United States’ political climates and the spread of SARS-2-COVID-19 during 2020

We tested whether the political climate in each U.S. state and Washington, DC determined the nature of the spread of COVID-19 cases and deaths in those polities during 2020. Political climate for each polity was indexed as a weighted average of the proportion of Republicans in legislatures in 2018 and the degree of public trust in both the White House and President Trump to handle COVID-19 in April, 2020. We found that polities higher on the political climate index had faster increases in per capita COVID-19 cases and deaths. Such Republican-trusting polities also had lower access to health care and less public engagement in prevention behavior, both of which mediated the influence of political climate on COVID- 19 cases and deaths. Further, the relationship between incidence of COVID-19 cases and deaths was weaker in more Republican-trusting polities. Political climate can be seen as contributing to more cases and deaths due to lower access to health care and to lower public adherence to public health guidelines in polities led by Republicans and which trusted the Trump White House to handle the pandemic.