Republican Leaders Are Killing Their Voters

Republicans are dying at a much higher rate than Democrats.

LOS ANGELES, CALIFORNIA – APRIL 22: Demonstrators participate in a vehicle caravan with a sign reading ‘Trust in God not vaccines’ outside City Hall, calling on California officials to re-open the economy amidst the coronavirus pandemic, on April 22, 2020 in Los Angeles, California. A protest movement has sprung up in states across the country calling for an end to shelter-at-home orders. Mario Tama/Getty Images/AFP

The Atlantic‘s Yasmin Tayag tries to answer a question that has been posed many times here at OTB over the past two years: “How Many Republicans Died Because the GOP Turned Against Vaccines?

No country has a perfect COVID vaccination rate, even this far into the pandemic, but America’s record is particularly dismal. About a third of Americans—more than a hundred million people—have yet to get their initial shots. You can find anti-vaxxers in every corner of the country. But by far the single group of adults most likely to be unvaccinated is Republicans: 37 percent of Republicans are still unvaccinated or only partially vaccinated, compared with 9 percent of Democrats. Fourteen of the 15 states with the lowest vaccination rates voted for Donald Trump in 2020. (The other is Georgia.)

We know that unvaccinated Americans are more likely to be Republican, that Republicans in positions of power led the movement against COVID vaccination, and that hundreds of thousands of unvaccinated Americans have died preventable deaths from the disease. The Republican Party is unquestionably complicit in the premature deaths of many of its own supporters, a phenomenon that may be without precedent in the history of both American democracy and virology.

Obviously, nothing about being a Republican makes someone inherently anti-vaccine. Many Republicans—in fact, most of them—have gotten their first two shots. But the wildly disproportionate presence of Republicans among the unvaccinated reveals an ugly and counterintuitive aspect of the GOP campaign against vaccination: At every turn, top figures in the party have directly endangered their own constituents. Trump disparaged vaccines while president, even after orchestrating Operation Warp Speed. Other politicians, such as Texas Governor Greg Abbott, made all COVID-vaccine mandates illegal in their state. More recently, Florida Governor Ron DeSantis called for a grand jury to investigate the safety of COVID vaccines. The right-wing media have leaned even harder into vaccine skepticism. On his prime-time Fox News show, Tucker Carlson has regularly questioned the safety of vaccines, inviting guests who have called for the shots to be “withdrawn from the market.”

[…]

Individual vaccine skepticism cannot be traced back to a single source, and even if it could, we don’t know exactly who is unvaccinated and what their political affiliations are.

What we do have is a patchwork of estimations and correlations that, taken together, paint a blurry but nevertheless grim picture of how Republican leaders spread the vaccine hesitancy that has killed so many people. We know that as of April 2022, about 318,000 people had died from COVID because they were unvaccinated, according to research from Brown University. And the close association between Republican vaccine hesitancy and higher death rates has been documented. One study estimated that by the fall of 2021, vaccine uptake accounted for 10 percent of the total difference between Republican and Democratic deaths. But that estimate has changed—and even likely grown—over time.

Partisanship affected outcomes in the pandemic even before we had vaccines. A recent study found that from October 2020 to February 2021, the death rate in Republican-leaning counties was up to three times higher than that of Democratic-leaning counties, likely because of differences in masking and social distancing. Even when vaccines came around, these differences continued, Mauricio Santillana, an epidemiology expert at Northeastern University and a co-author of the study, told me. Follow-up research published in Lancet Regional Health Americas in October looked at deaths from April 2021 to March 2022 and found a 26 percent higher death rate in areas where voters leaned Republican. “There are subsequent and very serious [partisan] patterns with the Delta and Omicron waves, some of which can be explained by vaccination,” Bill Hanage, a co-author of the paper and an epidemiologist at Harvard, told me in an email.

But to understand why Republicans have died at higher rates, you can’t look at vaccine status alone. Congressional districts controlled by a trifecta of Republican leaders—state governor, Senate, and House—had an 11 percent higher death rate, according to the Lancet study. A likely explanation, the authors write, could be that in the post-vaccine era, those leaders chose policies and conveyed public-health messages that made their constituents more likely to die. Although we still can’t say these decisions led to higher death rates, the association alone is jarring.

Complicating things further is that it’s not just COVID.

What’s most concerning about all of this is that partisan disparities in death rates were also apparent before COVID. People living in Republican jurisdictions have been at a health disadvantage for more than 20 years. From 2001 to 2019, the death rate in Democratic counties decreased by 22 percent, according to a recent study; in Republican counties, it declined by only 11 percent. In the same time period, the political gap in death rates increased sixfold.

Health outcomes have been diverging at the state level since the ’90s, Steven Woolf, an epidemiologist at Virginia Commonwealth University, told me. Woolf’s work suggests that over the decades, state policy decisions on health issues such as Medicaid, gun legislation, tobacco taxes, and, indeed, vaccines have likely had a stronger impact on state health trajectories than other factors. COVID’s high Republican death rates are not an isolated phenomenon but a continuation of this trend. As Republican-led states pushed back on lockdowns, the impact on population death rates was observed within weeks, Woolf said.

If the issue is indeed systemic, that doesn’t bode well for the future. Other factors could explain the higher death rate in Republican-leaning places—more poverty, less education, worse socioeconomic conditions—, though Woolf said isn’t convinced that those factors aren’t related to bad state health policy too. In any case, the long-term decline of health in red states indicates that there is an ongoing problem at a high level in Republican-led places, and that something has gone awry. “If you happen to live in certain states, your chances for living a long life are going to be much higher than if you’re an American living in a different state,” Woolf said.

While some of this is clearly ideological, a lot of it is surely geographic. Democrats disproportionately live in or very near our biggest cities, which have the lion’s share of the best hospitals and doctors and can much more easily and quickly utilize their services.

Regardless, it’s hard to deny that Republican politicians are literally advocating for policies that kill their constituents. It’s truly baffling.

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James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College. He's a former Army officer and Desert Storm veteran. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. EddieInCA says:

    Republican Leaders Are Killing Their Voters

    Are they? Isn’t it more like assisted suicide? I mean the GOP voters have to have to be given some agency in the situation.

    22
  2. OzarkHillbilly says:

    To repeat myself, ad nauseum, “Pro life my ass.”

    eta:

    Regardless, it’s hard to deny that Republican politicians are literally advocating for policies that kill their constituents. It’s truly baffling.

    It’s not so baffling when one considers the esteem with which they view their constituents.

    15
  3. Rugged individualism, dontcha know.

    And gotta keep those taxes low!

    2
  4. grumpy realist says:

    Is this any sillier than the tendency of a certain type of American male to insist on red meat, beer, and potato fries as the three food groups, with nary a green vegetable in sight?

    1
  5. Gustopher says:

    It’s a Christmas miracle!

    1
  6. MarkedMan says:

    The Republican behavior doesn’t make sense if you assume they view the purpose of governance is to promote the public good. But if you assume that they view the purpose to be ensuring the bulk of the population is poor and ignorant and easily taken advantage of by the powerful, and the method they use to do this is to identify different groups and set them against each other.

    3
  7. BugManDan says:

    @MarkedMan: Furthermore, in states that are very red, it barely matters at any level of government because of gerrymandering, EC, Senate.

    1
  8. steve says:

    Cities do tend to have most fo the best hospitals but they also have some of the worst in the poor areas of those cities. It also doesnt matter if an area has the “best” hospital but people dont follow its advice. Texas Children’s is by most accounts one of the top 5 peds hospitals in the country, but I have been in touch with one of my trainees who left us to go work there. They run into the same vaccine resistance everyone else does. Just like everywhere else when someone gets sick they go to the hospital. Also, please bear in mind that part of the reason rural hospitals are often inferior is due to GOP policies about funding of those hospitals and the preferred GOP policies that will make it harder to find people to work in those areas, especially the schools.

    Steve

    7
  9. Kathy says:

    I call this proof that maximizing shareholder value, keeping taxes low to promote “job creation,” and minimizing regulations for the alleged same purpose, is not compatible with human well-being.

    Also that voting one’s prejudices is less beneficial than voting one’s actual interests.

    2
  10. Scott F. says:

    Better to die owning the libs than live being a slave to some* science. (*Advanced technology in firearms, big screen TVs, and fast car is good. Medical science is bad.)

    2
  11. Mister Bluster says:

    @grumpy realist:..nary a green vegetable in sight.

    Back in my drinking days I always said hops and barley are vegetables. They certainly aren’t animal or mineral. And I always drank green beer on St. Patricks Day with my cheeseburger and french fries.

    4
  12. MarkedMan says:

    The Atlantic‘s Yasmin Tayag tries to answer a question that has been posed many times here at OTB over the past two years: “How Many Republicans Died Because the GOP Turned Against Vaccines?“

    Did she though? I read the article and she raised a lot of issues that pointed to the likelihood that it is a non-trivial number, but she didn’t seem to make any attempt to put an actual number to it.

    1
  13. Chip Daniels says:

    Commenter Davis X. Machina at LGM some years ago coined a saying that conservatives would prefer to live under a bridge roasting a sparrow over a trash fire, just so long as they could be assured that the black or gay guy under the next bridge didn’t even have the sparrow.

    Which is really an updating of LBJs observation that if you give a guy someone to hate he will not only let you pick his pocket, but turn them inside out for you.

    My dataset on this is the dairy farmers in Wisconsin.
    They voted overwhelmingly for Trump in 2016, then a significant number of them were financially damaged, even to the point of bankruptcy due to his foolish tariff policies, but still voted for him again in 2020.

    So statistically, there are a few dairy farmers who wore their MAGA hats to their bankruptcy hearings.

    7
  14. Kylopod says:

    Over the past three years I’ve been skeptical that Covid-denialism would have any significant electoral impact on account of the deaths being disproportionately Republican. While it’s unquestionably the deadliest pandemic in a long time, the deaths are still a blip in the overall population. I’ve been rethinking that position more recently. Some of the key races in 2022 in places like Arizona and Nevada, states with large rural areas, were decided by very narrow margins.

    If this is the case, I can only count it as a political blunder on the part of Republicans. But it’s almost like they can’t help themselves. For one thing, there has long been an element to right-wing media and organizations like TPUSA where their incentives aren’t necessarily to win elections–to some extent these places prosper more when Democrats are in power. It’s kind of like The Producers–you make more money when the play fails. This isn’t 100% true, obviously (otherwise how would the billionaire backers get all their tax breaks?), but they’re invariably drawn to the latest culture wars like moths to a flame, because it’s how they keep the rubes coming back. Occasionally you see commentators such as Hannity having these moments of sanity–“C’mon guys you really need to get the shot”–but it inevitably gets drowned out. Covid-denialism has just become too deeply stitched into the grift that it can be easily abandoned.

    3
  15. DK says:

    @Chip Daniels:

    They voted overwhelmingly for Trump in 2016, then a significant number of them were financially damaged, even to the point of bankruptcy due to his foolish tariff policies, but still voted for him again in 2020.

    Key plot point: the billions in free money the Trump government gave to rescue farmers hurt by his failed trade war he lost.

    That’s okay tho. It’s not socialism when a white Republican gets hundreds of thousands to millions of dollars to save his farm from the consequences of his stupid voting decisions — unlike $4.00 worth of food stamps per person per day to a poor Latino family, or those dastardly woke students getting a one time $10,000 loan writeofff.

    3
  16. DK says:

    @grumpy realist:

    Is this any sillier than the tendency of a certain type of American male to insist on red meat, beer, and potato fries as the three food groups, with nary a green vegetable in sight?

    You’re just a sneering woke elitist lol

    2
  17. DK says:

    @EddieInCA:

    Are they? Isn’t it more like assisted suicide?

    Darwinism?

    1
  18. anjin-san says:

    @Scott F.:

    Don’t you mean $cience?