BOSTON — Most voters probably know if they’re living in a “red” or “blue” county. For those hoping to live a long, healthy life, a new study finds the choice may come down whether Republicans or Democrats control your county. Researchers from Brigham and Women’s Hospital have discovered a growing “mortality gap” in Democratic and Republican-led counties.
Specifically, the team found that death rates decreased in Democratic counties by 22 percent between 2001 and 2019. During that same period, the death rates in Republican counties only dropped by 11 percent.
Looking at that phenomenon more closely, the team found a widening gap among white residents in key areas, including heart disease and cancer. In fact, the death rate among whites was four times higher in Republican counties than in Democratic counties during the study period.
“In an ideal world, politics and health would be independent of each other and it wouldn’t matter whether one lives in an area that voted for one party or another,” says corresponding author Haider Warraich, MD, of the Division of Cardiovascular Medicine at the Brigham, in a media release. “But that is no longer the case. From our data, we can see that the risk of premature death is higher for people living in a county that voted Republican.”
No impact on minority voters?
The team used data from the Wide-ranging OnLine Data for Epidemiologic Research (CDC WONDER) database and MIT’s Election Data and Science Laboratory during the study. They classified counties as either Democratic or Republican based on how voters living there voted for president every four years.
Results show that mortality rates in Democratic counties fell from 850 for every 100,000 people in 2001 to 664 in 2019 — a drop of 22 percent. In Republican counties however, the mortality rates went from 867 per 100,000 people to 771 — a decline of just 11 percent.
Notably, the same mortality gap researchers found among white Americans did not appear among Black and Hispanic Americans.
Study authors add that their results remained constant when they examined voting and health records during state gubernatorial elections as well. Democratic counties saw greater drops in the local death rate from the most common causes of death, including heart disease, cancer, chronic lower respiratory tract diseases, diabetes, the flu, pneumonia, and kidney disease.
Local decisions on Obamacare play a key role
Researchers believe some of this may have to do with the political policies each party sticks to when it comes to health care. One of the pivotal moments during the study was the creation of the Affordable Care Act (ACA) in 2010. More Democrat-led states adopted the Medicaid expansion than Republican-led state. The decision expanded health insurance coverage to more people with a low income.
However, the team cautions that their findings can’t definitively connect all the factors of the local mortality rate with a county’s political leanings. They also did not study what happens when a county “flips” — or switches from red to blue or vice versa. Moreover, the study ended prior to the COVID-19 pandemic, which had a significant impact on the country’s death rate as a whole.
“Our study suggests that the mortality gap is a modern phenomenon, not an inevitability,” Warraich concludes. “At the start of our study, we saw little difference in mortality rates in Democratic and Republican counties. We hope that our findings will open people’s eyes and show the real effect that politics and health policy can have on people’s lives.”
The findings appear in the British Medical Journal.