OBJECTIVES: This survey of a Census-balanced sample of the United States population elicited views on health beliefs, equity, and distribution of healthcare resources. The objectives were to provide context on views on health equity in the United States; and to compare our results to surveys fielded before COVID-19 and the social justice movement.

METHODS: Survey questions included items adapted from prior US surveys, such as the 2018 National Survey of Health Attitudes (NHSA), and standard demographic questions. Survey themes included health inequalities and access to care. Questions were framed around US population groups: ‘Better Off’, ‘Worse Off’, or ‘Middle’, in terms of length/quality of life and factors influencing geographic social vulnerability and social determinants of health. Respondents self-reported being in one of these groups. Survey responses were summarized using descriptive statistics and compared across groups.

RESULTS: Among 1864 respondents recruited between June and December 2023, 19% self-reported as ‘Better Off’, 20% as ‘Worse Off’ and 61% as ‘In the Middle’. 89% of worse-off and 76% of better-off respondents agreed/strongly agreed with the statement that they supported reducing health inequality between better- and worse-off Americans. 82% of all of respondents stated that it was harder for worse-off Americans to access healthcare versus better-off Americans. Access to healthcare, health insurance and economic resources were the top three reasons selected for why the worse off live 10 years less than the better off. In 2018, results from a similar question cited personal choices/behavior instead of health insurance as a top reason.

CONCLUSIONS: Our data suggest notably increased awareness of health equity, as well as a change in attitude among the American public in recognizing system versus individual level drivers of health inequalities. This indicates that a growing proportion of Americans are averse to health inequality and that these views are perhaps intensified among socially vulnerable Americans.