News Release

Harvard Public Health/Political ideology and COVID-19 health outcomes

Peer-Reviewed Publication

Harvard T.H. Chan School of Public Health

Boston, MA – The higher the exposure to political conservatism, the higher the COVID-19 mortality rates and stress on hospital intensive care unit (ICU) capacity, according to a new study from Harvard T.H. Chan School of Public Health. 

“Before our study, research on how political ideology affects COVID-19 looked solely at voters’ political lean; we expanded on that research to investigate associations of COVID-19 outcomes with the voting records of federal elected representatives and the concentration of political party power at the state level. The point is not partisan analysis, but rather to understand how politics, and political polarization, are affecting population health,” said Nancy Krieger, professor of social epidemiology at Harvard T.H. Chan School of Public Health and corresponding author of the study. 

The study will be published online in the Lancet Regional Health – Americas on November 1, 2022. 

Little prior research had looked at COVID-19 health outcomes in relation to U.S. congressional districts. The researchers analyzed data on COVID-19 mortality rates and stress on ICU capacity from April 2021 to March 2022, a period when adult vaccines were available, across all 435 U.S. Congressional districts. They examined three exposure variables that had not been used previously in COVID-19 research: the political ideology of U.S. elected members of Congress, as measured by their overall voting records; their votes on four key COVID-19 relief bills; and “state trifectas,” the concentration of political power at the State level, defined as the governor, House, and Senate, all under the control of one party.  

The study found that the higher the exposure to conservatism on each political metric, the higher the COVID-19 age-standardized mortality rates, even after adjusting for the district’s social characteristics, voters’ political lean, and vaccination rates. The same relationship held true for stress on hospital ICU capacity.  

For COVID-19 mortality rates, for example, models controlling for political and social metrics and vaccination rates showed that Republican trifectas were, respectively, 11% higher and conservative voter political lean 26% higher. 

“Our study offers new approaches to analyzing political determinants of COVID-19 metrics—such as mortality, illness, or vaccination rates—as one component of analyzing political accountability for populations’ COVID-19 burdens. It also points to the importance of analyzing political metrics in relation to population health outcomes more generally,” said Krieger. 

There was no funding for the study from any agency in the public, commercial, or not-for-profit sector.  

“Relationship of political ideology of US federal and state elected officials and key COVID pandemic outcomes following vaccine rollout to adults: April 2021-March 2022,” Nancy Krieger, Christian Testa, Jarvis T. Chen, William P. Hanage, Alecia J. McGregor, Lancet Regional Health – Americas, online November 1, 2022, doi: 10.1016/j.lana.2022.100384 

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Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives—not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health. 













































































































































































































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