Associations between COVID-19 vaccine uptake, race/ethnicity, and political party affiliation.

Despite widespread availability of vaccines, COVID-19 is a leading cause of death in the United States (US), and sociodemographic disparities in vaccine uptake remain. Race/ethnicity, partisanship, and perception of peer vaccination status are strong predictors of vaccine uptake, but research is limited among some racial/ethnic groups with small populations. The current study used an online survey to examine the relationship between these factors among a diverse sample of US adults (n = 1,674), with oversampling of racial and ethnic minorities. Respondents provided sociodemographic information and answered questions regarding COVID-19 vaccination status, political affiliation, perception of peers' vaccination status, COVID-19 death exposure, and previous COVID-19 infection. Respondents who identified as Asian American had higher odds of being vaccinated, whereas those who identified as Black/African American or American Indian or Alaska Native (AIAN) had lower odds. Respondents who identified as Independent/Other or Republican had lower vaccination odds. Respondents who perceived anything less than nearly all of their peers were vaccinated had lower vaccination odds. Further, lack of a primary care provider, younger age, and lower educational attainment were associated with lower vaccination odds. Findings may help to determine where additional work is needed to improve vaccine uptake in the US. Results indicate the need for intentional and tailored vaccination programs in Black/African American and AIAN communities; the need to understand how media and political actors develop vaccination messaging and impact vaccine uptake; and the need for additional research on how people estimate, understand, and form decisions around peer vaccination rates.

Influence of conspiracy mindset, trust in science, and political affiliation on COVID-19 reactance

The COVID-19 pandemic exposed extreme divisions in the social and political structure of the United States. When health organizations recommended strategies such as physical distancing, hand hygiene, sanitation of surfaces, and isolating when sick to slow the spread of the disease, Americans appeared to divide into two factions;those who followed the public health guidance and those who persistently ignored it, often voicing perceptions of loss of freedom due to the guidance. The purpose of this quantitative study was to examine the extent to which political affiliation moderated the relationship between conspiracy mindset, trust in science, and reactance responses to COVID-19 public health protocols. The social identity approach, a blend of social identity and self-categorization theories explains the polarization in the United States to public health guidance designed to slow the spread of disease. Online surveys were administered via Survey Monkey to 220 American citizens who were active politically. Results indicated that political conservatives were significantly more likely to endorse conspiracy theories and to resist compliance with COVID-19 public health protocols. Additionally, those who distrusted science were significantly more likely to resist compliance with COVID-19 mitigation practices. Findings from this study have the potential to promote positive social change through a better understanding of the reasons for resistance to public health protocols designed to thwart the spread of COVID-19. Importantly, these results can be used to develop messaging that targets those susceptible to conspiracy beliefs and instead direct their attention to the science that informs public safety protocols in the interest of us all. . (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Association between community-level political affiliation and peripartum vaccination.

BACKGROUND: Political affiliation has been associated with vaccine uptake, but whether this association holds in pregnancy, when individuals are recommended to receive multiple vaccinations, remains to be studied. OBJECTIVE: This study aimed to examine the association between community-level political affiliation and vaccinations for tetanus, diphtheria, and pertussis; influenza; and COVID-19 in pregnant and postpartum individuals. STUDY DESIGN: A survey was conducted about tetanus, diphtheria, and pertussis and influenza vaccinations in early 2021, with a follow-up survey of COVID-19 vaccination among the same individuals at a tertiary care academic medical center in the Midwest. Geocoded residential addresses were linked at the census tract to the Environmental Systems Research Institute 2021 Market Potential Index, which ranks a community in comparison to the US national average. The exposure for this analysis was community-level political affiliation, defined by the Market Potential Index as very conservative, somewhat conservative, centrist, somewhat liberal, and very liberal (reference). The outcomes were self-reported vaccinations for tetanus, diphtheria, and pertussis; influenza; and COVID-19 in the peripartum period. Modified Poisson regression was used and adjusted for age, employment, trimester at assessment, and medical comorbidities. RESULTS: Of 438 assessed individuals, 37% lived in a community characterized by very liberal political affiliation, 11% as somewhat liberal, 18% as centrist, 12% as somewhat conservative, and 21% as very conservative. Overall, 72% and 58% of individuals reported receiving tetanus, diphtheria, and pertussis and influenza vaccinations, respectively. Of the 279 individuals who responded to the follow-up survey, 53% reported receiving COVID-19 vaccination. Individuals living in a community characterized by very conservative political affiliation were less likely to report vaccinations for tetanus, diphtheria, and pertussis (64% vs 72%; adjusted risk ratio, 0.83; 95% confidence interval, 0.69-0.99); influenza (49% vs 58%; adjusted risk ratio, 0.79; 95% confidence interval, 0.62-1.00); and COVID-19 (35% vs 53%; adjusted risk ratio, 0.65; 95% confidence interval, 0.44-0.96) than those in a community characterized by very liberal political affiliation. Individuals living in a community characterized by centrist political affiliation were less likely to report vaccinations for tetanus, diphtheria, and pertussis (63% vs 72%; adjusted risk ratio, 0.82; 95% confidence interval, 0.68-0.99) and influenza (44% vs 58%; adjusted risk ratio, 0.70; 95% confidence interval, 0.54-0.92) than those in a community characterized by very liberal political affiliation. CONCLUSION: Compared with pregnant and postpartum individuals living in communities characterized by very liberal political beliefs, those living in communities characterized by very conservative political beliefs were less likely to report vaccinations for tetanus, diphtheria, and pertussis; influenza; and COVID-19, and those in communities characterized by centrist political beliefs were less likely to report vaccinations for tetanus, diphtheria, and pertussis and influenza. Increasing vaccine uptake in the peripartum period may need to consider engaging an individual's broader sociopolitical milieu.

A Tale of Two Cities: COVID-19 Vaccine Hesitancy as a Result of Racial, Socioeconomic, Digital, and Partisan Divides

The unprecedented COVID-19 pandemic has drawn great attention to the issue of vaccine hesitancy, as the acceptance of the innovative RNA vaccine is relatively low. Studies have addressed multiple factors, such as socioeconomic, political, and racial backgrounds. These studies, however, rely on survey data from participants as part of the population. This study utilizes the actual data from the U.S. Census Bureau as well as actual 2020 U.S. presidential election results to generate four major category of factors that divide the population: socioeconomic status, race and ethnicity, access to technology, and political identification. This study then selects a region in a traditionally democratic state (Capital Region in New York) and a region in a traditionally republican state (Houston metropolitan area in Texas). Statistical analyses such as correlation and geographically weighted regression reveal that factors such as political identification, education attainment, and non-White Hispanic ethnicity in both regions all impact vaccine acceptance significantly. Other factors, such as poverty and particular minority races, have different influences in each region. These results also highlight the necessity of addressing additional factors to further shed light on vaccine hesitancy and potential solutions according to identified factors.

Motivation to Correct Misinformation: Third-Person Perceptions and Perceived Norms

The proliferation of misinformation is an ongoing problem in the United States. The public's trust in news from the mainstream media is down, and the sharing of news items on social media is up—even the sharing of made-up news. Previous research has found third-person perceptions (TPP) indicate that people tend to believe that others are more influenced by misinformation than they are. People also believe they are more likely to correct their own misinformation than their perceived norm of how likely others are to correct misinformation that they have propagated. This replication study found that TPP and perceived norms influence a person's likelihood of self-correcting and correcting others when misinformation has been spread. Those with lower media hostility are also more likely to correct.

Does Outcome Bias Trump Political Tribalism?

Outcome bias occurs when people evaluate decision quality based on the outcome rather than the intentions of the decision maker. We replicate these findings and extend them to the realms of policy and politics. Approximately equal numbers of Republicans and Democrats judged policy decisions aimed at ameliorating the deleterious effects of the COVID-19 pandemic. We manipulated the affiliation of the decider (Republican vs. Democrat) and the aim of the policy (benefits health vs. benefits the economy;benefits health but hurts the economy vs. benefits the economy but hurts health). The results revealed that policy decisions aimed at addressing health problems or aimed at repairing the economy without negative externalities in other spheres of life were evaluated solely as a function of outcome in which successful outcomes generated significantly greater quality ratings than failures. However, judgments of policy decisions aimed at helping one sphere of life but hurting another (i.e., business closures) were qualified by significant interactions with the political party affiliation of the decision maker and that of the participant. Republicans' responses show evidence for outcome bias while favoring Republican deciders. In contrast, Democrats exhibited a greater degree of outcome bias while favoring decisions that prioritized health over the economy relative to decisions that prioritized the economy over health.

Demographic Differences in Compliance with COVID-19 Vaccination Timing and Completion Guidelines in the United States.

BACKGROUND: The development of vaccines has been a significant factor in eliminating the pandemic caused by the novel coronavirus (SARS-CoV-2). However, the primary series vaccination rate still falls short of our expectations, with an even lower rate of uptake for booster shots. This study examined demographic patterns of COVID-19 vaccination compliance by assessing patterns in the timing of the vaccine series start and vaccination completion and characterizing people by compliance with vaccination recommendations. METHODS: A cross-sectional survey was conducted online in August 2022. Participants answered questions about the COVID-19 vaccine and questions related to their personal backgrounds. We assessed the impact of demographic factors on COVID-19 vaccination using multivariable regression modeling. RESULTS: Among 700 eligible participants, 61% (389) were highly adherent (i.e., started by late 2020 and received a booster dose), 22% (184) were moderately adherent (i.e., started later than June 2021, and/or did not receive the booster dose), and 17% (127) were unvaccinated. Compliance was relatively low among non-Hispanic Black Americans, those with no religious affiliation, and among Independents and Republicans. CONCLUSION: Vaccination compliance varies across demographic groups. Race/ethnicity, religion, and political affiliation are highly associated with vaccination compliance. To promote vaccination compliance and decrease vaccine hesitancy, the government and healthcare institutions should establish a positive image to obtain public trust and adopt effective vaccine education and intervention.

Does outcome bias trump political tribalism?

Outcome bias occurs when people evaluate decision quality based on the outcome rather than the intentions of the decision maker. We replicate these findings and extend them to the realms of policy and politics. Approximately equal numbers of Republicans and Democrats judged policy decisions aimed at ameliorating the deleterious effects of the COVID-19 pandemic. We manipulated the affiliation of the decider (Republican vs. Democrat) and the aim of the policy (benefits health vs. benefits the economy;benefits health but hurts the economy vs. benefits the economy but hurts health). The results revealed that policy decisions aimed at addressing health problems or aimed at repairing the economy without negative externalities in other spheres of life were evaluated solely as a function of outcome in which successful outcomes generated significantly greater quality ratings than failures. However, judgments of policy decisions aimed at helping one sphere of life but hurting another (i.e., business closures) were qualified by significant interactions with the political party affiliation of the decision maker and that of the participant. Republicans' responses show evidence for outcome bias while favoring Republican deciders. In contrast, Democrats exhibited a greater degree of outcome bias while favoring decisions that prioritized health over the economy relative to decisions that prioritized the economy over health. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement What is the significance of this article for the general public?-Even though the COVID-19 pandemic is a health problem, a large proportion of people treated it as a political issue for which voters' political affiliation determined their response to the pandemic. Dealing effectively with the pandemic requires a unified response in a situation where health and the economy are frequently at loggerheads. Here we examined how voters think about policy decisions that aimed to address either public health or economic concerns stemming from the pandemic. In half of the cases, policies aimed at addressing one issue were detrimental to another. In general, people judge policy decisions as a function of their outcomes;however, they are more likely to be influenced by their political considerations when policies addressing one issue end up being detrimental to another. Specifically, Republicans' responses show evidence for outcome bias while favoring Republican deciders. In contrast, Democrats exhibited a greater degree of outcome bias while favoring decisions that prioritized health over the economy relative to decisions that prioritized the economy over health. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Red State, Blue State, Purple State; Higher and Increasing Blue COVID-19 Anxiety Rate.

The present study investigated COVID-19 Anxiety Scale (CAS) scores for participants from blue states, red states, and purple states across 276 days ranging from April 18, 2020 to January 23, 2021. The CAS scores increased with knowing and caring for an individual with COVID-19, following social distancing guidelines, hours talking and thinking about COVID-19, hypochondria, neuroticism, depression, anxiety, stress, negative PANAS, and time, whereas they decreased with positive PANAS. More importantly, the CAS scores were higher for participants from blue states than for participants from purple states, and the positive relation between CAS scores and time was only significant for participants from blue states. We connected media events that occurred concurrently for high CAS scores overall and for high CAS scores for participants from blue states. The spikes in CAS ratings occurred along with COVID-19 contagion, partisan reactions to protests for slain African Americans (e.g., George Floyd), and the 2020 presidential election.

Investigating the Relation of Political Orientation and Vaccination Outcomes: Identifying the Roles of Political Ideology, Party Affiliation, and Vaccine Hesitancy.

Popular press and academic articles alike suggest that political orientation is a primary determinant of vaccination willingness, vaccination, and vaccine word-of-mouth (i.e., sharing of information regarding vaccines). In the current article, we test the validity of these suggestions, and we also assess the differential roles of political ideology (e.g., liberal-conservative) and party affiliation (e.g., Democrat-Republican) as well as the mediating effect of vaccine hesitancy's dimensions. To do so, we perform a four-wave survey study with 223 participants that completed all waves. Our results support that political orientation indeed relates to our outcomes of interest. Our results also show that political ideology has a more pronounced effect than party affiliation, and the vaccine hesitancy dimensions of Health Risks and Healthy mediate many of these relations. From these results, we suggest many directions for future research and practice, including the integration of political discourse theories in studies on political orientations and vaccination.

What are the Attitudes of Medical Students and Housestaff Towards Health Advocacy? A Physician-Led Voter Registration Initiative and Health Advocacy Survey

Background Compared to the general population, physicians have been shown to be less engaged in civic participation and less likely to vote. However, perspectives of current trainees on health advocacy remain under-explored. Objective To investigate perspectives on a physician led voter registration initiative and identify current beliefs of physicians in training and medical students regarding physician health advocacy. Design Cross sectional survey performed at a single urban academic center. Participants A total of 366 medical students, residents, and fellows voluntarily participated in the survey out of a total of 1,719 available (21% response rate). Main Measures We examined the current perceptions surrounding health advocacy among medical students and physicians in training and how this was impacted by the COVID-19 pandemic. Responses were analyzed using Chi-square analysis and logistic regression. Key Results The voter registration code was scanned 131 times prior to the 2020 Presidential elections. Barriers to hospital-based voter registration included lack of time, lack of fit into the workflow and forgetting to ask. Over half of internal medicine-based residents and fellows (51%) and medical students (63%) agreed that physicians should be involved in helping patients register to vote compared to 34% of surgical-based trainees. A large majority (87%) indicated that the COVID-19 pandemic made it more necessary for physicians to be involved in politics. Conclusion A high proportion of medical students and housestaff across specialties report an obligation to be involved in health advocacy, though there were differing views towards direct involvement in voter registration.

Protection motivation unmasked: Applying protection motivation theory to skepticism toward COVID-19 mask and vaccine mandates.

Variants of COVID-19 have sparked controversy regarding mask and/or vaccine mandates in some sectors of the country. Many people hold polarized opinions about such mandates, and it is uncertain what predicts attitudes towards these protective behavior mandates. Through a snow-ball sampling procedure of respondents on social media platforms, this study examined skepticism of 774 respondents toward these mandates as a function of the Protection Motivation Theory (PMT) of health. Hierarchical linear regressions examined Protection Motivation (PM) as a predictor of mask and vaccine mandate skepticism independently and with political party affiliation as a control. PM alone accounted for 76% of the variance in mask mandate skepticism, p < 0.001 and 65% in vaccine mandate skepticism, p < 0.001. When political affiliation was entered (accounting for 28% of the variance in mask mandate skepticism, p < 0.001, and 26% in vaccine mandate skepticism, p < 0.001), PM still accounted for significant percentages of variance in both mask (50%) and vaccine (43%) mandate skepticism, ps < 0.001. Across regressions, perceived severity, outcome efficaciousness, and self-efficacy each directly accounted for unique variance in mask and vaccine mandate skepticism, ps < 0.001; only perceived vulnerability failed to account for unique variance in the regressions, ps > 0.05. Specifically, the more severe participants perceived COVID-19 to be and the greater the perceived efficacy of masks and vaccines preventing the spread of COVID-19, the lower participants' skepticism toward mask and vaccine mandates. Similarly, the higher participants' self-efficacy in wearing masks or receiving the vaccine, the lower their skepticism toward mask and vaccine mandates.

Emergence of Curbside Pickup: Consumers’ Usage Intention Amid COVID-19 Pandemic

This study examines how consumers’ intention to use a curbside pickup responds to the COVID-19 vaccination rates. With our first survey conducted in March 2021, we find that a low (high) vaccination rate is associated with consumers’ high (low) intention to maintain contact avoidance and their high (low) anticipation for shipping delays. Heightened contact avoidance and anticipation for shipping delays may encourage consumers to use a curbside pickup. Our results also show that when a product is needed immediately, and a consumer expects shipping delays, s/he is more likely to use a curbside pickup. However, with our second survey conducted in November 2021, we find heterogeneous consumer responses to the vaccination rates. Specifically, consumers’ political affiliation moderates the relationship between the vaccination rates and their intention to maintain contact avoidance. The association between the vaccination rates and the anticipation for shipping delays is also weakened compared to March 2021. Our empirical results illustrate how consumers’ intention to use a curbside pickup emerges and changes amid the COVID-19 pandemic. © 2022, Asia Pacific Journal of Information Systems. All Rights Reserved.

Prevention is political: political party affiliation predicts perceived risk and prevention behaviors for COVID-19.

BACKGROUND: Many US politicians have provided mixed messages about the risks posed by SARS-CoV-2/COVID-19 and whether and to what extent prevention practices should be put in place to prevent transmission. This politicization of the virus and pandemic may affect individuals' risk perceptions and willingness to take precautions. We examined how political party affiliation relates to risk perception for one's own and other people's likelihood of SARS-CoV-2 infection/COVID-19 illness. METHODS: We surveyed members of a nationally-representative, probability-sampling based survey panel (N = 410) to examine their risk perceptions, precautionary behaviors, and political party affiliation. RESULTS: The more strongly one identified as a Republican, the less risk one perceived to oneself from SARS-CoV-2/COVID-19 and the less risk one perceived other people faced. Moreover, those identifying as more strongly Republican engaged in fewer preventive behaviors. CONCLUSIONS: This differential response may affect virus transmission patterns and poses a considerable challenge for health communications efforts.

COVID-19 Infections and Mortality in Florida Counties: Roles of Race, Ethnicity, Segregation, and 2020 Election Results.

PURPOSE: This study investigates the association of racial and ethnic composition, segregation, and 2020 presidential election voting results with COVID-19 infections and deaths in Florida counties. METHODS: Florida county COVID-19 infection and death counts reported through March 2021 were supplemented with socioeconomic characteristics and 2020 presidential results to form the dataset employed in this ecological study. Poisson regression analysis measured the association of infection and mortality rates with county demographic and economic characteristics, then assessed the moderating role of county political preferences. RESULTS: Counties with higher proportions of Black residents experience disproportionately higher COVID-19 infection and mortality rates. Disparities are further inflated in counties with larger Republican vote shares. That voting effect extends to Hispanic population proportions and segregation, both of which are associated with higher COVID-19 infection and mortality rates in more Republican-leaning counties. CONCLUSIONS: Communities challenged by pre-existing health disparities, segregation, and economic hardship before the pandemic bear disproportionate risk of COVID-19 infection and mortality. Factors associated with voter preference for the 2020 Republican presidential candidate compound those problems, worsening consequences for all county residents, suggesting deeper structural health challenges.

Experience or attribution? Exploring the relationship between personal experience, political affiliation, and subjective attributions with mitigation behavioural intentions and COVID-19 recovery policy support.

Scholars argue that personal experience with climate change related impacts can increase public engagement, with mixed empirical evidence. Previous studies have almost exclusively focussed on individuals' experience with extreme weather events, even as scientific research on health impacts of climate change is burgeoning. This article extends previous research in the domain of public perceptions about climate-related public health impacts. Results from a nationally representative sample survey in New Zealand indicates that subjective attribution of infectious disease outbreaks to climate change and to human impact on the environment is positively associated with mitigation behavioural intentions and climate-focussed COVID-19 economic recovery policies. In contrast, knowledge about COVID-19 and self-reported economic impact due to COVID-19 is not associated with policy support. Moreover, significant interaction between political affiliation and subjective attribution to climate change on policy support indicate that learning about the links between health and climate change will particularly help increase mitigation engagement among right-leaning individuals. Subjective attribution may be the key to help translate personal experience to personal engagement.

COVID-19 vaccine acceptance: influential roles of political party and religiosity.

Given recent declines in US vaccination rates and the emergence of COVID-19 vaccines, identifying sociodemographic influencers of vaccine willingness holds importance for developing effective public health campaigns aimed at enhancing nationwide COVID-19 vaccine acceptance. The present study utilized a hierarchical binary logistic regression model to assess demographic variables (age, gender, race/ethnicity, pre-existing medical conditions), political party membership, religious affiliation, level of religiosity, and fear of COVID-19 as predictors of COVID-19 vaccine acceptance ('Yes', would receive a vaccine or 'No', would not receive a vaccine) in a national sample of US adults (N = 249). Participants were recruited from Amazon's Mechanical Turk (MTurk) and completed several online questionnaires pertaining to mental health, health behaviors, and responses to the COVID-19 pandemic. Both Democratic party membership and decreased level of religiosity predicted acceptance of a COVID-19 vaccine. This investigation supports political party membership and religiosity as influencers of COVID-19 vaccine willingness and suggests that these variables could represent potential targets for public health interventions aimed at increasing vaccine adoption.

Psychosocial determinants of anxiety about the COVID-19 pandemic.

Pandemic health threats can cause considerable anxiety, but not all individuals react similarly. To understand the sources of this variability, we applied a theoretical model developed during the H1N1 pandemic of 2009 to quantify relationships among intolerance of uncertainty, stress appraisals, and coping style that predict anxiety about the COVID-19 pandemic. We surveyed 1579 U.S. Amazon Mechanical Turk workers in April 2020. Using structural equation modeling, we found that individuals who were more intolerant of uncertainty reported higher appraisals of threat, stress, and other-control, which predicted higher anxiety when emotion-focused coping was engaged, and lower anxiety when problem-focused coping was engaged. Political affiliation moderated these effects, such that conservatives relied more on self-control and other-control appraisals to mitigate anxiety than independents or liberals. These results show that how people appraise and cope with their stress interacts with political ideology to shape anxiety in the face of a global health threat.

Political affiliation and risk taking behaviors among adults with elevated chance of severe complications from COVID-19.

This study determines whether COVID-related risk-taking behavior was different among Republicans, Democrats, and Independents, in adults with elevated chance of severe complications from COVID-19. Using US national survey data collected September 30-October 27, 2020 (N = 6095), behaviors in the prior week examined were: 7 potentially risky activities, mask wearing anywhere, and mask wearing while undertaking each activity. Differences among political affiliations were estimated for adults with 0 and with ≥1 medical risk factors for severe complications, adjusting for sociodemographic factors. Among adults with medical risk factors, the adjusted number of potentially risky activities was higher among Republicans (3.83) but not Independents (3.17) relative to Democrats (2.98). The adjusted percentage of adults with medical risk factors who wore a mask anywhere in the past week was lower for Republicans (87%) and Independents (91%) than for Democrats (97%). While undertaking each specific activity, the adjusted percentage of at-risk adults never wearing a mask was higher for Republicans than Democrats: 24% vs 8% at bar/club; 6% vs 0% at grocery/pharmacy; 63% vs 30% visiting at friend's home; 68% vs 41% hosting visitors; 30% vs 5% at gathering of ≥10 people; 25% vs 11% while within 6 ft of someone they do not live with. Rates of mask wearing among political Independents were between rates among Democrats and Republicans. Efforts to reduce COVID-related risky behavior should recognize that although Republicans take more risks, rates of mask wearing at common activities are low across political affiliations, even for populations vulnerable to severe complications.

Death by political party: The relationship between COVID-19 deaths and political party affiliation in the United States.

This study explored social factors that are associated with the US deaths caused by COVID-19 after the declaration of economic reopening on May 1, 2020 by President Donald Trump. We seek to understand how county-level support for Trump interacted with social distancing policies to impact COVID-19 death rates. Overall, controlling for several potential confounders, counties with higher levels of Trump support do not necessarily experience greater mortality rates due to COVID-19. The predicted weekly death counts per county tended to increase over time with the implementation of several key health policies. However, the difference in COVID-19 outcomes between counties with low and high levels of Trump support grew after several weeks of the policy implementation as counties with higher levels of Trump support suffered relatively higher death rates. Counties with higher levels of Trump support exhibited lower percentages of mobile staying at home and higher percentages of people working part time or full time than otherwise comparable counties with lower levels of Trump support. The relative negative performance of Trump-supporting counties is robust after controlling for these measures of policy compliance. Counties with high percentages of older (aged 65 and above) persons tended to have greater death rates, as did more populous counties in general. This study indicates that policymakers should consider the risks inherent in controlling public health crises due to divisions in political ideology and confirms that vulnerable communities are at particularly high risk in public health crises.