Political Ideology Related to Health Outcomes of COVID | News

For immediate release: Tuesday, November 1, 2022

Boston, Massachusetts – The higher the exposure to political conservatism, the higher the death rates from COVID-19 and the stress on hospital intensive care unit (ICU) capacity, according to a new study from the Harvard TH Chan School of Public Health.

“Prior to our study, research on how political ideology affects COVID-19 looked only at voters’ political leanings; we extended this research to examine the associations of COVID-19 outcomes with the voting records of federal elected representatives and the concentration of political party power at the state level. The point is not biased analysis, but rather to understand how politics and political polarization affect population health,” said Nancy Krieger, professor of social epidemiology at the Harvard TH Chan School of Public Health and corresponding author of the study.

The study was published online in Lancet Regional Health – Americas on November 1, 2022.

Little previous research has examined the health outcomes of COVID-19 in relation to US congressional districts. Researchers analyzed data on COVID-19 death rates and stress on ICU capacity from April 2021 to March 2022, a period when adult vaccines were available, in all 435 US congressional districts. They examined three exposure variables not previously used in COVID-19 research: the political ideology of elected members of the US Congress, measured by their overall voting records; their votes on four key bills to alleviate COVID-19; and “state trifectas,” the concentration of political power at the state level, defined as governor, house, and senate all under the control of one party.

The study found that the greater the exposure to conservatism on each political indicator, the higher the age-standardized rates of death from COVID-19, even after adjusting for the area’s social characteristics, voter political leanings, and levels of of vaccination. The same relationship applies to the stress on hospital ICU capacity.

For COVID-19 death rates, for example, models controlling for political and social indicators and vaccination rates showed Republican trifectas to be 11% higher and conservative political leanings to voters 26% higher, respectively.

“Our study offers new approaches to analyze the political determinants of COVID-19 indicators—such as mortality, morbidity, or vaccination rates—as one component of analyzing political responsibility for the population burden of COVID-19. It also points to the importance of analyzing policy indicators in relation to population health outcomes more broadly,” Krieger said.

There was no funding for the study from any agency in the public, commercial or not-for-profit sectors.

“Relationship Between Political Ideology of US Federal and State Elected Officials and Key Outcomes of the COVID Pandemic After Adult Vaccine Launch: April 2021-March 2022,” Nancy Krieger, Christian Testa, Jarvis T. Chen, William P. Hanage, Alessia J. McGregor, Lancet Regional Health – Americas, online 1 Nov 2022, doi: 10.1016/j.lana.2022.100384

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For more information:

Todd Datz
[email protected]


Harvard TH Chan School of Public Health brings together dedicated experts from many disciplines to train new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators and students, we work together to bring innovative ideas from the laboratory to people’s lives – not only by making scientific breakthroughs, but also by working to change individual behaviour, public policies and healthcare practices. Each year, more than 400 Harvard Chan School faculty teach over 1,000 full-time students from around the world and train thousands more through online courses and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the school is recognized as America’s oldest public health professional training program.

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