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

Wallace J, Goldsmith-Pinkham P, Schwartz JL. 

JAMA Intern Med. 

Published online July 24, 2023.

doi:10.1001/jamainternmed.2023.1154

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.

The research is here.

My Take

Beliefs are a powerful force that can influence our health behaviors. Our beliefs about health, illness, and the causes of disease can shape our decisions about what we eat, how much we exercise, and whether or not we see a doctor when we're sick.

There is a growing body of research that suggests that beliefs can have a significant impact on health outcomes. For example, one study found that people who believe that they have a strong sense of purpose in life tend to live longer than those who do not. Another study found that people who believe in a higher power tend to be more optimistic and have a more positive outlook on life, which can lead to better mental health, which can in turn have a positive impact on physical health.  However, certain beliefs may be harmful to health and longevity.

The study suggest that beliefs may play a role in the relationship between political party affiliation and excess death rates. For example, Republicans are more likely to hold beliefs that are associated with vaccine hesitancy, such as distrust of government and the medical establishment. These beliefs may have contributed to the lower vaccination rates among Republican-registered voters, which in turn may have led to higher excess death rates.

The Moral Determinants of Health

Donald M. Berwick
JAMA
Originally posted 12 June 20

Here is an excerpt:

How do humans invest in their own vitality and longevity? The answer seems illogical. In wealthy nations, science points to social causes, but most economic investments are nowhere near those causes. Vast, expensive repair shops (such as medical centers and emergency services) are hard at work, but minimal facilities are available to prevent the damage. In the US at the moment, 40 million people are hungry, almost 600 000 are homeless, 2.3 million are in prisons and jails with minimal health services (70% of whom experience mental illness or substance abuse), 40 million live in poverty, 40% of elders live in loneliness, and public transport in cities is decaying. Today, everywhere, as the murder of George Floyd and the subsequent protests make clear yet again, deep structural racism continues its chronic, destructive work. In recent weeks, people in their streets across the US, many moved perhaps by the “moral law within,” have been protesting against vast, cruel, and seemingly endless racial prejudice and inequality.

Decades of research on the true causes of ill health, a long series of pedigreed reports, and voices of public health advocacy have not changed this underinvestment in actual human well-being. Two possible sources of funds seem logically possible: either (a) raise taxes to allow governments to improve social determinants, or (b) shift some substantial fraction of health expenditures from an overbuilt, high-priced, wasteful, and frankly confiscatory system of hospitals and specialty care toward addressing social determinants instead. Either is logically possible, but neither is politically possible, at least not so far.

Neither will happen unless and until an attack on racism and other social determinants of health is motivated by an embrace of the moral determinants of health, including, most crucially, a strong sense of social solidarity in the US. “Solidarity” would mean that individuals in the US legitimately and properly can depend on each other for helping to secure the basic circumstances of healthy lives, no less than they depend legitimately on each other to secure the nation’s defense. If that were the moral imperative, government—the primary expression of shared responsibility—would defend and improve health just as energetically as it defends territorial integrity.

The info is here.

Massive genetic study shows how humans are evolving

Bruno Martin
Nature
Originally published 06 September 2017

Here is an excerpt:

Why these late-acting mutations might lower a person’s genetic fitness — their ability to reproduce and spread their genes — remains an open question.

The authors suggest that for men, it could be that those who live longer can have more children, but this is unlikely to be the whole story. So scientists are considering two other explanations for why longevity is important. First, parents surviving into old age in good health can care for their children and grandchildren, increasing the later generations’ chances of surviving and reproducing. This is sometimes known as the ‘grandmother hypothesis’, and may explain why humans tend to live long after menopause.

Second, it’s possible that genetic variants that are explicitly bad in old age are also harmful — but more subtly — earlier in life. “You would need extremely large samples to see these small effects,” says Iain Mathieson, a population geneticist at the University of Pennsylvania in Philadelphia, so that’s why it’s not yet possible to tell whether this is the case.

The researchers also found that certain groups of genetic mutations, which individually would not have a measurable effect but together accounted for health threats, appeared less often in people who were expected to have long lifespans than in those who weren't. These included predispositions to asthma, high body mass index and high cholesterol. Most surprising, however, was the finding that sets of mutations that delay puberty and childbearing are more prevalent in long-lived people.

The article is here.

Note: This article is posted, in part, because evolution is not emphasized in the field of psychology. There are psychologists who believe that humans did not evolve in the way other plants and animals evolved.  I have argued in lectures and workshops that we humans are not in our final form.

Adding ages: The fight to cheat death is hotting up

The Economist
Originally published August 13, 2016

Here is an excerpt:

Scientists at the Institute for Ageing Research at the Albert Einstein College of Medicine, in New York, want to mount a trial of metformin in elderly subjects to see whether it delays various maladies (and also death). If that turns out to be the case, it will go a long way to showing that there is a generalised ageing process that can be modulated with drugs. Nir Barzilai, one of the researchers involved, says an important reason to do the trial is to have an indication against which next-generation ageing drugs can be assessed by regulators.

This sort of interest seems to be triggering a change of tone at America’s Food and Drug Administration over whether it might approve an anti-ageing drug. The regulator is thinking about when a broad, and so far unprecedented, claim of anti-ageing might be considered to be supported by the evidence; it is “looking forward to seeing this area of science evolve”. In the dry language of a government agency these are encouraging words.

If an unregulated diet can do the trick, why does the world need drugs? Three reasons. One is that taking a few pills a day will be easier for most than subsisting on low-calorie muffins and salad. A second is that companies can make money making pills and will compete to create them. A third is that pills may work better than diets. Dr Barzilai, who is in the pill camp, points out that CR works less well in primates than other mammals, and that people with low body-mass indices, a natural condition for those restricting their calories, are in general more likely to die. Those who do well on CR, he says, are likely to be a subset benefiting from the right genetic make-up. His hope is that a range of targeted therapies might allow everyone to get the benefits.

The article is here.