A Study of Cumulative COVID-19 Mortality Trends Associated with Ethnic-Racial Composition, Income Inequality, and Party Inclination among US Counties

Abstract

This research analyzes the association between cumulative COVID-19 mortality and ethnic-racial composition, income inequality, and political party inclination across counties in the United States. The study extends prior research by taking a long view—examining cumulative mortality burdens over the first 900 days of the COVID-19 pandemic at five time points (via negative binomial models) and as trajectories of cumulative mortality trends (via growth curve models). The analysis shows that counties with a higher Republican vote share display a higher cumulative mortality, especially over longer periods of the pandemic. It also demonstrates that counties with a higher composition of ethnic-racial minorities, especially Blacks, bear a much higher cumulative mortality burden, and such an elevated burden would be even higher when a county has a higher level of income inequality. For counties with a higher proportion of Hispanic population, while the burden is lower than that for counties with a higher proportion of Blacks, the cumulative COVID-19 mortality burden still is elevated and compounded by income inequality, at any given time point during the pandemic.