Societal inequities and politicians’ differing responses were among the reasons why the Covid-19 pandemic played out in different ways across the U.S., according to a new state-by-state analysis examining the driving forces behind variations in health, education and economic performance during the pandemic.
Despite the U.S. having the highest number of recorded Covid deaths and one of the highest fatality rates from Covid per capita globally, researchers found individual states had vastly different Covid experiences, with Hawaii and New Hampshire seeing the lowest cumulative Covid death rates and Arizona and Washington D.C. seeing the highest, according to the study, published Thursday in the Lancet.
Researchers used state-level data from January 2020 to July 2022 to compare government policy responses and population behaviors like vaccination and mask use, to evaluate states’ efforts to limit Covid infections and deaths.
The study found that Covid exacerbated existing inequities: States with less access to quality health care, higher poverty rates and lower rates of educational attainment saw disproportionately high rates of Covid infections and death.
Rates of Covid infection and death were not impacted by how much money a state spent on public health or how many public health personnel a state had per capita, according to the research.
Among the state-imposed protective mandates—mask use, vaccines and mobility restrictions—researchers found only vaccine coverage was strongly associated with a state’s variation of Covid deaths.
Overall, local economies across the U.S. were neither “hindered nor helped” by different politices aimed at slowing the spread of the virus or cutting death rates, the study found—though higher employment rates did correlate with higher rates of Covid.
Restaurants were one exception: Researchers found mandatory restaurant closures and mask requirements were associated with larger falls in states’ employment rates.
Researchers also examined how political orientation impacted infection and death rates, and found that the share of the state that voted Republican in the 2020 presidential election was a key predictor of Covid infections and deaths. The research echoed findings from a 2022 study, which found people living in U.S. counties that voted for former President Donald Trump in 2020 were more likely to die from Covid than people who lived in counties that voted Democrat in the 2020 presidential election. However, Thursday’s study found there was no association between the political affiliation of states’ governors and Covid death rates.
In recent months the federal government and most state governments have significantly rolled back Covid restrictions initially instituted to reduce infection and death rates. None of 569 U.S. counties that provide information about masking requirements to the U.S. Labor Department currently have a mask mandate in place. While Covid infections continue to plague the U.S.—an average of 20,771 new cases per day were reported in the week ending Thursday, according to the New York Times—test positivity and hospitalizations have fallen in the past few weeks, and infections and deaths are well below peak levels.
By Ana Faguy, Forbes Staff