Republican Counties Have Higher Mortality Rates Than Democratic Ones, Study Finds

Topline

Americans living in counties that voted Republican during presidential elections from 2000 to 2016 experienced higher death rates than those who lived in Democratic counties, according to a new British Medical Journal study, which researchers said added to a growing body of evidence that liberal policies may lead to better health outcomes.

Key Facts

Mortality rates dropped 22% in Democratic counties compared to 11% in Republican counties from 2001 to 2019, according to the study, which used data from the Centers for Disease Control and Prevention linked to county-level presidential election data.

Between 2001 and 2019, the gap in death rates between Democratic and Republican counties also grew by more than 500%, driven largely by deaths from heart disease; cancer; chronic lung disease; unintentional injuries, including drug overdoses; and suicide.

Black and Hispanic residents experienced similar improvements in mortality rates in Democratic and Republican counties, while white residents in Democratic counties saw 15% lower mortality rates than their white counterparts in Republican counties in 2019, compared to a 3% gap in death rates in 2001.

Black Americans saw higher mortality rates in both Democratic and Republican counties compared to white and Hispanic Americans from 2001 to 2019, although Black residents in both Democratic and Republican residents experienced substantial improvements in mortality rates since 2001.

Rural Republican counties experienced the highest mortality rates out of all groups and saw the smallest improvement in death rates over time, suggesting political environments play a crucial role in the widening mortality gap between urban and rural areas, according to the researchers.

What We Don’t Know

Exactly how and what local policies may have affected health outcomes. Researchers studied mortality rates based on whether counties voted for Democratic or Republican presidential candidates, but they did not study specific factors linking political environment and mortality.

Key Background

Previous research has shown counties that elect Republicans tend to see worse health outcomes, including fewer improvements in life expectancy and higher rates of deaths from suicide, drugs and alcohol. The new research comes a day after a study published in Health Affairs showed people living in counties that voted Republican in the 2020 presidential election were more likely to die from Covid-19 than those in counties that voted for Democrats. Researchers have found more liberal policies such as labor, immigration and environmental protections are linked with better life expectancy, while more conservative policies like abortion restrictions and lax gun control laws are associated with lower life expectancy. More liberal states are also more likely to implement welfare policies that act as a safety net for vulnerable populations, such as Medicaid expansion, which has led to better health care and reductions in mortality, while Republican-led states are more likely to have higher rates of uninsured people, according to the researchers. The BMJ study is the first to include data from after the 2016 presidential election as well as a breakdown of mortality rates by sex, race, ethnicity and location. Researchers suggested further studies should focus on the factors causing a growing difference in mortality rates between Republican and Democratic counties.

Further Reading

Life expectancy tied to voting choices in last U.S. presidential election (Reuters)