Pro-Trump counties continue to suffer far higher COVID death tolls

By

Daniel Wood

Geoff Brumfiel

People who identify with the political right are less likely to be
vaccinated and more likely to believe misinformation about vaccines.
Ted S. Warren/AP

Even with widely available vaccines and newly effective treatments,
residents of counties that went heavily for Donald Trump in the last
presidential election are more than twice as likely to die from COVID-19
than those that live in areas that went for President Biden. That's
according to a newly-updated analysis from NPR, examining how
partisanship and misinformation are shaping the pandemic.

NPR examined COVID deaths per 100,000 people in roughly 3,000 counties
across the U.S. from May 2021, the point at which most Americans could
find a vaccine if they wanted one. Those living in counties that voted
60% or higher for Trump in November 2020 had 2.26 times the death rate of
those that went by the same margin for Biden. Counties with a higher
share of Trump votes had even higher mortality rates.

The scale of the preventable loss of life is staggering. According to a
recent analysis by Brown University, nearly 320,000 lives nationwide
could have been saved if more people had chosen to get vaccinated. The
Brown analysis also shows a partisan split in how those preventable
deaths are distributed. States that went most heavily for Trump �
including Wyoming and West Virginia � have among the highest rates of
preventable deaths, while states that voted heavily for Biden � such as
Massachusetts and Vermont � had among the lowest.
This is how many lives could have been saved with COVID vaccinations in
each state
Shots - Health News
This is how many lives could have been saved with COVID vaccinations in
each state

"How you vote should not predict whether you die of COVID," says Jennifer
Nuzzo, an epidemiologist at Brown University School of Public Health. The
social causes of the divide are complex, but the immediate reason is dead
simple: Trump-leaning counties have far lower vaccination rates than
those that went for President Biden. NPR's analysis showed that the gap
was 21 points, with 81% of adults vaccinated in heavily-Biden counties
compared to 60% of adults in counties that went for Trump.
Pro-Trump counties now have far higher COVID death rates. Misinformation
is to blame
Shots - Health News
Pro-Trump counties now have far higher COVID death rates. Misinformation
is to blame

According to the CDC, vaccinated individuals are 10 times less likely to
die from a COVID-19 infection than the unvaccinated.

Nuzzo says she sees the partisan divide in COVID deaths as one of the
major failures of public health messaging in this pandemic. "Public
health advice about vaccines often says, 'Talk to your doctor,'" Nuzzo
says. But many people don't have one.

Meanwhile anti-vaccine advocates have found new audiences on social
media, often by feeding into conspiracy theories on the political right.
Trusted conservative sources of information tend to have far higher
levels of vaccine misinformation than liberal sources. "It's hard for
people to actually find the facts, particularly if they are of certain
political persuasion," she says.

Political affiliation continues to be the largest predictor of
vaccination status, says Liz Hamel, director of public opinion and survey
research at the Kaiser Family Foundation, a non-partisan think tank.
Roughly 90% of Democrats say they are vaccinated compared to just 55% of
Republicans. Moreover, Hamel says that 37% of Republicans now say they
will definitely not get vaccinated. "It does appear that there's a sort
of hardening of attitudes among those who have decided not to get the
vaccine," she says.

Hamel says that previous polling has shown that belief in misinformation
is highly correlated with being unvaccinated. Kaiser examined several
common pieces of misinformation such as the idea that the government is
exaggerating the severity of the pandemic, or that the vaccines contain a
microchip. Kaiser's poll found that 94% of Republicans believed one or
more false statements about the vaccines.

"There was some indication that people who trusted conservative news
media sources for COVID information were more likely to believe
misinformation than those who trusted more mainstream news sources,"
Hamel says.

Despite these factors, the death gap between the pro-Trump and pro-Biden
counties did shrink slightly over the winter from 2.73 to 2.26.

That likely was mostly down to the Omicron variant, according to William
Hanage, an epidemiologist at Harvard University. Hanage says that Omicron
is much more effective at evading masks and other measures to prevent
infection. "Before Omicron, actions that people were taking, like masks
in schools, would have a really significant impact," he says. "After
Omicron they have far less."

The variant's high transmissibility has likely allowed Omicron to reach
communities in more Democrat-leaning parts of the country that were
previously able to protect themselves. Nuzzo also suspects that the
narrowing gap is partially due to older Americans of all political
persuasions who are not getting a booster shot, even when eligible.
According to recent Kaiser data, 30% of Americans 65 and older remain
unboosted. "It's a huge factor," she says.

Nuzzo and Hanage both say they expect the gap in deaths by political
affiliation to shrink with time. As more Americans survive COVID
infections, their chances of death from subsequent bouts with COVID will
decrease. But Nuzzo says, new people are being born every day, and others
are aging into different risk categories. Vaccination will likely remain
an important tool for controlling COVID into the future. "The fact that
we haven't gotten to the bottom of this hesitation," she warns, "is
setting us up for bigger problems."
Untangling Disinformation
Inside the growing alliance between anti-vaccine activists and pro-Trump
Republicans

And Hanage foresees even deeper problems if a subset of far-right
politicians are willing to "take vaccines and turn them into a wedge
issue for political gain." He worries that deeply Republican parts of the
country will soon start to refuse vital childhood vaccines, such as the
measles, mumps and rubella shot, which prevent outbreaks of other
infectious diseases. "It's part of the long-term damage that happens when
you have politicians relentlessly trying to denigrate it and turn it into
a political football," he says.

Methodology

COVID-19 deaths per 100,000 residents are calculated by dividing total
cumulative deaths from COVID-19 by the county or group of counties'
populations. County population data come from the U.S. Census Bureau's
2020 decennial census.

The line chart is a calculation of cumulative COVID-19 deaths per 100,000
residents since March 1, 2020 among the three groups analyzed: counties
that voted heavily for Donald Trump in 2020, counties that voted heavily
for Joe Biden in 2020 and the overall average. Death data are collected
by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins
University and are current as of May 18, 2022.

The dot chart shows COVID-19 deaths per 100,000 residents by county since
May 1, 2021. May 1, 2021 was chosen as the start date of our analysis
because that is roughly the time when vaccines became universally
available to adults ages 18 and older. Death data are also from Johns
Hopkins University except for data from Utah, Ohio and Missouri, which
came from the CDC Community Profile Report, produced by the White House
COVID-19 Team.

Vaccination rate data are the rate of full vaccination among all people
18 years of age or older, as of May 18, 2022. They are from the Centers
for Disease Control and Prevention.

2020 election result data are from MIT Election Data and Science Lab.

Nebraska, Hawaii and Alaska were excluded from all analyses due to
insufficient data.

All averages are weighted by county population. A total of 3014 counties
are used in this analysis.

Thanks to Beth Blauer from the Centers for Civic Impact at Johns Hopkins
University for discussions about our methodology.

https://www.npr.org/2022/05/19/1098543849/pro-trump-counties-continue-to-
suffer-far-higher-covid-death-tolls