader Ho Chi Minh a secret ultimatum that demanded, in effect: Soften your negotiating position for ending the war in Vietnam by 1 November or face a new and potentially devastating military escalation in the war. Soon after, White House security aides began considering a variety of options that would mete out punishment if Ho failed to meet the president halfway. At the time that Nixon sent his ultimatum, the antiwar movement was relatively dormant, giving the new president a brief honeymoon while he fulfilled his campaign promise to bring the war in Vietnam to a speedy conclusion. When this did not happen by that summer, activists began to plan for a new series of demonstrations against the war. On 15 October 1969, protesters held their largest and most successful antiwar action of the entire war, the Moratorium. In a decentralized series of mostly quite dignified and decorous demonstrations, marches, and prayer vigils, more than two million Americans in some 200 cities took time off from work or school to send the message to Washington that they were displeased with the pace of withdrawal from Vietnam. More important for Nixon, the tone was liberal, not radical, the participants more middle-class adults than hippies. Even Lyndon Johnson's chief negotiator at the Paris peace talks, the distinguished diplomat W. Averell Harriman, took part in the ceremonies. And Moratorium leaders promised another such demonstration every month until the war in Vietnam ended.

Nixon was astonished by the breadth and depth of antiwar sentiment. When the North Vietnamese called his bluff and failed to respond to his ultimatum on 1 November, he decided not to go through with any of the retaliatory "savage blows" planned by his aides. Although the vast support for the Moratorium was not the only reason why he chose not to escalate, it weighed heavily with him. Indeed, it compelled him to go on the offensive against the antiwar movement, beginning with his celebrated Silent Majority speech of 3 November and with a concurrent campaign against the allegedly antiwar liberal media, spearheaded by Vice President Spiro T. Agnew. When the time came again to escalate, Nixon hoped to neutralize if not destroy those who disagreed in public with his policies in Vietnam.

Public Opinion About Life and Death

LIFE AFTER DEATH

Since the dawn of history, many people have believed that human beings do not simply cease to exist once they die. Many religions and cultures teach that the physical body may die and decompose but that some element of the person goes on to what many call the afterlife.

Between 1972 and 1982, when the Roper Center for Public Opinion Research (http://www.ropercenter.uconn.edu/) asked the American public, “Do you believe there is life after death?” 70% said they believed in an afterlife. In 1996, when the Roper Center asked the same question, 73% of respondents said yes. The National Opinion Research Center at the University of Chicago revealed similar results in its General Social Survey 2002 (http://www.cpanda.org/cpanda/getDDI.xq?studyID=a00079). Seventy-two percent of those polled said they believed that there is a life after death. More recently, the article “Poll: Majority Believe in Ghosts” (CBSNews.com, October 30, 2005) notes that 78% of adult Americans believe in life after death.

These data suggest that the proportion of the U.S. population believing in an afterlife is growing, from about 70% between 1972 and 1982 to about 78% in 2005. Data from the General Social Survey agree. (See Figure 11.1.) These data show that the percentage of Jewish Americans who said they believed in an afterlife rose dramatically between 1973 to 2004. In 1973, 16.7% of Jewish Americans believed in an afterlife, but by 2004 the percentage was 35.1%. The percentage of Protestant and Catholic Americans believing in an afterlife rose as well during this period. The percentage of Catholics who believed in an afterlife rose from 68.8% in 1974 to 77.3% in 2004. The percentage of Protestants who believed in an afterlife rose from 75.6% in 1973 to 77.7% in 2004.

Are there differences between those who attend religious services and those who do not? The article “Poll: Majority Believe in Ghosts” indicates what the most and the least religiously observant Americans said on the subject of afterlife. About 90% of those who attended religious services weekly or almost every week believed that humans transition to an afterlife after the physical body dies. About 70% of those who rarely or never attended religious services believed in an afterlife.

Frank Newport of the Gallup Organization notes in Americans More Likely to Believe in God Than the Devil, Heaven More Than Hell (June 13, 2007, http://www.gallup.com/poll/27877/Americans-More-Likely-Believe-God-Than-Devil-Heaven-More-Than-Hell.aspx) that when asked in polls about an afterlife and what that “eternal destination” might be, many Americans expressed a belief in heaven, where people who led a good life are eternally rewarded after death, and hell, where unrepentant people who led a bad life are eternally punished. Newport determines that belief in the existence of heaven and hell increased over time as has the more general belief in an afterlife. From 1997 to 2007 a majority of respondents (72% in 1997 and 81% in 2007) acknowledged a belief in heaven. (See Table 11.1.) In addition, a majority of respondents (56% in 1997 and 69% in 2007) acknowledged a belief that hell exists in the afterlife. (See Table 11.2.)

FEAR AND ANXIETY ABOUT DEATH

In “Poll Analysis: Aging in America” (Los Angeles Times, April 2, 2000), Susan Pinkus, Jill Richardson, and Elizabeth Armet find that people over age sixty-five think about and fear death the least, whereas those aged eighteen to twenty-nine think about and fear it the most. In 2000, 7% of those aged sixty-five and older said they were afraid to die, whereas 20% of eighteen- to twenty-nine-year-olds expressed a fear of dying.

Linda Lyons of the Gallup Organization indicates in What Frightens America's Youth? (March 29,2005, http://www.gallup.com/poll/15439/What-Frightens-Americas-Youth.aspx) that those younger than eighteen are also

R. J. Russac et al. of the University of North Florida conducted studies not only to examine the consistent assertion in the medical literature that young adults typically report higher levels of concern about death than do older adults but also to examine the assertion that women typically report higher levels of concern about death than men do. The researchers report in “Death Anxiety across the Adult Years: An Examination of Age and Gender Effects” (Death Studies, vol. 31, no. 6, July 2007) that the results of their studies support these findings and that anxiety about death peaks at about age twenty. Their results also support previous findings that women report higher levels of concern about death than men do. However, the results also show that the decline in death anxiety after age twenty differed between men and women. Concern about death declined after age twenty in both sexes, but in women a secondary peak in anxiety about death occurred in their early fifties.

concerned about death. She finds that death and dying was the second greatest fear of U.S. teens aged thirteen to seventeen in 2005. (See Figure 11.2.) This number-two spot was shared with a fear of spiders. The number-one fear of teens in this age group was terrorist attacks. Teens were more concerned about death than about war, gang violence, and not succeeding in life.

Fearful Aspects of Dying

Russac et al. wondered why young people would be more anxious and fearful of dying than older people. Other researchers, they note, suggest that older Americans come to terms with death as they age. Other hypotheses include that death is more appealing to those in old age than to younger people (especially to older people with chronic conditions and illnesses), that older people are more religious and this affected their views, and that older people have more experience with death over their lifetime so are less anxious about it. Russac et al. instead consider why young people would be anxious about death and suggest that it might have to do with the concurrent peak in their reproductive years. Their concerns might actually be about their children and wondering what would happen to their youngsters if they were to die. Likewise, some researchers suggest that women report more anxiety about death than men because they are the primary caretakers, not only of children but also of the elderly and those who might be dying. One hypothesis for the peak of anxiety about death in the fifties is that women reach menopause during those years and this change of life may remind women that they are getting older and closer to death.

Even though they may not fear death or spend much time thinking about their own death, Americans are fearful about some aspects of dying. In a survey published in 2001 and conducted by Yankelovich Partners, Time magazine, and CNN, two-thirds of respondents expressed much or some concern about dying in pain. Another two-thirds said they were “very fearful” or “somewhat fearful” of leaving loved ones behind, and 43% of respondents were “very fearful” or “somewhat fearful” about dying alone.

The Yankelovich Partners/Time /CNN survey found that most people (73%) would prefer to die at home rather than in a hospital, hospice, or nursing home. Despite these expressed wishes to die at home, less than half (43%) believed they were likely to die at home—28%thought they were likely to die in a hospital, nursing home, or hospice.

The Seriously Ill Have Different Concerns

In “What Matters Most in End-of-Life Care: Perceptions of Seriously Ill Patients and Their Family Members” (Canadian Medical Association Journal, vol. 174, no. 5, February 28, 2006), Daren K. Heyland et al. find that when patients with advanced chronic illnesses and advanced cancer were asked whether they agreed or strongly agreed about the importance of a variety of end-of-life issues, their concerns were quite different from those of the general population. Even though dying at home appears to be a priority for many Americans, dying in the location of choice (home or hospital) was twenty-fourth on the patients' ranked list of concerns. Their top priorities (very or extremely important) were trusting their physician (ranked first), not being kept on life support when there was little hope (ranked second), having their physician communicate with them honestly (ranked third), and completing things and preparing for death (resolving conflicts and saying good-bye) (ranked fourth). Seriously ill patients also revealed that they did not want to be a physical or emotional burden on their families (ranked fifth), wanted to have an adequate plan of home care were they to be discharged from the hospital (ranked sixth), and wanted to have relief from their symptoms (ranked seventh).

GETTING OLDER

Living to Age One Hundred

The ABC News/USA Today poll “Most Wish for a Long Life—Despite Broad Aging Concerns” (October 24, 2005, http://abcnews.go.com/images/Politics/995a1Longevity.pdf) reveals that in 2005 only one-quarter of a random national sample of one thousand adults wanted to live to be one hundred years or older. Twenty-three percent stated they would like to live into their nineties and 29% into their eighties.

Those surveyed by the ABC News/USA Today poll were asked how likely they thought it was that they would live to be one hundred years old and still have a good quality of life. Thirty-five percent thought it very or somewhat likely, whereas 64% thought it somewhat or very unlikely.

Concerns about Aging

The aging of the baby boomers (the generation born between 1946 and 1964) and the growing number of people living longer have focused much attention on concerns that come with aging. The ABC News/USA Today poll finds that even though respondents wanted to live longer, most were concerned about losing their health (73%). Seven out of ten worried about losing their mental abilities (69%) and losing their ability to care for themselves (70%). The respondents were also worried about being a burden to their families (54%) and living in a nursing home (52%).

Opinions on Nursing Homes

The Henry J. Kaiser Family Foundation conducted a national survey that included questions about nursing homes and reported its findings in Toplines: Update on the Public's Views of Nursing Homes and Long-Term Care Services (December 2007, http://www.kff.org/kaiserpolls/upload/7719.pdf). When asked if they thought that during the past five years “the quality of nursing homes in this country has gotten better, gotten worse, or stayed about the same,” only 14% thought they had gotten better. Thirty-one percent thought nursing homes had gotten worse, whereas 32% felt that they had stayed about the same.

More than half (53%) of respondents felt nursing homes were understaffed, and only 19% believed nursing homes “have staff who are concerned about the well-being of their patients.” (See Table 11.3.) Forty-three percent thought there was not enough government regulation of

these facilities. Only 12% believed that nursing homes provide high-quality services.

SUICIDE

The General Social Survey 2002 and the General Social Survey 2004, both conducted by the National Opinion Research Center (http://www.norc.org/homepage.htm), found that 58% of respondents in each survey approved of suicide if a person had an incurable disease, but only a small minority approved of it if the person had gone bankrupt (8% in 2002 and 11% in 2004), had dishonored his or her family (9% in 2002 and 11% in 2004), or was simply tired of living (15% in 2002 and 16% in 2004). In comparison, a survey from 1977 found that a much lower percentage of people (38%) thought suicide was acceptable if one had an incurable illness. Suicide in other situations was also found less acceptable in the 1977 survey than in the 2002 and 2004 surveys.

According to the Centers for Disease Control and Prevention (March 20, 2008, http://www.cdc.gov/ncipc/wisqars/default.htm), in 2005 suicide was the eleventh-leading cause of death in the United States, the second-leading cause of death among young people aged twenty-five to thirty-four, and the third-leading cause of death among young people aged ten to twenty-four. In Nearly Half of Teens Aware of Peer Suicide Attempts (May 25, 2004, http://www.gallup.com/poll/11776/Nearly-Half-Teens-Aware-Peer-Suicide-Attempts.aspx), Coleen McMurray of the Gallup Organization reports that 22% of American teens (aged thirteen to seventeen) had “ever talked or thought about committing suicide.” Girls were more likely (28%) than boys (16%) to have had suicidal thoughts. When asked if

they had ever tried to commit suicide, only 4% of boys and 9% of girls had.

PHYSICIAN-ASSISTED SUICIDE AND EUTHANASIA

Many advocates of physician-assisted suicide believe that people who are suffering from uncontrollable pain should be allowed to end their life with a lethal dose of medication prescribed by their physician. U.S. public opinion rose slowly from 1996 to 2001 in favor of physician-assisted suicide, from 52% in 1996 to 68% in 2001. After 2001 a slow decline occurred, with 56% in favor of physician-assisted suicide in 2007. (See Figure 11.3.) Results of the same polls show that, in general, a greater percentage of Americans support euthanasia—allowing a doctor to end the life of a patient who is suffering from an incurable disease and wants to die, without requiring the patient to administer the drugs to him- or herself. Figure 11.4 shows that support for euthanasia has increased considerably since the 1940s.

Joseph Carroll of the Gallup Organization indicates in Public Divided over Moral Acceptability of Doctor-Assisted Suicide (May 31, 2007, http://www.gallup.com/poll/27727/Public-Divided-Over-Moral-Acceptability-DoctorAssisted-Suicide.aspx) that in 2007 more Democrats than Republicans supported euthanasia (77% versus 64%, respectively) and physician-assisted suicide (62% versus 49%, respectively). Support of both euthanasia and physician-assisted suicide also varied by frequency of attendance of religious services. Those who seldom or never attended services were the most supportive of both euthanasia (84%) and physician-assisted suicide (73%). Those who attended almost weekly or attended monthly were the next most supportive: 70% supported euthanasia and 52% supported physician-assisted suicide. The least supportive were those who attended religious services each week: 47% supported euthanasia and 35% supported physician-assisted suicide.

Oregon Physician-Assisted Suicide Law

In 1994 Oregon became the first jurisdiction in the world to legalize physician-assisted suicide when its voters passed the Death with Dignity Act. Under the act, Oregon law permits physician-assisted suicide for patients with less than six months to live. Patients must request physician assistance three times, receive a second opinion from another doctor, and wait fifteen days to allow time to reconsider.

Before the Death with Dignity Act could take effect, opponents of the law succeeded in obtaining an injunction against it. Three years later, in November 1997, Oregon's legislature let the voters decide whether to repeal or retain the law. Voters reaffirmed the Death with Dignity Act. The Harris Poll indicates in “Majorities of U.S. Adults Favor Euthanasia and Physician-Assisted Suicide by More Than Two-to-One” (April 27, 2005, http://www.harrisinteractive.com/harris_poll/index.asp?PID=561) that in August 1997, before voters' reaffirmation of the law, 68% of those surveyed said they would approve of a similar law allowing physician-assisted suicide in their state. Asked again in 2001 whether they would favor or oppose such a law in their own state, 61% of respondents indicated they favored such legislation. In April 2005, 67% favored such a law.

Using Federally Controlled Drugs for Assisted Suicide

After the Death with Dignity Act took effect in November 1997, Timothy Egan reports in “Threat from Washington Has Chilling Effect on Oregon Law Allowing Assisted Suicide” (New York Times, November 19, 1997) that Thomas Constantine (1938–) of the U.S. Drug Enforcement Administration (DEA) announced that “delivering, dispensing, or prescribing a controlled substance with the intent of assisting a suicide” would be a violation of the federal Controlled Substances Act of 1970. The U.S. attorney general Janet Reno (1938–) overruled Constantine.

In November 2001 the U.S. attorney general John D.

Ashcroft (1942–) overturned Reno's ruling in an attempt to again allow the DEA to act against physicians who prescribe lethal doses of controlled substances under Oregon's physician-assisted suicide law. In December 2001 the Harris Poll asked adults nationwide whether they considered Ashcroft's effort to overrule the proposition right or wrong. More than half (58%) of respondents believed his action was wrong. On April 17, 2002, Judge Robert E. Jones (1927–) of the U.S. District Court for the District of Oregon agreed, noting that “to allow an attorney general—an appointed executive …—to determine the legitimacy of a particular medical practice … would be unprecedented and extraordinary.” Jones's ruling reaffirmed the Death with Dignity Act. The U.S. Department of Justice appealed the ruling to the Ninth Circuit Court of Appeals. On May 26, 2004, the court upheld Jones's ruling against Ashcroft.

In February 2005 the U.S. Supreme Court agreed to hear the Bush administration's challenge to Oregon's physician-assisted suicide law. The debate of this issue was heard in October 2005 before the High Court. On January 17, 2006, the Court ruled 6–3 that the state's authority overrode federal authority with regard to the Oregon's Death with Dignity Act, thereby upholding the lower courts' rulings.

WITHHOLDING NUTRITION AND HYDRATION: THE TERRI SCHIAVO CASE

The death of Terri Schiavo in March 2005 and the events leading up to her death resulted in an intense debate among Americans over end-of-life decisions and brought new attention to the question of who should make the decision to stop life support, most specifically nutrition and hydration. Schiavo died on March 31, 2005, after her feeding tube was withdrawn days earlier. Schiavo had been in a persistent vegetative state (PVS) since 1990. Her husband, Michael Schiavo, believing that she would never recover and saying that his wife did not want to be kept alive by artificial means, petitioned a Florida court to remove her feeding tube. Her parents, however, believed that she could feel, understand, and respond. They opposed the idea of removing the feeding tube. After years of legal disputes, the feeding tube was removed permanently and Schiavo died.

Two primary questions emerged as the nation watched the Schiavo case unfold: (1) If you were in a PVS would you want to be kept alive by artificial means?, and (2) Who should have the final say in the matter if you had not left an advance directive (living will)? Lydia Saad of the Gallup Organization reports in Americans Choose Death over Vegetative State (March 29, 2005, http://www.gallup.com/poll/15448/Americans-Choose-Death-Over-Vegetative-State.aspx) that in 2005, 53% of respondents worried “a great deal” about “the possibility of being vegetable-like for some period of time.” In exploring this issue more deeply, Dalia Sussman and Gary Langer report in “Two-Thirds Back Spouse in Right to Die Cases” (March 15, 2005, http://abcnews.go.com/images/Politics/975a3Schiavo.pdf) on an ABC News/Washington Post poll, which asked: “If you were in this condition [that of Terri Schiavo] would you want to be kept alive, or not?” Only 8% said “yes,” whereas 87% said “no.” When asked who should have the final say, 65% felt that the spouse should have the final say, whereas 25% believed it should be the parents.

It may be hard to determine the effect of the Terri Schiavo case on the American public, but in an attempt to do so, a FOX News/Opinion Dynamics poll (http://www.foxnews.com/projects/pdf/033105_poll.pdf) of March 31, 2005, asked the question: “Prior to the recent coverage of the Terri Schiavo case, had you ever discussed end of life medical decisions with your spouse, family or friends?” A huge majority (78%) reported that they had. Only 20% had not. Thus, a majority of the American public had dealt with this question before it was highlighted in the media. Nonetheless, the case appeared to generate strong interest in living wills as suggested by a March 25, 2005, poll (http://www.srbi.com/TimePoll-Final_Report-2005-03-25.pdf) by Time /SRBI. Results of the survey revealed that 93% of respondents had heard of a living will, but only 37% had executed such a document. When those who had no living will were asked, “Has the Schiavo case made you think about drafting a living will or discussing with your family your wishes for medical treatment should you be unable to communicate them yourself?” 69% responded “yes.”