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You are here: Home / Anderson On Health Insurance / Partisanship as a determinant of health

Partisanship as a determinant of health

by David Anderson|  July 25, 202311:28 am| 39 Comments

This post is in: Anderson On Health Insurance

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In this week’s JAMA Internal Medicine Wallace et al examined death rates by voter registration in Ohio and Florida during the first 21 months of the COVID pandemic. They found that there was no differential death rate by partisan identity when there were no vaccines. However, as soon as vaccines became widely available to the adult population differential death rates were observed:

After May 1, 2021, when vaccines were available to all adults, the excess death rate gap between Republican and Democratic voters widened from −0.9 percentage point (95% PI, −2.5 to 0.3 percentage points) to 7.7 percentage points (95% PI, 6.0-9.3 percentage points) in the adjusted analysis; the excess death rate among Republican voters was 43% higher than the excess death rate among Democratic voters. The gap in excess death rates between Republican and Democratic voters was larger in counties with lower vaccination rates and was primarily noted in voters residing in Ohio.

Previous researchers had found substantial differences in death rates at the aggregate county level. This study looks at individual level effects within counties and found substantial variation.

We know from ACA research that partisanship is one hell of a predictor of purchase of regulated health insurance. Republicans, for a given level of health and income, were less likely to purchase a policy than Democrats. We know political identity is important in the ACA context, and now we know it has huge mortality differentials in the COVID vaccination context.

I think we really need to get our head around partisan identity as a social determinant of health as I would be shocked if these two examples are isolated examples.

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39Comments

  1. 1.

    Suzanne

    July 25, 2023 at 11:39 am

    I think we really need to get our head around partisan identity as a social determinant of health as I would be shocked if these two examples are isolated examples.

    We already know that “toxic masculine” attitudes toward seeking out healthcare contribute to a lower life expectancy for men.

    Get that colonoscopy and stop being weird!

    I have a friend who tried to “tough out” a strep throat infection so long that he got scarlet fever. Like our college dorm was some goddamn Victorian orphanage and campus health wasn’t a couple of blocks away.

  2. 2.

    FelonyGovt

    July 25, 2023 at 11:43 am

    And of course, the rest of us pay for their bad, partisan choices through increased medical bills, insurance premiums, etc.

  3. 3.

    evodevo

    July 25, 2023 at 11:46 am

    Not at ALL surprising…

  4. 4.

    Fraud Guy

    July 25, 2023 at 11:50 am

    Dying to own the libs.  SMDH.

  5. 5.

    rikyrah

    July 25, 2023 at 11:51 am

    not shocking results.

  6. 6.

    Elizabelle

    July 25, 2023 at 11:52 am

    Moar of this, wingnuts.  We need some more competitive districts.

  7. 7.

    Villago Delenda Est

    July 25, 2023 at 11:54 am

    The common clay of the New West they are…

  8. 8.

    Albatrossity

    July 25, 2023 at 11:56 am

    When folks point out that the modern GOP is a death cult, this is what they are talking about.

  9. 9.

    patrick II

    July 25, 2023 at 11:58 am

    There is a higher death rate among those who did not take the vaccine, and since many Republicans were persuaded not to take the vaccine (throw Fauci in jail!), the results of this survey are not very surprising,

    The persuaders face no penalty but complain about being censored.  The core problem is that it has become profitable to lie to the gullible with small consequences and giant rewards.

    I just saw a sitdown interview with Tucker Carlson and he was asked if he took the vaccine.  He plainly lied and said no.  He worked at FOX News where they were all vaccinated so the real answer was yes.  Tucker has made millions by selling lies. It’s not that hard to do if you have no conscience. He is just one example of the marketplace of death and that is what needs to be fixed.

    And the sad thing is if you show the results of this survey to the people who need to see it the most — they won’t believe you.  Hell, they will hate you for it. You’ll probably get death threats sent to your home.

  10. 10.

    Tom Levenson

    July 25, 2023 at 12:27 pm

    @Albatrossity: This is ONE of the things they are talking about…

  11. 11.

    Eunicecycle

    July 25, 2023 at 12:31 pm

    When I first became eligible for the Covid vaccine I literally couldn’t find an appointment within 100 miles. I finally found appointments in Jim Jordan’s Congressional district (no surprise). There were people there from Michigan and Pennsylvania, too.

  12. 12.

    Lord Fartdaddy (Formerly Mumphrey, Smedley Darlington Mingobat, et al.)

    July 25, 2023 at 12:32 pm

    Killing themselves to own the libs. Well, color me owned.

  13. 13.

    Elizabelle

    July 25, 2023 at 12:35 pm

    These are the same morons who are falling for the buy gold scams prevalent on Fox and rightwing emails and media.  (The WaPost has a big article on that today.  And surprise, surprise, these gold scammers are not advertising on “leftwing” or mainstream media.)

    In this case, some of them are paying with their lives.

  14. 14.

    RevRick

    July 25, 2023 at 12:36 pm

    Given how many Democrats are lower-income persons of color, with greater incidences of poverty, one would think this would have an adverse impact on the health outcomes for Democrats. But that is due to insufficient resources to support their health. With Republicans, it’s a matter of choice due to a sick cultural belief system.

  15. 15.

    CaseyL

    July 25, 2023 at 12:37 pm

    These are people who truly cannot do abstract reasoning of any kind: they believe what they’re told, even if it contradicts what they were told one day ago.  No abstract thinking skills and no object permanence.

    I’d love to know if they were always that way – this is a kind of intelligence you can’t, SFAIK, test for – or became that way after years of marinating in the kind of propaganda that requires you to turn off your abstract/critical thinking skills.

    We absolutely don’t need more people like that, so I applaud their suicide pact with the GOP.

  16. 16.

    RevRick

    July 25, 2023 at 12:42 pm

    @Albatrossity: Umberto Eco, in his 1995 essay on “Ur-fascism,” noted that one of the hallmarks of fascisms is a contempt for women coupled with the exaltation of action over reflection, which manifests itself in a cult of the hero, which becomes a death cult. It is the thinking that “I’ll prove I’m not some girly man who’s afraid of a measly virus by refusing to wear a mask or get vaccinated.”

  17. 17.

    smith

    July 25, 2023 at 12:44 pm

    @RevRick: And that sick cultural belief system led them to not only avoid vaccination but to resist masking and social distancing, as well as rely on crackpot cures like ivermectin. I don’t think POC were convinced by the “covid is not real, I’m gonna do what I like,” mindset at all.

  18. 18.

    Chief Oshkosh

    July 25, 2023 at 12:49 pm

    @Eunicecycle: Yep. We were in the Atlanta metro area when vaccines became available. Had to drive over to Alabama to get ours. Long line at the drugstore in Podunk AL. Every person in the line was from ATL.

    Roll Tide, you dumb motherfuckers! But thanks for the vaccines!

  19. 19.

    Parfigliano

    July 25, 2023 at 12:56 pm

    Die faster GOPer dumbasses

  20. 20.

    Chip Daniels

    July 25, 2023 at 12:57 pm

    Its almost as if Donald Trump was engineered in a lab as a weapon to kill Republicans.

  21. 21.

    JoyceH

    July 25, 2023 at 12:57 pm

    Man, I remember how thrilling it was when the vaccine became available! Mary Washington hospital set up a big vaccine station and rolled people through hundreds a day. I post my getting a vaccine pic on Facebook. As I recall it, the vaccine denial didn’t start up, at least in a big way, for a few months.

  22. 22.

    Albatrossity

    July 25, 2023 at 12:58 pm

    @Tom Levenson:

    This is ONE of the things they are talking about…

    Yes, I should have made that more clear! Plenty of other examples, for sure!

  23. 23.

    Baud

    July 25, 2023 at 1:02 pm

    Partisanship as a determinant of health

    Also too, moral fiber, attractiveness, and body odor.

  24. 24.

    JoyceH

    July 25, 2023 at 1:05 pm

    When the Canadian wildfire smoke was bad on the east coast, Fox was saying it was perfectly harmless and no need to wear masks outside. We might not even have to defeat these clowns, just outlive them.

  25. 25.

    satby

    July 25, 2023 at 1:09 pm

    Propaganda works. But we can’t celebrate that, we need effective counters to it; it endangers all of us. I’ve started pointing out this excess deaths statistic to some of the farmers market reds, and ask them if they get that the party they support is willing to kill / has killed some of them just to stay in power and keep the cash flowing. Even if they pooh-pooh it, the seed of doubt is planted.

  26. 26.

    CaseyL

    July 25, 2023 at 1:15 pm

    @satby: I don’t encounter many people like that, and am never sure how to talk to them if I do.

    I’m tempted to seemingly agree with them on all matters health-related, then add that there are way too many humans and anything that kills large numbers of humans is good, so “Yay” to the GOP, because killing large numbers of humans is one of the few things the GOP is really, really good at. (The other being robbing people blind before killing them.)

    Usually I just walk away without engaging.

  27. 27.

    Kent

    July 25, 2023 at 1:21 pm

    @JoyceH:Man, I remember how thrilling it was when the vaccine became available! Mary Washington hospital set up a big vaccine station and rolled people through hundreds a day. I post my getting a vaccine pic on Facebook. As I recall it, the vaccine denial didn’t start up, at least in a big way, for a few months.

    Yep.  It didn’t really start up until the vaccine mandates started for travel and employment.  Because Freedumb.  That is when you started getting all the dipshit nurses and such refusing to get vaccinated.

    During the initial months of the rollout in Feb-May of 2021 it was so hard to get vaccine that there were no mandates and it was all volunteer.  I got a fairly early dose as a school teacher but I had to drive a LONG way to the nearest Kaiser clinic that had open appointments.

  28. 28.

    Nina

    July 25, 2023 at 1:24 pm

    How many Democrats still smoke tobacco? How many Republicans still smoke?  Given the advertising that I’ve seen lately, I suspect the demographic shifts heavily towards the R.

  29. 29.

    JoyceH

    July 25, 2023 at 1:26 pm

    @Nina: Sadly, I still smoke and I’m as blue as blue can be.

  30. 30.

    Betsy

    July 25, 2023 at 1:55 pm

    Bad things happen when one discards a commitment to empirical reality.  One more of countless examples.

    I’m for sticking with the good old-fashioned Enlightenment.  Let’s make it 300 years and counting.  None of this new-fangled stuff for me.

  31. 31.

    Betsy

    July 25, 2023 at 1:57 pm

    @RevRick: Who was on last evening or afternoon’s thread with the short but excellent essay comment, about how fascists behave in legislatures?  and how fascism is ultimately a suicide wish.

  32. 32.

    VOR

    July 25, 2023 at 2:03 pm

    I literally drove to another state to get the COVID vaccine. Granted it was only 40 miles, but the point stands. Meanwhile the Republican candidate for Governor in my state for 2022 was chosen BECAUSE he was a COVID denier and purveyor of mis-information.

    I am truly frightened for what will happen if something more dangerous than COVID like the Bird Flu makes the species jump.

  33. 33.

    scav

    July 25, 2023 at 2:05 pm

    See also gun nuts and the odds of dying by suicide or by homicide at home.

  34. 34.

    RSA

    July 25, 2023 at 2:08 pm

    I thought this was interesting, just for context. Not unexpected:

    The median age at death was 78 years (IQR, 71-89 years).

     

  35. 35.

    Snarki, child of Loki

    July 25, 2023 at 2:11 pm

    I, for one, applaud the GOPers that perform frequent cleanings of their copious collection of firearms. But only if they aren’t like wimpy pinko skeerdy-cats that do all that “check it’s unloaded” first; Jeebus will protect them!

    Or gather them up, also good.

  36. 36.

    Ksmiami

    July 25, 2023 at 2:46 pm

    @Suzanne: Did he get rickets too?

  37. 37.

    Ksmiami

    July 25, 2023 at 2:47 pm

    @Betsy: I saw that – it’s because the only thing fascism gives is nihilism, factional authoritarianism and death

  38. 38.

    Nettoyeur

    July 25, 2023 at 3:47 pm

    @FelonyGovt: I think male MAGAs should be encouraged to smoke and drink heavily sob as to die at or before age 60, like many men used to do in the 1950s. Keeps number of grumpy old MAGAs down and cuts Social Security/Medicare costs.

  39. 39.

    RevRick

    July 25, 2023 at 3:49 pm

    @Betsy: I missed that, but I am only on here haphazardly.

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