![]() In a study that focused on life expectancy in the U.S. In an editorial that accompanied the BMJ paper, Woolf wrote, “Corroborating evidence about the potential health consequences of conservative policies is building.” As health outcomes such as life expectancy have diverged in recent years, “state policies have been becoming more polarized,” says Steven Woolf, a physician and epidemiologist at Virginia Commonwealth University. Still, experts say some policy choices may have a larger role than individual behavior in causing poor health. For white Americans, however, the difference was profound-a fourfold increase in the mortality gap between those living in Republican and Democratic areas. “It didn’t really matter where they lived,” Warraich says. Black Americans still have the highest mortality rates of any racial group, but they saw relatively similar improvement. Hispanic Americans everywhere saw significant improvements in their risk of death. But people living in Republican states, whatever their own political leanings, were more likely to smoke.Īnd an analysis of the new study’s data by subgroups supports the idea that individual choices play a role. For example, Democrats had higher odds of smoking, and Republicans were less likely to exercise. ![]() Previous research has found differences between Republican and Democratic regions in health-related behaviors such as exercising or smoking. What is it about conservative areas that might lead to this disadvantage in health outcomes? Multiple factors probably contribute to the gap. (The gap for cerebrovascular disease, which includes stroke and aneurysms, remained but narrowed.) Political environment, the authors suggest in the paper, is a “core determinant of health.” They found the gap in mortality rates between Republican and Democratic counties increased for nine out of 10 causes of death. The researchers then analyzed county-level results in each of the five presidential elections that took place during their study period, identifying counties as Republican or Democratic for the subsequent four years. These include heart disease, cancer, lung disease, unintentional injuries and suicide. The new study, conducted by researchers in Texas, Missouri, Massachusetts and Pakistan, covers the years 2001 through 2019 and examines age-adjusted mortality rates-the number of deaths per 100,000 people each year-from the top 10 leading causes of death, as recorded in 2019. “It joins an already existing, pretty robust literature showing that politics polarization do have life-and-death consequences,” Montez says. The study’s longitudinal approach and county-by-county analysis replicate and extend a clear pattern, says Jennifer Karas Montez, a sociologist and demographer at Syracuse University, who was not involved in the research. But the improvement for those living in Republican counties by 2019 was half that of those in Democratic counties-11 percent lower versus 22 percent lower.Ĭredit: Amanda Montañez Source: “Political Environment and Mortality Rates in the United States, 2001-19: Population Based Cross Sectional Analysis,” by Haider J. mortality rate has decreased in the nearly two decades since then (albeit not as much as in most other high-income countries). ![]() In 2001, the study’s starting point, the risk of death among red and blue counties (as defined by the results of presidential elections) was similar. In a study published in June in The BMJ, Warraich and his colleagues showed that over the two decades prior to the pandemic, there was a growing gap in mortality rates for residents of Republican and Democratic counties across the U.S. Warraich, a physician and researcher at the VA Boston Healthcare System and Brigham and Women’s Hospital in Boston. “COVID has really magnified what had already been brewing in American society, which was that, based on where you lived, your risk of death was much different,” says Haider J. ![]() And although the highly transmissible Omicron variant narrowed the gap in infection rates, hospitalization and death rates, which are dramatically reduced by vaccines, remain higher in Republican-leaning parts of the country.īut COVID is only the latest chapter in the story of politics and health. That divergence continued through 2021, when vaccines became widely available. The consequences of those differences emerged by the end of 2020, when rates of hospitalization and death from COVID rose in conservative counties and dropped in liberal ones. Republican-leaning “red” states were much more resistant to health measures. Democrat-leaning “blue” states were more likely to enact mask requirements and vaccine and social distancing mandates. During the COVID-19 pandemic, the link between politics and health became glaringly obvious. ![]()
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