Abstract
Coronavirus (COVID-19) is a potentially fatal viral infection. This study investigates geography, demography, socioeconomics, health conditions, hospital characteristics, and politics as potential explanatory variables for death rates at the state and county levels. Data from the Centers for Disease Control and Prevention, the Census Bureau, Centers for Medicare and Medicaid, Definitive Healthcare, and USAfacts.org were used to evaluate regression models. Yearly pneumonia and flu death rates (state level, 2014–2018) were evaluated as a function of the governors’ political party using a repeated measures analysis. At the state and county level, spatial regression models were evaluated. At the county level, we discovered a statistically significant model that included geography, population density, racial and ethnic status, three health status variables along with a political factor. A state level analysis identified health status, minority status, and the interaction between governors’ parties and health status as important variables. The political factor, however, did not appear in a subsequent analysis of 2014–2018 pneumonia and flu death rates. The pathogenesis of COVID-19 has a greater and disproportionate effect within racial and ethnic minority groups, and the political influence on the reporting of COVID-19 mortality was statistically relevant at the county level and as an interaction term only at the state level.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiologic agent of the coronavirus (COVID-19) pandemic
What attributes of geography, demography, population density, economy, population health, hospital characteristics, and politics might explain the deaths per 100,000 at the county level as of 31 August 2020? Second, did COVID-19 death rates at the state level differ based upon governor party affiliation after accounting for other relevant variables? As a control for our second line of inquiry, we examined whether variation existed in previous flu/pneumonia death rates (2014–2018) based upon the governor’s party affiliation
We evaluated the data that pointed toward political interference in the reporting of COVID-related deaths
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiologic agent of the coronavirus (COVID-19) pandemic. As of 31 August 2020, the associated death toll in the United States is reported to have surpassed 180,000 [1], the highest of any country in raw numbers but equivalent to many other developed countries when adjusted for population [2]. There is some concern surrounding the veracity of the data and factors contributing to COVID-19 deaths. Media outlets provide daily updates on the number of cases and deaths but draw this information from data collection and reporting agencies that have adjusted their methods over time [5]. The resulting inconsistencies have led to charges of underreporting [6,7] and overreporting [8,9], and have contributed to the politicization of the pandemic
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