Covid Deaths 2x Higher in Red Counties
In November, I showed that Covid deaths were lower in states that had higher vaccination rates, and that vaccination rates go up strongly with percentage of Democratic vote (State Covid Rates Decrease With Vaccination – Or Do They?). Pew Charitable Trust has looked at more recent data on the county level to show a similar trend, and Philip Bump wrote about the results in the Washington Post.
Here are some graphics to further illustrate their results. After the initial wave, there was an even stronger trend than the article’s original graph showed.
Vote Distribution
Pew divided the US population by vote in the 2020 presidential election into quintiles, showing the one fifth of the total population living in the “reddest” counties with the highest vote for Trump, one fifth in the counties with the next highest Trump vote, etc. As the graph shows, about one fifth of the population lives in overwhelmingly pro-Trump counties, where the Trump vote ranged from over 60% to over 95%. Similarly, another fifth lived in the “bluest” counties where Biden got anywhere from over 65% to over 95% of the vote. These are the regions where perhaps people have trouble even imagining that anyone votes for the “other” candidate. To put it another way, about 40% of the country lives in very partisan counties, with another 60% living in more evenly split counties.
Looking at the 50%-vote border, about 2/5ths of the nation lives in counties where Trump won, and 3/5ths in counties where Biden won. So, by this measure, much more of the country lives in “blue” counties than in “red”.
These graphs are divided evenly by population, not by number of counties. There are many more pro-Trump counties, because these tend to be more rural counties with lower populations.
Distribution by Death Rate
The Pew article took each of the vote quintiles discussed above and showed their overall numbers of Covid deaths from mid-March 2020 to the end-of-February 2022. As the top panel shows, the most pro-Trump quintile had about 40% more deaths than the most pro-Biden one. The smallest death rate was actually in the 2nd-most-blue quintile, with only about 15% range in deaths between quintiles if we exclude the reddest one.
The bars in the top panel are also divided into different “waves” of the pandemic. This shows the well-known fact that when the pandemic first hit in Spring, 2020, deaths were overwhelmingly in urban, Biden-voting counties. Because of this, the whole-pandemic numbers that Pew graphed hide some strong trends in more recent waves.
As bottom left panel shows, in the two waves that hit before the vaccine was universally available (summer 2020 to winter 2021), there was a clearer trend from fewer deaths in the more Biden-voting quintiles to more deaths in Trump voting counties. For every quintile, the higher the Trump vote, the higher the death rate.
During the vaccine waves (spring 2021 to winter 2022), the trend intensified (bottom right panel). The most pro-Trump quintile had around 2.5 times as many deaths as the most pro-Biden quintile.
Red Versus Blue
The county data reinforces the view that earlier data showed. When Covid first hit, nobody was prepared, and because it first hit Democratic-leaning, urban areas more plugged into international travel, these were the counties with the most deaths. Over the next few seasons, people resisted Covid with non-medical measures such as avoiding crowds and wearing masks. Republicans did not embrace these measures as much as Democrats, perhaps because President Trump told them not to take the disease seriously. Consequently, Republican counties had higher death tolls. The differences became more dramatic when vaccines became available. As conservative media continued to promote skepticism that Covid was dangerous and that vaccines were safe and effective, Republicans resisted getting vaccinated, and more of them were killed.
It’s possible that other factors were important. For instance, if red counties tended to have more older people than blue counties, that would boost their death rates. I haven’t seen any evidence that this is the case.
I used to think that the only way Trump fans would turn against Trump was if Trump started a war and their kids started coming home in body bags. Yet Covid has shown America that even that may not be enough to change minds. After a million US Covid deaths, the bodies have piled up without any reckoning in Red America even though it is pro-Trump areas that have been hit the hardest because of hostility to medical advice among conservative media and politicians.
Some Details
All data is from the Pew article linked in the Intro. First figure is my plot. In second figure, top panel is Pew plot, bottom panels are cut/pasted from top panel.