For immediate release: Tuesday, November 1, 2022

BOSTON, MA – The greater the exposure to political conservatism, the greater the COVID-19 death rates and the strain on hospital intensive care unit (ICU) capacity, according to a new study from Harvard T.H. Chan School of Public Health.

Prior to our study, research on how political ideology affects COVID-19 only looked at voters’ political inclination; We have expanded on this research to investigate the associations of COVID-19 outcomes with the voting records of federal elected representatives and the concentration of political parties’ power at the state level. The goal is not to analyze partisanship, but rather to understand how politics and political polarization affect population health, said Nancy Krieger, professor of social epidemiology at Harvard T.H. Chan School of Public Health and corresponding author of the study.

The study was published online in the Lancet Regional Health – Americas on November 1, 2022.

Little previous research has looked at COVID-19 health outcomes in relation to US congressional districts. Researchers analyzed data on COVID-19 mortality rates and stress on ICU capacity from April 2021 to March 2022, the period during which adult vaccines were available, in all 435 US congressional districts. They examined three previously unused exposure variables. In COVID-19 Research: The Political Ideology of Elected Members of Congress in the United States, According to Their Aggregate Voting Records; their vote on four major COVID-19 relief bills; and “state trifectas,” the concentration of political power at the state level, defined as the governor, the House of Representatives, and the Senate, all under the control of a single party.

The study found that the higher the exposure to conservatism on each political metric, the higher the standardized COVID-19 death rates, even after adjusting for a region’s social characteristics, voter political propensity, and vaccination rates. The same relationship has been demonstrated with regard to pressure on hospital intensive care unit capacity.

For COVID-19 mortality rates, for example, models controlling for political and social metrics and vaccination rates showed that Republican trifectas, respectively, were 11% higher and the conservative voter leaning at 26%.

Our study presents new approaches to analyze the political determinants of COVID-19 metrics—such as mortality, morbidity, or vaccination rates—as a component of the analysis of political accountability for the COVID-19 demographic burden. It also points to the importance of analyzing policy metrics in relation to population health outcomes in general.

There was no funding for the study from any agency in the public, commercial or non-profit sector.

“The Relationship between Political Ideology of Federal and State Elected Officials in the United States and Key Outcomes of the COVID Epidemic After the Vaccine Rollout for Adults: April 2021 – March 2022,” Nancy Krieger, Christian Testa, Jarvis T Chen, William P. Hanage, Alicia J. McGregor, Lancet Regional Health – Americas, online November 1, 2022, Available here. doi: 10.1016/j.lana.2022.00384

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Todd Datz
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Harvard TH Chan School of Public Health Bringing together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to move innovative ideas from the lab into people’s lives—not only to achieve scientific breakthroughs, but also to transform individual behaviors, public policies, and healthcare practices. Each year, more than 400 Harvard Chan School faculty teach more than 1,000 full-time students from around the world and train thousands more through online and executive courses. Founded in 1913 as the Harvard MIT School of Health Administrators, the school is recognized as America’s oldest professional training program in public health.

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