Abstract

Policy failures impacted, sickened, and killed disabled New Jerseyans from the beginning of New Jersey's reign as an epicenter in the COVID-19 pandemic. Through a qualitative content analysis of Governor Phil Murphy's coronavirus press briefings, I argue that New Jersey's public health messaging relies on ableist and eugenicist conceptions of intelligence through both an insistence on individual "smartness" to combat the pandemic and a shaming of individual actions which are rhetorically connected to "stupidity." The official state government messages reflect a moralizing, individualizing focus on behavior and shaming of "unintelligent" actions, which shifts attention from leadership and statewide policies to personal responsibility for safety during a public health crisis. In this way, the State of New Jersey abdicates responsibility for illness and death, no matter the personal cost to marginalized populations.


Introduction

Disabled New Jerseyans faced discrimination and disproportionate levels of disease and death from the very start of the COVID-19 pandemic, yet the official message from New Jersey seemed clear: the pandemic's perpetuators were the unintelligent "knuckleheads" whose individual actions should be officially shamed, not the state government whose policy decisions made life-or-death choices which reinforced existing inequalities. New Jersey quickly became one of the epicenters of the COVID-19 pandemic in the U.S. during Spring 2020; as the country's most densely populated state, and with an economy tightly tied to New York City, New Jersey boasted the worst death rate in the nation from COVID-19 for all of 2020 (Statista, 2021). Disabled New Jerseyans were affected at every level, from school districts asking special education students to sign away their right to litigation in order to access virtual school services (Klein, 2020), to administrators at veterans homes forbidding members, vendors, and first responders from wearing masks during March 2020 as the pandemic surged, "devis[ing] a series of penalties with the help of Gov. Phil Murphy's office against nurses who wore the homes' masks without permission" (Fallon, 2020). In April 2020, one NJ nursing home was investigated for a gruesome makeshift morgue of seventeen dead residents (Tully, 2020). Meanwhile, state-run psychiatric hospitals lacked tests or policies to separate sick residents, and in early April, staff members "consistently lacked personal protection equipment…[and] were discouraged from wearing masks 'because it would scare the patients'" (Livio, 2020). In April, reports came in of "nursing homes or hospitals… pressuring guardians to consent to DNRs [do-not-resuscitate orders] and DNHs [do-not-hospitalize orders] without informed consent" (Disability Rights New Jersey, 2021). New Jersey's crisis care standards alarmingly disadvantaged and deprioritized disabled and older New Jerseyans for scarce medical resources (Disability Rights New Jersey, 2021). People of color and disabled people died at disturbingly and disproportionately high rates (New Jersey, 2021). Due in part to a huge crisis in institutions, marginalized disabled people bore a large burden of sickness and death across nursing homes, psychiatric hospitals, veterans homes, state developmental centers, and prisons (New Jersey, 2021). These violations and tragedies represent a long history of devaluing disability—a history that is reflected in the state's pandemic communications. I use a qualitative content analysis approach to argue that by using ableist and eugenicist ideas of intelligence and reliance on the moral model of disability, public health rhetoric works against the interests of one group of people simultaneously affected and sidelined by pandemic policy and language—disabled people.

Setting the Scene: New Jersey, Disability Policy, and the Pandemic

When the novel coronavirus hit New Jersey, it hit a state with pre-existing disability-related policy problems. The state over-relies on the eugenics-era solution of institutionalization (Spitalnik, 2010). Despite closing two state developmental centers in the 2010s and cutting the public institution population in half from 2012-2017 (Larson et al., 2020, p. 102), by the pandemic's beginning in February 2020, the State of New Jersey still operated five developmental centers with 1,238 residents (New Jersey Department of Human Services, 2020). With about 45,000 people in nursing homes, New Jersey failed its disabled and older adult residents through structural and governance problems, according to the Manatt report, which detailed the early toll on nursing home residents at the request of the state (Manatt, 2020). Crowded conditions, with two-to-four residents per room and older buildings, promoted disease spread in facilities, a third of which had been "cited for an infection prevention and control deficiency" pre-pandemic (Manatt, 2020, p. 17). Underfunding, poor technology, and lack of state oversight and emergency planning exacerbated the crisis.

Lack of "federal partnership" in its pandemic response limited New Jersey's ability to control COVID-19 in institutions (Manatt, 2020, p. 53). While NJ lacked control over needed federal resources and guidance, Gov. Murphy wielded considerable power over the local pandemic response because of the way that the U.S. is structured legally, without a federal "police power" to enact certain public health measures (Witt, 2020, p. 112). There's a long history of states controlling epidemic-related response; once the coronavirus pandemic hit,

governors, sometimes desperately and often creatively, exercised state-level legal authority over a nationwide—indeed, worldwide—crisis. Decentralization, however, meant wide legal variation and poor coordination. States, for example, adopted different standards for what counted as an essential business. Efforts to reopen were badly mismatched. Indeed, state and local divergence in coronavirus policies became a hallmark of American law's response to the new contagion. (Witt, 2020, p. 111)

Gov. Murphy and his administration were not alone in steering the state through an infectious disease outbreak; individualism and state-level epidemic responses are encoded into U.S. legal governance structures, and the impact is far-reaching for both disability rights and pandemics. The "expansive conception of state authority" provided by the Supreme Court decision Jacobsen v. Massachusetts (1905) provided precedent for eugenic sterilization (Witt, 2020, p. 59). Both state authority and historical disability policy shaped New Jersey's pandemic outcomes. In New Jersey and across the nation, disability rights activists fought against pandemic government policies with eugenic overtones and grave consequences for disabled people—medical rationing and triage standards for healthcare systems, unmitigated infection spread in institutions, blocked access to needed medications and disability services. The same advocacy goals took on a new urgency in the context of a virus reported to target disabled people and older adults. Amid painful political debates about expendability, sharply visible COVID-19 illness and death rates among disabled people and people of color brought eugenics' role in public health policy into immediate focus.

Public Health, Morality, and Disability

Disability studies has a complicated relationship with public health. Public health campaigns helped position disability as a threat against normalcy. Aparna Nair (2020) argues that "in the 21st century, public health campaigns continue to use disability to instill fear and shame in order to drive certain health behaviors" (Nair, 2020). Eli Clare (2017) calls a Sierra Club campaign, which linked pollution to asthma and cancer, "only a single example in a long line of public health campaigns—against drunk driving, drug use, lead paint, asbestos, unsafe sex, and on and on—to use disability and chronic illness as cautionary tales" (p. 56). Public health and disability studies further disagree on medicalizing disability, rhetoric around disability "prevention" (Hayward, 2004) and systemic ableism in health policy (Seelman, 2004).

Public health policies and interventions can save lives, yet they have harmed marginalized people worldwide. The eugenics movement, which deported, sterilized, institutionalized, and in some cases killed disabled people, people of color, immigrants, queer and transgender people, women, and working class people, was intertwined with public health in rhetoric and practice, from advocating for birth control for undesired potential parents (Ehrenreich & English, 1973/2011) and using compulsory vaccination as precedent for involuntary sterilization of disabled people (Buck v. Bell, 1927), to documenting and surveilling "unfit" Austrians in Nazi Vienna (Sheffer, 2018, p. 88). Europeans used "disease control and 'hygiene' …as important justifications" for imperialism, and public health as a tool of violent control in West Africa (Farmer, 2020, p. 239). With a narrow goal of disease containment, colonizers applied a discriminatory and often-ineffective "control-over-care paradigm" to epidemics, which has persisted to this day (p. 261). During the 2014 Ebola epidemic in West Africa, policies prioritized stopping the spread over caring for sick people. West African patients died in Ebola "treatment" units without supportive care—and often without basic vital sign monitoring or bloodwork (p. 464). Framed as an invariably fatal virus by medical authorities and mainstream media sources alike, Ebola killed West African patients for whom "a lower standard of care was fixed as policy" while Europeans and Americans survived the same dangerous strains, as long as they had access to critical care (p. 487). The control-over-care approach harms marginalized people during outbreaks by devaluing lives, and marginalized Americans have long been devalued and mistreated during epidemics (Witt, 2020, p. 39). U.S. health law is a two-tiered system based on power and privilege:

For middle-class white people and elites, public health policy typically reflected liberal sanitationist values. The law has protected property rights of the wealthy and attended to the civil liberties of the powerful. At the nation's borders, however, and for the disadvantaged and most people of color, the United States has more often been authoritarian and quarantinist. American law has regularly displayed a combination of neglect and contempt toward the health of the powerless. (Witt, 2020, p. 9)

The combination of state control and prioritizing individualism in America worsened disabled people's and other marginalized people's experience of the pandemic.

The moral model of disability provides a useful approach for analyzing New Jersey's governmental communications surrounding the novel coronavirus. The moral model of disability positions disability as "a defect caused by moral lapse or sins" (Olkin, 1999, p. 25) and "as a punishment from God for a particular sin or sins that may have been committed by the person with disability" (Retief & Letšosa, 2018, p. 4). The moral model associates disability with "failure of faith, evil, test of faith" and has the implication of "bring[ing] shame to the person with the disability and his or her family" (Olkin, 2002, p. 133). Within and outside of the field of disability studies, the same concept has gone by other names, such as "archaic conceptions [which] define disease as punishment for bad conduct and the breaking of cultural taboos (Hallowell, 1941; Ackerknecht, 1971: 16; Murdock, 1980: 26)" (Rushing, 1995/2018, pp. 131-132) and "the symbolic (or metaphorical) paradigm, under which a particular impairment serves as a trope for a moral or spiritual condition" (Couser, 2005, p. 22). Western definitions of the moral model create a false dichotomy between the United States and Europe versus the rest of the world. The moral model is named as the first and "oldest" approach to disability (Sontag, 1990; Olkin, 1999; Olkin, 2002; Couser, 2005; Retief & Letšosa, 2018) and as "archaic" (Rushing, 1995/2018). Places where the moral model is perceived as the central conception of disability are portrayed as "non-literate" (Rushing, 1995/2018, p. 163) and "dominated by religious or magical ways of thinking" (Karna, 1999, as cited in Retief & Letšosa, 2018, p. 4), versus a medicalized "scientific" approach to disability, which "prevail[s] in a rationalized society" (Rushing, 1995/2018, p. 132). Racist and colonialist framings appear when scholars elevate Westernized cultures as "rationalized" and "literate," unlike the "magical," "archaic," "religious," "non-literate" societies which moralize disability and disease (Karna, 1999, as cited in Retief & Letšosa, 2018; Rushing, 1995/2018).

However, white European Christians imposed moralizing interpretation onto impairments like leprosy (Chace, 2019), and Christianity contributed to the ideas of "disease [as]… a particularly appropriate and just punishment" (Sontag, 1990, p. 43). Over time, "the blame shifted from sin to 'dirt,' but the moral implications hardly changed" (Ehrenreich & English, 1973/2011, pp. 123-124). I argue that analyzing rhetoric surrounding the COVID-19 pandemic shows how the moral model of disability is an organizing idea in the contemporary United States.

A range of disabilities and diseases provoke sociocultural responses of blame and moralizing, including epidemics like the bubonic plague (Almeida, 2013; Rushing, 1995/2018) and cholera (Almeida, 2013; Rushing, 1995/2018; Sontag, 1990), as well as Hansen's disease (also known as leprosy) (Chace, 2019), cancer (Sontag, 1990), heart conditions (Sontag, 1990), AIDS (Chace, 2019; Rushing, 1995/2018; Sontag, 1990; Witt, 2020), tobacco and substance use disorders (Sered, 2014), and Type 2 diabetes (Brookes & Harvey, 2015). While "obesity" is a contested category from a disability perspective, from a medicalized perspective, fatness is pathologized and couched in blame (Mackenzie, 2010; Thomson, 2009). Many of these disabilities, including cancer, diabetes, and heart conditions, as well as obesity and smoking, are included on the Center for Disease Control and Prevention's (2020) list of conditions that may cause a more severe version of COVID-19, which is reflected in the overrepresentation of New Jerseyans with heart conditions, diabetes, and cancer in state COVID-19 mortality data (New Jersey, 2021).

Medical professionals and policymakers pin health outcomes on individuals by framing disability as a consequence of immoral choices. As disability rights activist Imani Barbarin poignantly points out, "[COVID-19], like any other disability, disease, or illness, doesn't have a moral compass and by projecting one onto the virus, people are subtly saying that those who also contract it are just as deserving" (2020). Improved medical knowledge doesn't necessarily halt moralizing (Rushing, 1995/2018). Blaming disability on individual citizens' choices represents a

neoliberal approach to public health whereby the onus for well-being is placed firmly on the shoulders of the self-determining citizen, a corollary of which is to absolve the government of responsibility towards the health of its citizens (Kemshall 2002, 42; Inthorn and Boyce 2010, 84). The maintenance of health thus becomes the concern of the individual, rather than the state. (Brookes & Harvey, 2015, p. 59)

Lobbying groups for food, beverage, and tobacco industries leverage the interrelated "verbal tactics" of "personal responsibility, consumer choice, and common sense" to build a case against lawsuits for dangerous and unhealthy products, instead blaming people (Thomson, 2009, p. 6). The lobbying group Center for Consumer Freedom uses language and imagery that connects "personal responsibility" to intelligence through an appeal to "common sense" in advertising campaigns:

These ads work not just by appealing to the viewer's desire to be on the smart (rather than stupid) side of the equation but also by making the claim that nutrition and obesity are matters of common knowledge and "common sense" and are thus within the domain of personal responsibility and out of the reach of government regulation (or corporate accountability). (Thomson, 2009, pp. 7-8)

Pandemics can create an environment of moralizing and cause people to question "how could God – or the government – have allowed it? Who is to blame?" (Strong, 1990, p. 254). When "disease outbreaks are perceived as part of a blaming system," it impacts risk communication to the public from public health and government officials (Abraham, 2009, p. 605). News articles during past pandemics attribute responsibility and blame to governments and individuals alike (Liu & Han, 2012; Luther & Zhou, 2005; Lee & Paik, 2017). Rhetoric about morality, disability, and COVID-19 is built upon existing structures and conceptions of American disability and health policy, and illuminates the connections between New Jersey's official pandemic communications and policies.

Methods and Findings

I conducted a qualitative content analysis of 144 publicly available New Jersey state government press conferences about coronavirus, covering the span of March 2nd, 2020, when NJ began being affected by the COVID-19 pandemic, to December 31st, 2020. Qualitative content analysis is "a method that can be used to ascertain and interpret the symbolic themes or cultural meanings about disability that are prevalent in society" (Berger, 2015, p. 186). I coded the press briefings, focusing on emerging themes of intelligence and personal responsibility versus "bad behavior." I analyzed a selection of press briefings within the context of disability-related state pandemic policies and their outcomes on disabled New Jerseyans. As a disability studies scholar, I analyzed this public health messaging from a critical disability studies perspective. My findings are that the NJ government's public health communications during the first year of the pandemic drew upon stereotyped ideas of intelligence and stupidity. I argue that through calls for "smart" behavior, "common sense," and a following of "the basics," the use of the intelligence-associated insult "knucklehead" for public shaming, and a rhetoric of "personal responsibility," the Murphy administration taps into eugenicist notions of intellect, moralizes disability and illness, and shifts the blame for pandemic response from the state onto the public. These messages replicate and reflect the ableist, eugenicist public policies behind the words, which devalue disabled lives.

"Be Smart" and "Use Common Sense"

Language of intelligence weaves its way through New Jersey's public health messaging through the Murphy administration's imploring New Jerseyans to be smart, use common sense, and follow the basics. Beginning in March, the press conferences connect intelligence to following public health measures. In the March 2nd, 2020 briefing, Assistant Health Commissioner Chris Neuwirth said, "To residents, the surest way you could protect yourself and your loved ones and friends is to wash your hands frequently with soap and water, to be smart and cover your cough or sneeze, not with your hand but in your sleeve, and to avoid touching your eyes, nose or mouth" (03/02/2020). "Being smart" is about protecting others as well as yourself: "Please think of others across our state, let alone within your own family whose lives may depend on you doing the right thing and the smart thing" (03/26/2020). "Being smart" in these health communications evolved to include handwashing, physical distancing, following quarantine protocols, staying at home, wearing a mask, and answering contact-tracing calls, as well as following changing guidelines about indoor and outdoor gatherings and businesses; as officials communicated it, "practice smart hygiene" (03/07/2020), "staying home, staying smart" (04/06/2020). Murphy's team linked intelligence with calmness in militaristic language, especially in the chaotic early days of the pandemic. Murphy attempts to defuse anxiety by imploring the public to "be smart" all across March 2020. The governor "accept[s] the anxiety; we understand it. Who couldn't? We appreciate it but it's time for us to be smart, for each and everyone one of us to do our part" (03/15/2020). Panicking is positioned as the opposite of "being smart": "It still is no time to panic. It's time for smart, aggressive, proactive action" (03/16/2020). The government can take on fear for its citizens as long as the citizens will do their duties of being smart: "Leave the anxiety and the worrying to us up here at the table and our colleagues. Keep doing the smart things to protect your families—the basic stuff" (03/20/2020). This call for intelligent action is necessary in the military-style language of battle against the novel coronavirus: "I mentioned several times over the past number of days, we are at war. And you win wars like WWII not because you panic but because you're aggressive, you're smart, you're proactive" (03/23/2020). Anxiety-as-unintelligence draws on associations between types of mental disability while constructing an ideal pandemic citizen: one who is clear-minded, calm, responsible, and smart.

The message to "be smart" stayed constant as the state's guidance changed. In mid-March, Murphy responded to a reporter asking why the 250-person gathering limit was a recommendation versus a ban by saying, "We are assuming that folks are smart enough to adhere to that" (03/14/2020). Murphy opines that "kids are entitled to Spring Break. And bless their hearts, as long as they're smart and they practice social distancing, and they do the sorts of things that we've been encouraging from day one …that's all well and good" (03/15/2020). These are vague exhortations and the rules shift, but the language stays the same. Telling citizens to "just be smart" (09/21/2020) and "please do the smart stuff that we know" (10/22/2020) continued even as the State of New Jersey relaxed the rules, allowing in-person schooling to resume and reopening indoor dining and several riskier indoor-based establishments as a part of a move to a "Phase 3" plan. As if there is nothing the state government can do about links in case increases to the return of indoor dining, Murphy instead implores: "You know, we could not be stronger in our plea in private settings to be in your own bubble, do the smart things, have small scale Thanksgivings" (11/09/2020). Murphy is in charge of what happens to restaurants yet focuses attention on individual dinners at home.

Pleas for "common sense" are given heightened importance. New Jerseyans should "use your common sense" (03/02/2020) about air travel and "use common sense and smart decision-making throughout the holidays" (12/09/2020) to control future COVID-19 cases and hospitalizations in the state. The Murphy administration uses calls for "common sense" to place intelligent action on state residents rather than itself. Prior to Memorial Day weekend, after Murphy raised the outdoor gathering limit to 25 people, a reporter asked if two people from different households could gather, and Murphy agrees but warns people "you've got to be smart. You've got to use common sense" and admits that it will be "a challenge for everyone as we further open, how do you responsibly" open while protecting "vulnerable" people, including "seniors, comorbidities, intensely congregated persons… communities of color" (05/22/2020). Even when acknowledging that his decision to loosen restrictions will impact marginalized communities most, the governor leans on the call for individual intelligent action rather than considering health policy impact. Further, his language surrounding disability is objectifying ("comorbidities") and creates an image of dependency ("vulnerable").

"The basics" show up in gratitude for lowered case numbers and fewer hospitalizations— "it's because you've taken to heart the basics" (06/02/2020)—and disappointment in rising illness levels— "There's only one way to get these numbers back down to where they were only a few weeks ago, and that's by doing the basics" (10/15/2020). Reacting to President Trump's statements post-hospitalization for COVID-19, Murphy wove a tale of personal responsibility and the gravity of the virus that expressed that the tasks asked of people were "basic," especially in a time before medication and vaccines: "The silver lining is what we've got is not advanced calculus. This is basic stuff, folks" (10/08/2020). The underlying meaning here is that you don't need to be the smartest person to understand and comply with public health measures. This line of thinking connects directly to rhetoric that positions as unintelligent people who refuse to follow protocols. I argue that "being smart," "common sense," and "the basics" all describe so-called intelligent actions by individuals, not statewide health policy. "Common sense" is used to emphasize individual choice over government regulation in health messaging, aligning the viewer with the idea of being a smart consumer (Thomson, 2009). These amorphous exhortations change based on policy shifts, yet invariably place the burden for lowered COVID-19 cases, hospitalizations, and deaths on New Jerseyans versus on the state government. The linkage of intelligence to taking action against a pandemic raises questions about who belongs to a community and what causes public health crises. By relying on the outdated idea that intelligence is needed to battle disease, New Jersey's rhetoric inadvertently draws upon eugenicist logic that connects intellectual disability to disease and moralizes individual behavior and illness.

"Don't Be a Knucklehead"

Intelligence in New Jersey COVID-19 briefings is not just about "being smart" but also, conversely, about lack of intelligence and following public health orders. One unique word with interest from a disability studies perspective that emerged in Murphy's public health messaging was undoubtedly "knucklehead." Knucklehead is an intellect-based insult meaning "stupid person," based off a character who modeled bad behavior on 1940s U.S. Air Force training posters (Online Etymology Dictionary, n.d.). Beyond naming and shaming "knuckleheads" in coronavirus press briefings, Murphy also used the insult on traffic signs and official tweets (Murphy, 2020). If there were any doubt that his definition related to ideas of intelligence and stupidity, he dispelled it easily, saying,

We've got knucklehead, the silver medal winner was wingnut, and I want to propose a third flavor for the folks who just no matter what we say or do, just don't do the right thing. …The new nominee I want to put into the category of knucklehead and wingnut is covidiot. (09/04/2020)

Murphy intentionally uses the term with all of its connotations as a part of his public health messaging. At the start of the pandemic, he defends his right to label and shame anybody who willfully breaks New Jersey's COVID-19 expectations, not just teenagers: "A knucklehead is a knucklehead. I don't discriminate based on age" (04/03/2020). There is a wide variety of things you can do to become a "knucklehead":

  • threatening to make other people sick: "a case of another knucklehead – he stated that he was traveling and had coronavirus, and started to cough at police and medical personnel" (03/25/2020); "there are still knuckleheads out there who are claiming they've got it and spitting on people and coughing" (04/15/2020);
  • making threats on social media to a pharmacy testing site: "compliance to the knuckleheads who have been called out, they deserve to be called out for that kind of behavior, running people over at a testing site. I mean, are you kidding me?" (04/20/2020);
  • refusing to follow mask or capacity orders when running a business: "knucklehead behavior, particularly the pictures of those outside bars that we've been seeing. … That's noncompliant unacceptable behavior" (07/02/2020);
  • refusing to wear masks while being in a crowd: "Standing around maskless in a crowd outside a bar is just as big a knucklehead move as standing around maskless inside one" (08/10/2020);
  • throwing Halloween parties: "Parties are subject to both indoor and outdoor gathering limits. You may wish to dress as a knucklehead this Halloween, but we don't want anyone to act like one" (10/05/2020);
  • throwing and attending the New York Young Republicans Club's unmasked, non-socially distant indoor gala in Jersey City when New York would not allow their event: "That is representative Matt Putz — sorry, Matt Gaetz. And based on his past performances, it is obvious being a knucklehead is not beyond the pale for him" (12/04/2020);
  • serving alcohol past a 10 p.m. curfew at reopened bars and restaurants: "By the way, when you act like a knucklehead, you show your true self. You show you don't care about your community. You show you don't care about your customers or your employees. You prove that you only care about yourself" (12/07/2020);
  • not following operation rules for restaurants and bars: "We will not tolerate knucklehead behavior and we will not hesitate to shut you down" (12/11/2020);
  • hosting a warehouse party: "some knucklehead behavior in large scale" (12/28/2020).

In April, Murphy brings up "Knucklehead Row" and warns the state, "Let me be clear, we are taking a zero tolerance policy against anyone who acts as stupidly or puts others in danger, or makes them fear for their health" (04/02/2020). According to the press briefings, a "knucklehead" is not just unintelligent, but also somebody who endangers other people through selfish, noncompliant, scary behavior. Conflating criminality with "act[ing] stupidly," and linking the term to others that play on intellectual disability, such as "covidiot" and "wingnut," harkens back to eugenics, when "feebleminded" raised disability as a dangerous threat to society and the future, and connects back to moralizing disease, such as how New York City's "public health was originally a police function" (Ehrenreich & English, 1973/2011, p. 124).

Shaming people for endangering public health by insulting their intelligence, however, is more likely to further stigmatize New Jerseyans with intellectual disabilities than the parties who defy pandemic restrictions: McDaniel and Renfro (2019) critique liberal/progressive rhetoric that positions former President Trump as childlike, unmanly, and disabled rather than critiquing his harmful policies, which are "an extreme threat to people with disabilities." Considering how progressive members of "The Resistance" constantly argued that Trump's behavior was proof of a mental disability, McDaniel and Renfro argue that "these speculative diagnoses have done little to thwart Trump's rise or undercut his popularity, and the principal victims of such rhetoric—whether utilized by Trump, his critics, or others—are likely to be people with disabilities themselves" (2019). Similarly, the Murphy administration's use of intelligence-based insults in public health messaging—and the New Jersey Democratic State Committee printing the infamous "Don't be a knucklehead" slogan on $25 shirts as a coronavirus relief fundraiser (Gstalter, 2020)—will do most harm to disabled state residents, who have already paid a high price in illness and death in part from the policies NJ has enacted. Considering the outbreaks in the five state developmental centers, it bears mentioning the role that Vineland Developmental Center played in the eugenics movement: Vineland's director of research was none other than Henry Goddard, and during his time at the institution, he shifted IQ tests from tools for treatment to tools to categorize intellectual disability severity (Ferrari, 2017). Goddard's work at Vineland led him to add "morons" to the diagnostic terms used for "feebleminded" people, bringing together a combination of immorality and lack of intelligence. A century later, "covidiot" made it onto Oxford's words of 2020 list; disability rights activist Cal Montgomery noted that the portmanteau "is based on an old term for people with intellectual disabilities (ID), and it perpetuates the bias that people with ID inherently cannot be trusted to make good choices because they aren't 'intelligent' and/or make immoral choices" (2020). Defined as "a person who disobeys guidelines designed to prevent the spread of Covid-19" (p. 8), the individualistic, moralizing, and ableist concept it represented was tightly woven into American pandemic rhetoric. The eugenics movement echoes during a deadly pandemic as once again immorality and stupidity are conflated in order to publicly-shame rulebreakers, while people with intellectual disabilities are not guaranteed medical care, services, or inclusive housing.

"Personal Responsibility"

For the entire 2020 year of the pandemic, the Murphy administration emphasized the importance of personal responsibility in communications to the public. It is the "personal responsibility" of New Jersey's residents to "avoid gatherings both small and definitely large" (03/15/2020) and to keep the state's healthcare system functioning: "take personal responsibility to reduce the spread of COVID-19 by staying home" (03/23/2020). By following public health laws and recommendations, "you are personally responsible for saving lives in New Jersey" (04/13/2020); during Black Lives Matter protests against the police murder of George Floyd, "please do that responsibly, and I mean that not just peacefully, but do it with face protection, with social distancing and if you can, please get yourself tested" (06/05/2020). When returning from a state on the quarantine list, "practice self-responsibility and good citizenship by complying with our travel advisories" (08/05/2020). To bring the rate of transmission down so that the virus spreads slower, "the only tried and true way we can do it is by social distancing, wearing a mask, practicing good hand hygiene, and taking responsibility for our actions. By the way, that means no crowded indoor house parties" (08/05/2020). Overall, the message to New Jerseyans is that individual action alone will stave off COVID cases; the tied-in message is that "bad behavior" by individuals is the cause of outbreaks and case increases.

Two important patterns emerge from analysis of the theme of personal responsibility: first, that it is related to intelligence, and second, that it places blame on the public versus the state government. Linking intelligence and personal responsibility when reopening the parks, Murphy paternalistically discusses "placing tremendous trust in you to keep up with your social distancing" but threatens "to reverse course and close our parks again," ending with an admonition that calls up his favorite insult: "Do not let a minority of knuckleheads ruin this" (04/30/2020). Considering factors about reintroducing dining, the governor muses about how to do so safely when that means going out of your bubble: "I don't think there's any real guidance we can give you on that, other than the basic stuff of be responsible. You know, common sense for the common good, as we said yesterday, and do it right" (06/02/2020). Vague statements such as this one can hardly be called an easy-to-follow public health directive. He draws on common sense when loosening restrictions while hospitalization and death rates are still too high: "So while the stay at home order may be lifted, social distancing, face coverings, personal responsibility must remain our priorities. Common sense again, for the common good" (06/10/2020). The government positions personal responsibility as intelligence: "I hope everybody had a good and responsible weekend.… With the return of limited indoor dining and limited capacity movie showings, among everything else, we had very few reported cases of knucklehead behavior" (09/08/2020).

Personal responsibility places blame on the public versus the state government: Commissioner of Health Judith Persichilli says, "We expect that the spread of the virus can be slowed if we act now and if we act together. Each of us must take personal responsibility for braking [sic] the cycle of this outbreak in our communities" (03/16/2020), placing the onus of stopping the spread on individuals. The government knew the state's plan to reopen meant "we will see COVID-19 cases" (04/27/2020). Restarting the economy, a choice the government and not individuals can make, will lead to cases, which in turn will lead to hospitalizations and deaths. Yet Murphy puts the wellbeing of the state back on individuals when attributing the progress to "the millions of you who have kept the need for social distancing and personal responsibility close to your hearts" (04/27/2020). One egregious example at the beginning of the pandemic is when a reporter asks about whether New Jerseyans should avoid riding mass transit. While Commissioner Persichilli admits that "when you're on a subway I don't know how you could keep six feet away," she ultimately responds, "I think people have to take personal responsibility for making those decisions." State Epidemiologist Dr. Tan agrees "some of that will have to be a personal decision as far as if they have a private conveyance versus if their only option is mass transit" (03/10/2020). This response frames riding the only form of transportation for many people—including people in cities, people who cannot afford cars, and some disabled people—as both dangerous and "a personal decision," rather than acknowledging external factors leading to public transit use or enacting policy to make transit options safer and more accessible.

In response to a reporter asking whether there would be another stay-at-home order if cases worsen, Murphy replies that "all options remain on the table" but pivots to "forget what we decide to do up here. The biggest game changer is personal behavior, especially in the holidays" (12/09/2020). Similarly, Persichilli says, "As we approach the holidays, all of us at the Department of Health wish you a safe and joyous season filled with the joy of knowing that each of you have the ability to protect your loved ones, your neighbors and your community" (12/21/2020). Finally, right before Christmas, the message becomes, "Our healthcare workers are doing heroic things, but it is up to us to keep our loved ones out of the hospital" (12/23/2020). It's one thing to suggest collective measures, but quite another to blame people whose family members are hospitalized with coronavirus. One problem with relying too heavily on personal responsibility rhetoric in health communications surrounding the COVID-19 pandemic is that

emphasizing solidarity and the responsibility of the public places the brunt of the responsibility of dealing with others' social problems on the public and can obfuscate the obligations of the authorities. It can divert attention from the fact that the serious challenges of the pandemic (e.g., limited resources for testing or medical treatment, crowdedness) are a result of previous government policies that resulted in the neglect of the healthcare infrastructure and contributed to health and socioeconomic inequities. (Guttman & Lev, 2021, p. 121)

New Jersey's rhetoric shows how "personal responsibility" becomes not just an action for individuals to practice, but also a tacit means of the government blaming its citizens for its own lack of action. As Aparna Nair observes, in public health campaigns, "Not only is disability a medical 'problem' to be prevented, treated, or cured, it is also framed as the consequence of individual behaviour, [and] the result of moral failures" (Nair, 2020). I argue that the moral model of disability is highly visible in New Jersey's pandemic rhetoric through the attaching of blame to individuals who get sick without acknowledging the complex context and inequities of navigating pandemic life, especially for marginalized people. Since people with "high-risk COVID" conditions, such as diabetes, obesity, and tobacco use disorder, are often blamed for their disabilities, I argue that the moralizing surrounding the COVID-19 pandemic occurs in layers: disabled people who catch COVID-19 can be positioned as doubly immoral—first for being disabled, then for catching the virus. When people are blamed for illness exposures, it is no longer seen as the government's fault for a poor response, or the government's responsibility to act.

Conclusions

Farmer (2020) observes, "The entry of a virus into a human host is never merely a molecular event. As with all things human, inequality plays a noxious role" (p. 471). New Jerseyans with disabilities did not fall ill and perish from COVID-19 at devastating rates solely because of "high-risk" conditions; rather, sociocultural conditions, from institutionalization and inaccessible healthcare to systematized poverty, unjust legal systems, and the persistent historical legacy of eugenics, created this tragedy. With a significant proportion of illness and deaths in New Jersey tied to institutions and affecting people with certain impairments, the pandemic's cost is devastating for disabled people, and within structurally racist systems, this fatal impact is felt disproportionately by disabled people of color. I argue that shifting the burden of illness to the public ignores conditions created or sustained by governments which heighten the possibility of coronavirus transmission. The moral model of disability is prevalent in New Jersey's official coronavirus messaging: "Blaming the victim is inherent in the moral interpretation of disease. People believe the sick are the cause of their own disease" (Rushing, 1995/2018, p. 165). By using moralizing language around COVID-19, the state government's public health messaging lends a feeling of blame and individual responsibility toward those New Jerseyans who are unfortunate enough to contract the novel coronavirus. Personal responsibility damages and blames individuals while shirking policy responsibility:

The script of personal responsibility for suffering pours salt on the wounds of sufferers. At the same time, by assigning individual rather than collective responsibility for human suffering, we divert attention from the misery caused by economic, racial and gender inequalities and absolve governments and corporate leadership from public responsibilities for the wellbeing of citizens. (Sered, 2014, p. 43).

Throughout New Jersey's response to the COVID-19 pandemic, the Murphy administration uses personal responsibility rhetoric. The actions of individuals during public health crises are indubitably important to curbing the spread of disease; however, individuals and their actions cannot replace equitable and just public health policy. The mass media and government's choice to moralize AIDS by associating it with sin and "divine punishment" had "a chilling effect on public policy" and therefore tragic consequences for people with AIDS (Chace, 2019). Blaming people for causing their own illnesses and impairments ignores lack of government regulation (Brookes & Harvey, 2015; Thomson, 2009). The stakes are high during a pandemic, as disabled people and other marginalized people face barriers not just to care, but also to life itself. Even with the best of intentions, public health messaging that relies on intelligence-based insults, moralizing calls for smart action, and an insistence on personal responsibility for community health ignores that public health policy is dependent not on people's choices but on political choices—and uses ableist moralizing language that, in concert with inequitable pandemic policy, harms disabled people.

While popular conceptions imagine Democrats as the party of government regulation, the Murphy administration's approach to the pandemic squarely emphasizes personal responsibility, connecting to broader trends in how American policymakers on both sides of the aisle talk about, interact with, and legislate health. A Democrat leading a liberal-leaning state, Gov. Murphy's messaging reifies ideas about intelligence while some of his early pandemic disability policies further marginalize and endanger disabled people—including/especially people with intellectual disabilities, who face higher rates of COVID-19 illness and death. This continual ableism in speech echoes ableist coronavirus policies and connects to broader critiques of ableism in progressive movements. Given that public health messaging can influence the actions of populations, a critical disability studies lens is necessary because of the material impacts of the pandemic on disabled people's lives in New Jersey.

References

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