Associations of presidential voting preference and gubernatorial control with county-level COVID-19 case and death rates in the continental United States

Abstract

Objective To investigate the associations of state gubernatorial party control and 2016 county-level presidential election preference on COVID-19 case and death rates in the United States. Study design This was a secondary analysis of publicly available data. Methods Data including county-level COVID-19 case and death counts through February 9, 2021, 2020 gubernatorial data, and county-level US Census Bureau data, Broadstreet area deprivation index, and 2016 presidential voting tallies were included. Negative binomial regression estimated the adjusted impact of each variable on COVID-19 case and death rates. Results A total of 3102 counties in the 48 continental United States plus Washington DC were included. County-level case and death rates were higher (12% and 22%, respectively) in Republican vs Democrat controlled states. Case and death rates were higher in counties voting Republican vs Democrat in 2016 and were modified by counties with median ages ≥ 50 years (54% increase in case rate and 91% increase in death rate). Conclusions These data further support the need for prevention efforts to focus on public health while extricating guidance and prevention from political agendas.

Deep Learning Analysis of COVID-19 Vaccine Hesitancy and Confidence Expressed on Twitter in 6 High-Income Countries: Longitudinal Observational Study

“…The sociodemographic variables included political affiliation (Republican as the reference or Democrat party) [30], population density (number of people per square mile), percentage of people aged ≥65 years, and log-transformed gross domestic product per capita [31]. Current evidence shows that Democrats were estimated to have a higher vaccination rate, lower hesitancy toward COVID-19 vaccination, and fewer COVID-19 cases and deaths [6,[32][33][34][35]. Population density was estimated to be associated with risks of infection, with a higher density catalyzing the spread of COVID-19 [36], which may lead to a higher willingness to COVID-19 vaccination.…”

Hurt on Both Sides: Political Differences in Health and Well-Being during the COVID-19 Pandemic

“…Despite the rise of "party sorting"-in which beliefs and attitudes tend to cluster by partisanshipmost Americans fall somewhere in the middle (Abrams and Fiorina 2015), and they endorse policy stances or beliefs in ways not fully captured by political affiliation or voting behavior (Boutyline and Vaisey 2017; Brandt and Morgan 2022; Grumbach 2018; Kiley and Vaisey 2020).However, even with this heterogeneity across dimensions of political background, political divides in mortality and prophylactic health behavior during the COVID-19 pandemic have been strikingly clear. Epidemiological research finds higher COVID-19 infection and mortality rates in conservative or Republican-leaning geographic areas compared to more liberal or Democratic areas, even after adjusting for demographic confounders (e.g., Eden et al 2021;Sehgal et al 2022)-with some notable exceptions early in the pandemic (e.g., New York City; Chen and Karim 2022). Meanwhile, stark differences in attitudes about the pandemic, including lower perceived risk, less endorsement of masking, and weaker support 1200500H SBXXX10.…”

“…However, even with this heterogeneity across dimensions of political background, political divides in mortality and prophylactic health behavior during the COVID-19 pandemic have been strikingly clear. Epidemiological research finds higher COVID-19 infection and mortality rates in conservative or Republican-leaning geographic areas compared to more liberal or Democratic areas, even after adjusting for demographic confounders (e.g., Eden et al 2021; Sehgal et al 2022)—with some notable exceptions early in the pandemic (e.g., New York City; Chen and Karim 2022). Meanwhile, stark differences in attitudes about the pandemic, including lower perceived risk, less endorsement of masking, and weaker support for public health agencies, have been observed among conservatives or Republicans compared to liberals or Democrats (Barrios and Hochberg 2020; Gadarian, Goodman, and Pepinsky 2021; Kwon 2023; Stroebe et al 2021; Wolaver and Doces 2022; Young et al 2022).…”