In an ideal world, public health would be independent of politics. Yet recent events in the U.S., such as the Supreme Court’s impending repeal of Roe v. Wade, the spike in gun violence across the country, and the stark partisan divide on the response to the Covid-19 pandemic, are putting public health on a collision course with politics.
I say that based on a comprehensive analysis my colleagues and I performed and published [June 7] in The BMJ. In this study, in which we linked U.S. mortality and election data from 2001 to 2019, people in counties that voted for Republican presidential candidates were more like to die prematurely than those in counties that voted for Democratic candidates, and the gap has grown sixfold over the last two decades.
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There was no single cause of death driving this lethal wedge: The death rate due to all 10 of the most common causes of death has widened between Republican and Democratic areas.
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Why is this gap widening? Health policy is one possibility our study points to. Based on statistical testing, the gap in mortality appeared to particularly widen after 2008, which corresponds to the passage of the Affordable Care Act in 2010, a major part of which was Medicaid expansion.
