Experts in many fields — domestic violent extremism, civil conflict, democracy studies — are concerned about the likelihood that political violence will soon break out in the United States. Nearly 90 percent of Americans are concerned, too, according to a Washington Post-ABC News Poll conducted after the politically-motivated assault on Paul Pelosi.
Our group of clinicians and researchers approaches political violence as a public health problem. Like violence generally, political violence passes the Satcher test for health problems: It kills and injures people and has important adverse effects across entire populations.
From that vantage point we have been monitoring concurrent developments — unprecedented increases in firearm homicide and suicide and in purchases of firearms, widespread support for overtly racist beliefs and notions such as the QAnon complex and the ”great replacement” conspiracy, weakening support for democracy as a form of government, and concerningly high levels of endorsement for violence to achieve political objectives — that point toward a grim future for the United States.
One of the first steps toward changing the nation’s trajectory is understanding it better. In July we published the first report from a nationwide survey, presenting whole-population data on support for and willingness to engage in political violence. I discussed that report in this commentary.
A critical element of the public health approach is knowing who’s most at risk; such knowledge underlies effective prevention work. With that in mind, we’ve just published two studies of variation in the prevalence of violence-related extreme beliefs and in support of and willingness to engage in political violence.
The first study was conducted with 8,620 respondents drawn from the IPSOS KnowledgePaneland focused on variations associated with political party affiliation and political ideology. We found that, on the whole, Republicans were more likely than Democrats to endorse the use of physical force or violence to achieve specific political objectives. This is consistent with prior survey research and other evidence that the threat from domestic extremism arises chiefly from the right.
The second study was conducted with 7,255 respondents from that sample of 8,620 for whom information about the respondents’ party affiliation, 2020 voting information and opinion on the legitimacy of the 2020 presidential election was available. The study focused specifically on MAGA (Make America Great Again) Republicans, defined as Republicans who voted for Donald Trump in 2020 and who agreed strongly or very strongly with the statement that “the 2020 election was stolen from Donald Trump, and Joe Biden is an illegitimate president.” Among the respondents were 1,128 “MAGA Republicans,” 640 “strong” Republicans, 1,571 “other” Republicans and 3,916 non-Republicans (Democrats and those reporting no party affiliation).
This study addressed questions arising from two recent speeches President Biden gave in Maryland and one in Pennsylvania: Are MAGA Republicans a distinct subset of Republicans? Are they more likely than others to endorse political violence?
The answer was an emphatic “yes” in both cases.
Compared to self-identified strong Republicans, other Republicans, and non-Republicans, MAGA Republicans were more likely to choose “having a strong leader” over “having a democracy” (31 percent, 17.8 percent, 17 percent and 15.2 percent, respectively) and to predict civil war in the next few years (30.3 percent, 7.5 percent, 10.8 percent, 11.2 percent).
They were far more likely than others to agree strongly or very strongly with the assertion that “in America, native-born white people are being replaced by immigrants” (51 percent, 23.1 percent, 14.4 percent, 7 percent) and with the QAnon delusion that American institutions “are controlled by a group of Satan-worshipping pedophiles who run a global child sex trafficking operation” (26.7 percent, 5.4 percent, 6.5 percent, 5.6 percent).
MAGA Republicans were much more likely than others (58.2 percent, 38.3 percent, 31.5 percent, 25.1 percent) to endorse violence as usually or always justified to advance at least one of 17 specific political objectives, and they were more likely to endorse violence to advance eight of those 17 objectives considered individually. Examples include “to return Donald Trump to the presidency this year,” “to preserve an American way of life based on Western European traditions,” and “to stop illegal immigration.” They were more likely than others to predict that they would be “armed with a gun” (18.6 percent, 9.5 percent, 8.1 percent, 4.7 percent) and “carry a gun openly” (9.3 percent, 4 percent, 3.2 percent, 2.6 percent) in a situation where they considered political violence justified.
These concerning findings on MAGA Republicans gain additional significance with new reports from the New York Times and Washington Post that more than 200 Republicans just elected to Congress and important state offices may, by our definition, be members of that group.
To take all this information at its worst: We may have just elected an entire cohort of racist conspiracy theorists who prefer a strong leader to democracy, endorse political violence and think civil war is coming.
How might such beliefs among MAGA legislators translate into policy? Consider the implications for violence prevention of belief in the “great replacement”: a conspiracy to replace native-born white Americans with immigrants and people of color. For a believer who’s a native-born white American, it’s possible to see interpersonal violence not just as “not my problem” (because the people at greatest risk don’t look like me), but as not a problem at all. For such a person, interpersonal violence could be the solution to a problem — it eliminates their replacements. Deep-seated racism and xenophobia could underlie active opposition to violence prevention efforts, particularly where structural change is involved.
Not all the news is bad; there were important hopeful findings in all three of our survey reports. First, most respondents rejected political violence altogether. Second, when we asked those who endorsed violence in the abstract about their personal willingness to participate, a large majority — about 80 percent — said that they were unwilling to engage in political violence themselves. In most cases, less than 3 percent of our study groups — Democrats, Republicans, MAGA Republicans, liberals and conservatives — were very or completely willing to commit violence against other people.
This hopeful news comes with two caveats, unfortunately. First, broad support for political violence, even if most supporters want no part in it themselves, can ease the path to violence for those who have no scruples about personal involvement. Second, with 258.3 million American adults, a small percentage of such a large number is still a large number.
Nonetheless, the findings demonstrate that most Americans do not endorse political violence, and as often happens with a public health approach, they point to a specific opportunity for intervention among those who do. The challenge is to prevent support for violence in the abstract from evolving into a personal willingness to commit such violence. Others have written at length about the factors driving that evolution and what interventions might help those at risk take a few steps away from the cliff. Still, others are already conducting small experimental trials — vaccines against violence is an appropriate metaphor — and the results are promising. And for the first time, a government-wide strategy to combat violent domestic extremism is being implemented.
We cannot allow today’s sense of relief to reduce our concern for political violence as a threat to the nation. An emergency could yet develop as vote counting drags on or as tensions build ahead of Georgia’s Senate runoff election. With luck, we might even have until November 2024, but absent a concerted effort and a change in our current trajectory, it’s likely just a matter of time.
Garen Wintemute, M.D., M.P.H., is director of the California Firearm Violence Research Center and the Violence Prevention Research Program, both at UC Davis. He is a practicing emergency physician.