It Didn’t Go Away: The Political and Social Determinants of COVID-19 Mortality Rates across Counties in the United States

Abstract

Research over the last several years has demonstrated a wide variety of inequalities in the COVID-19 pandemic by socio-demographic characteristics, place, and political and religious ideology. In this study, by combining several county-level data sources, we examine how the social conditions of counties across the United States relate to their differential COVID-19 mortality rates. We find that percent Black, percent Hispanic, and income inequality are all positively related to higher mortality rates at the county level. Moreover, the percentage of the population that voted for Trump in the 2020 election was a significant and substantively large predictor of higher mortality rates. We also include healthcare-related variables, but compared to the social circumstances of the pandemic, these effects are relatively small. These results indicate that the social conditions of areas are strong predictors of how counties have experienced the pandemic and where the greatest loss of life has occurred.

Keywords

• COVID-19
• mortality
• political polarization
• social determinants of health