Tag: JAMA Internal Medicine

Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2807617

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Key Points

Question  Was political party affiliation a risk factor associated with excess mortality during the COVID-19 pandemic in Florida and Ohio?

Findings  In this cohort study evaluating 538 159 deaths in individuals aged 25 years and older in Florida and Ohio between March 2020 and December 2021, excess mortality was significantly higher for Republican voters than Democratic voters after COVID-19 vaccines were available to all adults, but not before. These differences were concentrated in counties with lower vaccination rates, and primarily noted in voters residing in Ohio.

Meaning  The differences in excess mortality by political party affiliation after COVID-19 vaccines were available to all adults suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been a factor in the severity and trajectory of the pandemic in the US.

Abstract

Importance  There is evidence that Republican-leaning counties have had higher COVID-19 death rates than Democratic-leaning counties and similar evidence of an association between political party affiliation and attitudes regarding COVID-19 vaccination; further data on these rates may be useful.

Objective  To assess political party affiliation and mortality rates for individuals during the initial 22 months of the COVID-19 pandemic.

Design, Setting, and Participants  A cross-sectional comparison of excess mortality between registered Republican and Democratic voters between March 2020 and December 2021 adjusted for age and state of voter registration was conducted. Voter and mortality data from Florida and Ohio in 2017 linked to mortality records for January 1, 2018, to December 31, 2021, were used in data analysis.

Exposures  Political party affiliation.

Main Outcomes and Measures  Excess weekly deaths during the COVID-19 pandemic adjusted for age, county, party affiliation, and seasonality.

Results  Between January 1, 2018, and December 31, 2021, there were 538 159 individuals in Ohio and Florida who died at age 25 years or older in the study sample. The median age at death was 78 years (IQR, 71-89 years). Overall, the excess death rate for Republican voters was 2.8 percentage points, or 15%, higher than the excess death rate for Democratic voters (95% prediction interval [PI], 1.6-3.7 percentage points). 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.

Conclusions and Relevance  In this cross-sectional study, an association was observed between political party affiliation and excess deaths in Ohio and Florida after COVID-19 vaccines were available to all adults. These findings suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been factors in the severity and trajectory of the pandemic in the US.

Author(s): Jacob Wallace, PhD1; Paul Goldsmith-Pinkham, PhD2; Jason L. Schwartz, PhD1

Publication Date: 24 July 2023

Publication Site: JAMA Internal Medicine

Association of Cardiovascular Health With Life Expectancy Free of Cardiovascular Disease, Diabetes, Cancer, and Dementia in UK Adults

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2801750?guestAccessKey=9c49772f-a1bb-4a29-9a46-445f585b3781&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=olf&utm_term=022723

Cite: JAMA Intern Med. Published online February 27, 2023. doi:10.1001/jamainternmed.2023.0015

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Question  What is the association of cardiovascular health (CVH) levels, estimated by the American Heart Association’s Life’s Essential 8 score, with life expectancy free of major chronic diseases?

Findings  In this cohort study of 135 199 adults from the UK Biobank study, high CVH level was associated with substantially longer life expectancy free of 4 major chronic diseases (cardiovascular disease, diabetes, cancer, and dementia) in both men and women. Furthermore, the disease-free life expectancy was similar between low and other socioeconomic groups among participants with high CVH.

Meaning  These findings support improvement in population health by promoting a high CVH level, which may also narrow health disparities associated with socioeconomic status.

Author(s): Xuan Wang, MD, PhD1; Hao Ma, MD, PhD1; Xiang Li, MD, PhD1; et al

Publication Date: 27 Feb 2023

Publication Site: JAMA Internal Medicine

Excess Mortality in California During the Coronavirus Disease 2019 Pandemic, March to August 2020

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774273?guestAccessKey=c8fe2604-92e1-4640-b62b-2ac686cef7f0&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_term=mostread&utm_content=olf-widget_12222020

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From March 1 through August 22, 2020, 146 557 deaths were recorded in California, with an estimated 19 806 (95% prediction interval, 16 364-23 210) deaths in excess of those predicted by historical trends (Table). Per capita excess mortality was highest among people aged 65 years and older, men, Black and Latino residents, and those without a college degree. Comparing deaths in March through April vs May through August, Latino residents and those without a high school degree or general education development (GED) certificate had the greatest increase in excess deaths, with Latino deaths tripling (from 16 to 51 excess deaths per million) and deaths in those without a high school degree/GED increasing by a factor of 3.4 (from 21 to 72 excess deaths per million). Across age groups, younger adults had the greatest increases in excess death, with rates more than doubling between shutdown and reopening (age, 25-54 years: from 4 to 11 excess deaths per million, 55-64 years: from 12 to 30 excess deaths per million).

In most weeks of the pandemic, Black residents had higher per capita excess mortality than other racial/ethnic group (Figure). Late in the shelter-in-place period, White, Asian, and Black residents had a decline in excess per capita mortality. In contrast, Latino residents and those without a high school degree/GED saw a substantial and sustained increase in per capita mortality.

Author(s): Yea-Hung Chen, PhD, MS1; M. Maria Glymour, ScD, MS2; Ralph Catalano, PhD, MRP3; et al

Publication Date: 21 December 2020

Publication Site: JAMA Internal Medicine