Deep dive into the wide death gap across the political corridor

New research indicates that politics can be a matter of life or death.

A survey published by BMJ on June 7 examined the death rate and voting patterns in the last five presidential elections and found that those who lived in the constituency who consistently voted democratically did better than those who voted for Republicans.

“We all aspire to live and exist in a system where politics and health do not intersect,” said Dr. Haider Waraich, lead author of the study. “But what this paper actually shows is that politics and health, especially in the United States, are deeply involved.”

Researchers have linked data from the Center for Disease Control and Prevention’s Wonder Database to data on presidential elections and state governor races to determine how the political environment has turned an area’s mortality rate from 2001 to 2019. They have used age-adjustment instead of raw-rate mortality to ensure that there are no differences due to the age of the population. It is helpful, for example, to more accurately compare an area with a larger number of elderly residents – who are more likely to be infected with a chronic disease – than areas with a smaller population.

They classified the counties as “democratic” or “republican” for the four years following the presidential election. They sought to determine whether such patterns were influenced by gender, race, or ethnicity, as well as by urban or rural conditions.

Overall, from 2001 to 2019, they found that Democratic counties did better in reducing their age-consistent mortality. During that time, Republican County has seen an 11% decline (from 867 to 771 deaths per 100,000 inhabitants) to 22% (850 to 664 deaths per 100,000 inhabitants).

Bottom line: “The death toll in Republican voting counties is higher overtime than in Democratic voting counties,” the researchers wrote.

“My fear is that the gap will widen after the epidemic,” Waraich said.

Waraich stressed that health policies are not the only factor that shapes the well-being of a community. “It simply came to our notice then. It’s going to be an educational environment; It’s going to be health behavior, and it’s going to be health policy, ”he said. “So what we’re seeing is, in fact, the growing influence of a lot of different things.”

Researchers, for example, point to a previous study showing that “more liberal” state policies on tobacco control, labor, immigration, civil rights and environmental protection were associated with improved life expectancy, while “more conservative” state policies – such as abortion Restrictions on and less stringent gun laws – were associated with lower life expectancy among women.

Left-leaning states were also more likely to enact policies such as the Medicaid expansion under the Affordable Care Act, which sought to widen the safety net for vulnerable populations. Of the 12 states that have not expanded their Medicaid programs, nine have Republican governors and 10 have voted for former President Donald Trump in 2020.

Types of mortality between Republican and Democratic counties were generally consistent between ethnic and racial subgroups, such as non-Hispanic black Americans and Hispanic peoples. But regardless of political motives, the death rate of black Americans was higher than any other race or ethnicity.

This gap was most striking among white Americans. From 2001 to 2019, the death toll among whites in Democratic County dropped by 15%. Meanwhile, the number of white residents in Republican County has dropped by only 3%. Rural Republican counties have experienced the highest age-consistent mortality rates and the lowest improvement.

Dr Steven Wolf, who wrote an editorial with the study, said the results transcended the correlation between political values ​​and health.

“If there is more poverty in an area, if there are fewer people who have graduated from high school, their health results will be worse and the death rate will be higher,” Wolf said. “And that could be more true and prevalent in Republican County,” he added. The study, then, is more a reflection of the economic well-being of certain populations, he said.

According to researchers, heart disease and cancer are the leading causes of death in both Democratic and Republican counties. But the decline in these rates was even more pronounced in democratic areas, which led them to write: “Understanding the factors that contribute to the growing disparity in heart disease and cancer mortality across the political environment is critical.” They point to a number of possibilities – including the underlying differences in access to healthcare and the lack of insurance coverage.

According to research, other factors contributing to the increase in mortality gap are chronic diseases of the lower respiratory tract, unintentional trauma and suicide rates.

“So the key message here, which is very important, is that we really need to focus on political research in political parties because it affects the results,” said Dr. Robert Blendon, a professor of health policy and political analysis at Harvard. Was not associated with the study.

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