Abstract
Introduction As the response to the COVID-19 pandemic has become increasingly politicized in the United States (US), political party affiliation of state leaders may contribute to policies affecting the spread of the disease. We examined differences in COVID-19 infection and death rates stratified by governor party affiliation across the 50 US states and the District of Columbia (DC).
Methods We conducted a longitudinal analysis examining daily COVID-19 incidence and death rates from March 1 to September 30, 2020, for each US state and DC. We fit a Bayesian negative binomial model to estimate adjusted daily risk ratios (RRs) and posterior intervals (PIs) comparing infection and death rates by gubernatorial (mayoral for DC) party affiliation. We adjusted for several state-level variables, including population density, age, race, poverty, and health.
Results From March to early June 2020, Republican-led states had, on average, lower COVID-19 incidence rates compared to Democratic-led states. However, on June 8, the association reversed, and Republican-led states had higher per capita COVID-19 incidence rates (RR=1.15, 95% PI: 1.02, 1.25). This trend persisted until September 30 (RR=1.26, 95% PI: 0.96, 1.51). For death rates, Republican-led states had lower average rates early in the pandemic, but higher rates from July 13 (RR=1.22, 95% PI: 1.03,1.37) to September 30 (RR=1.74, 95% PI: 1.20, 2.24).
Conclusion Gubernatorial party affiliation may drive policy decisions that impact COVID-19 infections and deaths across the US. As attitudes toward the pandemic become increasingly polarized, policy decisions should be guided by public health considerations rather than political ideology.
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
Dr. Neelon is a part-time employee of the Department of Veterans Affairs. The content of this article does not represent the views of the Department of Veterans Affairs or the U.S. government. The article represents the views of the authors and not those of the VA or Health Services Research and Development. Dr. Mueller was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number K01HL141589 (PI: Mueller).
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Footnotes
Conflicts of Interest: Dr. Mueller was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number K01HL141589 (PI: Mueller). The funder had no influence on the study’s design, implementation, or findings.
Financial Disclosure: No financial disclosures were reported by the authors of this manuscript.
Data Availability
All data used in this paper are publicly available.