Objective: Although the Centers for Disease Control and Prevention eventually recommended wearing masks in public to slow the spread of the coronavirus, the practice has been unevenly distributed in the United States. Methods: In this article, we model county-level infrequent mask usage as a function of three pillars of conservatism: (1) Republican political leadership (percentage of votes for Donald Trump in the 2016 presidential election), (2) conservative Protestantism (percentage evangelical Christian), and (3) right-wing media consumption (Google searches for Fox News). Results: Our analyses indicate that mask usage tends to be lower in counties with greater support for President Trump (in majority Trump counties), counties with more evangelical Christians, and areas with greater interest in Fox News. Conclusion: Given the effectiveness of masks in limiting the transmission of respiratory droplets, conservative ideological resistance to public health and recommended pandemic lifestyles may indirectly support the spread of the coronavirus.
KEYWORDS COVID-19, health behavior, politicsAfter spreading around the world in a matter of months, the novel coronavirus (SARS-CoV-2/COVID-19) has become a leading cause of death in the United States. According to the Coronavirus Resource Center at Johns Hopkins University (2021), nearly 600,000 Americans have already died from COVID-19. Although the United States accounts for only 4 percent of the global population, it has contributed 17 percent of all COVID-19 deaths worldwide. In an effort to slow the spread of the coronavirus, the Centers for Disease Control and Prevention (CDC, 2020) have proposed several mitigation strategies like staying home, social distancing, hand sanitizing, and wearing masks or other protective face coverings. The recommendation of wearing masks has been particularly contentious in the United States. Because wearing a mask is so important for public health, we must begin to seriously model this polarization. The fundamental question