The COVID-19 pandemic shined a light on the link between politics and health. But the mortality gap between Republican and Democrat areas was already brewing.

A study published in June in The BMJ showed that over the two decades prior to the COVID-19 pandemic, there was a growing gap in mortality rates for residents of Republican and Democratic counties across the U.S. In 2001, the study’s starting point, the risk of death among red and blue counties (as defined by the results of presidential elections) was similar. Overall, the U.S. mortality rate has decreased in the nearly two decades since then. But the improvement for those living in Republican counties by 2019 was half that of those in Democratic counties.

The study’s longitudinal approach and county-by-county analysis replicate and extend a clear pattern, says University Professor and demographer Jennifer Karas Montez, who was not involved in the research. “It joins an already existing, pretty robust literature showing that politics [and] polarization do have life-and-death consequences,” Montez says.

Read more in the Scientific American article, "People in Republican Counties Have Higher Death Rates Than Those in Democratic Counties."