Data from: The association of county-level presidential election outcome and COVID-19 mortality in Colorado, 2020-2022

Context:  The Coronavirus disease 2019 (COVID-19) pandemic
occurred during a time of political tension in the United States.
County-level political environment may have been influential in COVID-19
outcomes. Objective:  This study examined the association between
county-level political environment and age-adjusted COVID-19 mortality
rates from 2020 to 2022. Design & Setting:  Political
environment was measured by the 2020 Presidential election results and
compared with age-adjusted COVID-19 mortality rates by county in Colorado.
Main Outcome Measures:  Rate ratios (RR) and 95% confidence
intervals (CI) were estimated using negative binomial regression
incorporating a population offset term. Models adjusted for populational
differences using the demographics percentile from Colorado’s EnviroScreen
Environmental Justice Tool. Results:  Age-adjusted county
mortality rates ranged from 14.3 to 446.8.0 per 100,000. 2021 COVID-19
mortality rates were nearly twice as high in counties voting for Donald
Trump compared to those voting for Joseph Biden (adjusted RR = 1.98, 95%
CI: 1.59, 2.47). Results for 2020 and 2022 mortality models were also in
the positive direction, though the confidence intervals crossed null
values. Conclusion:  These results build on a growing body of
evidence that the political environment may have been influential for
COVID-19 mortality, helping to understand the drivers of health outcomes.
Implications for the public health system as we shift into the endemic
period of COVID-19 include motivation for collaborative work to restore
and rebuild trust among and between stakeholders and the community, as
well as increase health education given its’ influence on both individual
and community behaviors.