The Evolving Roles of US Political Partisanship and Social Vulnerability in the COVID-19 Pandemic from February 2020 - February 2021

Abstract

The COVID-19 pandemic has had intense, heterogeneous impacts on different communities and geographies in the United States. We explore county level associations between COVID-19 attributed deaths and social, demographic, vulnerability, and political variables to develop a better understanding of the evolving roles these variables play in relation to mortality. We focus on the role of political variables, as captured by support for either the Republican or Democrat presidential candidates in the 2020 elections and the stringency of state-wide governor mandates, during three non-overlapping time periods between February 2020 and February 2021. We find that during the first three months of the pandemic, Democratic-leaning and internationally-connected urban counties were affected. During subsequent months (between May and September, 2020), Republican counties with high percentages of Hispanic and Black populations were most hardly hit. Importantly, in the time period between October 2020 and February 2021, when the effectiveness of non-pharmaceutical interventions, such as social distancing and wearing masks indoors, had been well-established. During this period, we find that Republican-leaning counties experienced up to 3 times higher death rates than Democratic-leaning counties, even after controlling for multiple social vulnerability factors. We also find that Republican-leaning counties in states with less strict mandates experienced the most severe outbreaks. Our findings suggest that ideologies promoted by prominent political actors may not align with efforts to mitigate the impact of the ongoing pandemic and prevent deaths.

Note: Funding: MS was partially supported by the National Institute Of General Medical Sciences of the National Institutes of Health under Award Number R01GM130668.

Declaration of Interests: None to declare.

Keywords: COVID-19, COVID-19 mortality, social epidemiology, equity and inclusion, social disparities, politics, demographics, social vulnerability