County-level support for Trump linked to COVID-19 death rates

New research provides evidence that counties with higher levels of Trump support in 2016 fared worse than their non-Trump-supporting counterparts after implementing public health policies meant to prevent the spread of COVID-19. The study, which examined the early stages of the novel coronavirus pandemic, appears in the journal World Medical & Health Policy.

“This pandemic happened at a very special time in the United States with the presidential election going on,” said study author Jingjing Gao, a PhD candidate at The University of North Carolina at Charlotte. “The then president’s health policy preferences were different from health experts. We wanted to see whether political ideology played a role in the death outcomes at the beginning of this pandemic.”

The study utilized data from Johns Hopkins University’s COVID-19 Tracking Project and the 2016 U.S. Presidential Election. The researchers also used smartphone tracking data provided by SAFEGRAPH to estimate the effectiveness of stay-at-home policies from April 6 to May 25.

As expected, counties with a large population and a high percentage of elderly people tended to have greater death rates. County-level support for Trump by itself was not associated with COVID-19 death rates. However, the researcher found that “predicted rates of COVID-19-related deaths in counties with high levels Trump support increase along with the duration of implementation of several COVID-19 policies” such as stay-at-home orders.

In other words, after COVID-19 policies were put into place, the number of deaths per county increased more rapidly in counties with higher levels of Trump support than in counties with lower levels of Trump support.

“Sometimes people have to make personal choices about responding to a health crisis when they face mixed voices from politicians and health experts,” Gao told PsyPost. “Political polarization not only alienates Americans but it can also cause them to make decisions that kill them.”

The researchers found that individuals in counties with high levels of Trump support showed less compliance with stay-at-home policies, which suggests that “the positive interaction effects found between policy implementation duration and level of Trump support are likely the result of poor compliance with public health guidance,” the researchers said.

However, the link between Trump support and COVID-19 death rates did not appear to be related to noncompliance with stay-at-home policies in particular. Counties with a higher proportion the population staying completely at home tended to have greater COVID-19 death rates. “We suspect this may be due to reverse causality: compliance is higher in areas with greater coronavirus risk,” the researchers explained.

Instead, the link between Trump support and COVID-19 death rates might be a result of other types of noncompliance not captured by the study, such as “improper mask usage or failure to social distance in nonprofessional settings (e.g., parties or social gatherings),” the researchers added.

The findings are in line with another study published in the American Journal of Preventive Medicine, which found that per-capita rates of new COVID-19 cases and COVID-19 deaths were higher in states with Democrat governors in the first months of the pandemic in 2020, but became higher in states with Republican governors by mid-summer and through the rest of the year.

But the new study “only focuses on the first several months of this pandemic,” Gao noted. The findings may not generalize well beyond this timeframe. “We will have further research on the following period.”

The study, “Death by political party: The relationship between COVID-19 deaths and political party affiliation in the United States“, was authored by Jingjing Gao and Benjamin J. Radford.