The pandemic highlighted deep partisan divisions in the United States over public health measures. Disputes over masking and beliefs about science and vaccines that prevent severe illness and death from infection with SARS-CoV2, the virus that causes COVID-19, affected nearly every area of life. That rancor impacted death rates in counties that voted Republican in the 2020 presidential election, according to a new study out Monday in the journal Health Affairs.

In counties where 70% or more of eligible voters chose the Republican party, there were nearly 73 additional deaths from COVID-19 per 100,000 people compared with Democratic counties (where less than 30% voted Republican).

On today’s episode of Managed Care Cast, we speak with the lead author of the study, Neil J. Sehgal, PhD, MPH, assistant professor of health policy and management in the University of Maryland (UMD) School of Public Health. He discusses the findings of the paper, coauthored with other scholars from UMD, as well as the University of California, Irvine Program in Public Health.

The analysis, which included the majority of US counties, controlled for other characteristics likely to influence COVID-19 transmission and death such as age, race/ethnicity, vaccine uptake, unemployment status, burden of chronic disease, and health care access.