In Democratic districts, death rates have decreased by 22% since the beginning of the century, while in Republican areas they have decreased by only 11%
In Democratic districts the death rates decreased by 22%, while in Republican areas they decreased by only 11%.
A slowdown in the reduction of death rates among white Americans living in Republican districts between 2001 and 2019 was an important factor in the increase in the disparity in death rates of residents in different disease categories.
New research shows how politics and health conditions are increasingly intertwined over time. Between 2001 and 2019, researchers from Brigham and Women’s Hospital looked at death rates and information on federal and state elections in all counties of the United States. The researchers found a “mortality gap,” or a widening gap in age-adjusted death rates in counties that supported Democrats versus Republicans in previous presidential and gubernatorial elections.
The research team found that death rates fell by 22% in Democratic districts but only by 11% in Republican areas. Heart disease and cancer were among the top diseases where the difference in mortality increased, and during the study period the difference in mortality between white residents of Democratic and Republican districts increased about fourfold. The research findings were published in the British Medical Journal.
“In an ideal world, politics and health would be independent of each other and it wouldn’t matter if a person lived in an area that voted for one party or another,” said corresponding author Dr. Haider of the Brigham Division of Cardiovascular Medicine. “But that’s no longer the case. From our data, you can see that the risk of premature death is greater in people who live in a district that voted for Republicans.”
Vorich and his colleagues used data from CDC WONDER and election data and the MIT Science Lab. They classified counties as Democratic or Republican based on how a county voted in the last presidential election. . Mortality rates were adjusted for age.
Overall, the team found that death rates in Democratic counties dropped from 850 cases per 100,000 people to 664 (22%), but in Republican counties death rates decreased from 867 to 711 (11%). When the team analyzed by race, they found that there was only a small gap in reducing death rates for black and Hispanic Americans in Democratic and Republican districts, whereas among white Americans the gap between people living in Democratic and Republican districts was substantial.
The disparity in mortality decline remained consistent when the researchers looked only at counties that voted Republican or Democratic in each of the presidential election years studied, as well as in gubernatorial elections. Democratic districts had greater declines in death rates for most common causes of death, including heart disease, cancer, chronic lower respiratory disease, diabetes, influenza, pneumonia and kidney disease.
The authors note that the widening disparity in mortality rates may reflect the influence of politics on health policy. One of the turning points identified in the study corresponds to the Affordable Care Act (ACA), which was passed in 2010. More Democratic states than Republican states adopted the Medicaid expansion under the ACA, which extended health insurance to low-income people.
The study identifies a link between political environment and mortality but does not definitively determine the specific factors that may explain the link between the two. The researchers did not investigate the effect of changing the political environment – districts that switched from voting for one party to voting for another – on health outcomes.
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