Home Health A deep dive into the widening death gap in the political aisle

A deep dive into the widening death gap in the political aisle

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

A study published by the BMJ on June 7 examined death rates and voting patterns in the past five presidential elections, and found that people living in jurisdictions who voted consistently Democratically outperformed those who voted Republican.

“We all aspire to live and exist in a kind of system where politics and health don’t intersect,” says Dr. Haider Warraich, lead author of the study. “But what this article actually shows is that politics and health, especially in the United States, are deeply intertwined.”

Researchers linked information from the Centers for Disease Control and Prevention’s WONDER database with data from presidential elections and state governor races to determine how, from 2001 to 2019, political environments played a role in an area’s death rates. They used age-adjusted rather than raw mortality rates to ensure that differences are not due to the age of a population. That is useful, for example, to more fairly compare an area with higher numbers of older residents – who are more likely to develop chronic diseases – with areas with potentially younger populations.

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

Overall, from 2001 to 2019, they found that Democratic counties did better at lowering their age-adjusted death rates. Over that period, the rate dropped 22% (from 850 to 664 deaths for every 100,000 residents), compared with an 11% drop in Republican counties (from 867 to 771 deaths for every 100,000 residents).

Bottom line: “The mortality gap in Republican polling districts compared to Democratic polling districts has grown over time,” the researchers wrote.

“My fear is that this gap will widen even further after the pandemic,” Warraich said.

Warraich emphasized that health policies are not the only factors that determine the well-being of a community. “It’s about the economic conditions of those regions; it becomes the educational environments; it will be the health behavior, and it will also be the health policy,” he said. “So what we’re seeing is actually the cumulative effect of a lot of different things.”

For example, the researchers pointed to a previous study that found that “liberal” state policies on tobacco control, labor, immigration, civil rights and environmental protection were associated with better life expectancy, while “more conservative” state policies — such as restrictions on abortion and less stringent gun laws. – were associated with a lower life expectancy in women.

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

The patterns of death rates between Republican and Democratic counties were generally consistent across racial and ethnic subgroups, such as non-Hispanic Black Americans and Hispanic people. But black Americans had a higher death rate than any other race or ethnicity, regardless of political affiliation.

The gap was most noticeable among white Americans. According to the research, the death rate of white residents of Democratic counties fell by 15% between 2001 and 2019. Meanwhile, white residents of Republican counties saw only a 3% drop. Rural Republican counties had the highest age-adjusted death rates and the least improvement.

dr. Steven Woolf, who wrote an editorial accompanying the study, said the findings go beyond a correlation between political values ​​and health.

“If there is more poverty in an area, if there are fewer people who have completed high school, then they will have worse health outcomes and higher death rates,” Woolf said. “And this is truer and more common in Republican counties,” he added. So the study is more reflective of the economic well-being of certain populations, he said.

Heart disease and cancer remain the leading causes of death in both Democratic and Republican counties, according to the researchers. But declines in these rates were more pronounced in Democratic areas, prompting them to write, “It is critical to understand the factors contributing to the growing disparities in heart disease and cancer deaths in political settings.” They cite several possibilities, including underlying differences in health care access and lack of insurance coverage.

Other factors contributing to the widening death gap, according to the study, were chronic lower respiratory tract disease, accidental injuries and suicide rates.

“So the main message here, which is very important, is that in medical research we really need to pay attention to political parties because it influences the outcome,” said Dr. Robert Blendon, a professor of health policy and political analysis at Harvard, who was not involved in the study.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Together with Policy Analysis and Polling, KHN is one of the three major operational programs of KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization that provides information on health issues to the nation.

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