Mortality Effects of Healthcare Supply Shocks: Evidence Using Linked Deaths and Electronic Health Records

Ziedan, Engy; Simon, Kosali; Wing, Coady

doi:10.3386/w30553

Cited by 8 publications

(8 citation statements)

References 39 publications

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“…Because the Datavant mortality data do not contain state identifiers, we are unable to assess data completeness in our individual study states of Florida and Ohio. During the COVID-19 pandemic, Datavant mortality data have been used in other peer-reviewed 15 and publicly available 16 research on excess mortality. The Yale University Institutional Review Board exempted the study from review because the data were deidentified, and reporting adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.…”

Section: Data Sourcementioning

confidence: 99%

Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic

2023

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ImportanceThere is evidence that Republican-leaning counties have had higher COVID-19 death rates than Democratic-leaning counties and similar evidence of an association between political party affiliation and attitudes regarding COVID-19 vaccination; further data on these rates may be useful.ObjectiveTo assess political party affiliation and mortality rates for individuals during the initial 22 months of the COVID-19 pandemic.Design, Setting, and ParticipantsA cross-sectional comparison of excess mortality between registered Republican and Democratic voters between March 2020 and December 2021 adjusted for age and state of voter registration was conducted. Voter and mortality data from Florida and Ohio in 2017 linked to mortality records for January 1, 2018, to December 31, 2021, were used in data analysis.ExposuresPolitical party affiliation.Main Outcomes and MeasuresExcess weekly deaths during the COVID-19 pandemic adjusted for age, county, party affiliation, and seasonality.ResultsBetween January 1, 2018, and December 31, 2021, there were 538 159 individuals in Ohio and Florida who died at age 25 years or older in the study sample. The median age at death was 78 years (IQR, 71-89 years). Overall, the excess death rate for Republican voters was 2.8 percentage points, or 15%, higher than the excess death rate for Democratic voters (95% prediction interval [PI], 1.6-3.7 percentage points). After May 1, 2021, when vaccines were available to all adults, the excess death rate gap between Republican and Democratic voters widened from −0.9 percentage point (95% PI, −2.5 to 0.3 percentage points) to 7.7 percentage points (95% PI, 6.0-9.3 percentage points) in the adjusted analysis; the excess death rate among Republican voters was 43% higher than the excess death rate among Democratic voters. The gap in excess death rates between Republican and Democratic voters was larger in counties with lower vaccination rates and was primarily noted in voters residing in Ohio.Conclusions and RelevanceIn this cross-sectional study, an association was observed between political party affiliation and excess deaths in Ohio and Florida after COVID-19 vaccines were available to all adults. These findings suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been factors in the severity and trajectory of the pandemic in the US.

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Section: Data Sourcementioning

confidence: 99%

Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic

2023

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“…First, it is not contaminated by measurement error in the choice of what to label a "COVID" death, which could systematically vary across groups. Second, it allows us to capture not only direct effects of the pandemic on mortality but also potential indirect effects that might occur, for example, due to the declines in economic activity (Ruhm 2000;2005;Stevens et al 2015), effects of individual job loss (Sullivan and Von Wachter 2009), avoidance of medical care (Zhang 2021;Ziedan et al 2022), or changes in health behaviors such as drug use (Friedman and Akre 2021). 7 We use mortality records from January 2011 through February 2021 from the Census Bureau's version of the Social Security Administration's Numerical Identification (Census Numident) database.…”

Section: All-cause Mortalitymentioning

confidence: 99%

Heterogeneity in Damages from A Pandemic

Finkelstein¹,

Kocks²,

Polyakova³

et al. 2022

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“…Locations with an older population may have larger reductions in COVID‐19 deaths from SIP policies, while locations with younger populations may be more impacted by non‐COVID causes of excess death (e.g., deaths of despair). At the same time, older populations are more likely to be impacted by delayed non‐COVID medical care (Ziedan et al., 2022).…”

Section: Robustness Testsmentioning

confidence: 99%

The impact of COVID‐19 shelter‐in‐place policy responses on excess mortality

et al. 2023

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As a way of slowing COVID‐19 transmission, many countries and U.S. states implemented shelter‐in‐place (SIP) policies. However, the effects of SIP policies on public health are a priori ambiguous. Using an event study approach and data from 43 countries and all U.S. states, we measure changes in excess deaths following the implementation of COVID‐19 shelter‐in‐place (SIP) policies. We do not find that countries or U.S. states that implemented SIP policies earlier had lower excess deaths. We do not observe differences in excess deaths before and after the implementation of SIP policies, even when accounting for pre‐SIP COVID‐19 death rates.

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Mortality Effects of Healthcare Supply Shocks: Evidence Using Linked Deaths and Electronic Health Records

Abstract: NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

Cited by 8 publications

References 39 publications

Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic

Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic

Heterogeneity in Damages from A Pandemic

The impact of COVID‐19 shelter‐in‐place policy responses on excess mortality

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