Associations of presidential voting preference and gubernatorial control with county-level COVID-19 case and death rates in the continental United States


To investigate the associations of state gubernatorial party control and 2016 county-level presidential election preference on COVID-19 case and death rates in the United States. This was a secondary analysis of publicly available data. Data including county-level COVID-19 case and death counts through February 9, 2021, 2020 gubernatorial data, and county-level US Census Bureau data, Broadstreet area deprivation index, and 2016 presidential voting tallies were included. Negative binomial regression estimated the adjusted impact of each variable on COVID-19 case and death rates. A total of 3102 counties in the 48 continental United States plus Washington DC were included. County-level case and death rates were higher (12% and 22%, respectively) in Republican vs Democrat controlled states. Case and death rates were higher in counties voting Republican vs Democrat in 2016 and were modified by counties with median ages ≥ 50 years (54% increase in case rate and 91% increase in death rate). These data further support the need for prevention efforts to focus on public health while extricating guidance and prevention from political agendas.

Public Health, 198
Chris Prener
Chris Prener
Assistant Professor of Sociology

My research interests include first responder work, urban neighborhood disorder, and tracing the effects of place on poor health outcomes.