How Partisanship and Polarization Affected COVID-19 Policy and Outcomes in the United States Open Access

Abstract

The COVID-19 pandemic’s severe case rates and death toll made the disease one of the worst public health outbreaks in both the United States and world history.  Along with infecting and killing millions worldwide, COVID-19 has significantly changed the landscape of social and political relationships, negatively affecting the trust people have in the government and other people.  From the pandemic’s start, it was clear that elected officials and the public would not unify towards the guidance of health experts and public health officials to clamp down on COVID-19 immediately.  The federal government’s lack of consistent communication and policy-making sparked the politicization of the disease, with partisan state governments being responsible for adopting COVID-mitigating policies.  This response would only divide the public even more.  My work for this study builds on three aspects of scholarly literature on public health and politics: political polarization, public health partisanship, and public health policy.  I build on the connection between polarization and partisanship’s relationship with public health policy and how public health policy connects with public health outcomes.  To expand the literature, my theory focuses on partisanship and polarization’s effects on COVID-19 policy within state governments and how state COVID-19 policy affected state COVID-19 outcomes.  I use existing data that involves ideology scores, state partisan control, dates of COVID-19 policy, and government data on COVID-19 cases and deaths.  With this data, I examine the difference between state Democrats’ and Republicans’ policy responses to COVID-19 based on their political contexts and the connection between their policies with their respective state’s COVID-19 outcomes.  Descriptive results and a multivariate fixed effects regression analysis indicate that state Republicans were more likely to adopt short-term and loose COVID-19 policies compared to Democrats’ strict and long-term policies.  The analyses also indicate those strict COVID-19 policies were more successful in dealing with COVID-19 outcomes.  The theory of polarization could not be confirmed when measured by itself, but has a significant effect when interacted with the Republican party.  Future work is needed to explain political polarization’s effect on COVID-19 policies and outcomes and the role that demographic groups in states play in influencing public health policy. 

Table of Contents

Table of Contents

Introduction ....................................................................................... ........................................... 1

Literature Review ........................................................................................................................... 4

Political Polarization ................................................................................................................ 4

Public Health Partisanship .........................................................................................................7

Public Health Policy ................................................................................................................. 9

Theory ...........................................................................................................................................12

Hypotheses ....................................................................................................................................17

Data and Methods .........................................................................................................................17

Measuring COVID-19 Outcomes ...............................................................................................18

Measuring Polarization ............................................................................................................19

Measuring State COVID-19 Policies ...........................................................................................21

Results ..........................................................................................................................................30

Descriptive Results ...................................................................................................................30

Multivariate Analysis ................................................................................................................38

Discussion .....................................................................................................................................51

Conclusion ....................................................................................................................................55

Appendix .......................................................................................................................................58

Data Sources ..............................................................................................................................60

References .....................................................................................................................................64

List of Tables

Table 1. Early and late state adopters of COVID-19 policies ..................................................... 31

Table 2. Duration of state COVID-19 policies visualized by quarters ........................................ 34

Table 3. COVID case and death rates by type of government as of December 31, 2022..............35

Table 4. Percent of Population Vaccinated by Type of Government as of

December 31, 2022 ............................................................................................................36

Table 5. Average number of days policy active by quarter and by type of government ............. 40

Table 6. Demographic and political predictors of state COVID-19 policies ............................... 42

Table 7. Determinants of State COVID-mitigating and COVID-fueling policies........................ 43

Table 8. Determinants of COVID Outcomes, October 1, 2019 - December 2022 ....................... 44

Table 9. Determinants of State Vaccine Outcomes, January 2021 - December 2022:

Percent receiving at least one dose, October 1, 2020 - December 31, 2022............................... 47

Table 10. Determinants of COVID Outcomes, October 1, 2019 - December 2022 ..................... 50

About this Honors Thesis

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School	Emory College
Department	Political Science
Degree	B.A.
Submission	Honors Thesis
Language	English
Research Field	Political Science, General
Keyword	COVID-19 Partisanship Polarization
Committee Chair / Thesis Advisor	Dr. Michael J. Rich, Emory University
Committee Members	Dr. Alexander Bolton, Emory University Dr. Richard F. Doner, Emory University Dr. Holly Patrick, Emory University

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