Additional descriptive research, at the state and national level in the US, and also in other countries, has documented how political polarization, whether measured by voter political lean, policies passed, or rhetoric deployed, has undermined effective pandemic response.
2,
3,
4,
7,
8,
9,
28 Thus,
likely mechanisms causally connecting the range of political variables examined in our study to pandemic impacts plausibly include the roles of federal and state politicians in (a) obtaining and disbursing resources for, and passing or blocking legislation supportive of public health infrastructure, pandemic preparedness, and medical care; (b) facilitating or hindering the range of actions and resources state and local public health departments can deploy; and (c) communicating with, shaping, and responding to the views of their political funders and constituents.
2,
3,
4,
7,
8,
9,
10,
11,
28,
29 In the case of COVID-19, the salience of overall political ideology, as reflected in the total record of votes, and not solely COVID-19 votes, and also state-level concentrations of party political power, is that the politics of COVID-19 have become bound with ideological arguments over fiscal policies, social programs, personal freedom, and the extent to which governments can impose mandates on the behaviours of both the private sector and individuals in order to protect the population's health.
2,
3,
4,
7,
8,
9,
10,
11,
28,
29
Together, our study findings underscore the critical importance of analyzing and monitoring population health mapped onto meaningful units of political geography and using informative political variables that can aid ascertainment of political accountability. Such data serve a different purpose for monitoring population health and other characteristics compared to more stable administrative geographic units, such as census tracts, which in the US were expressly created in the early 20th century CE to overcome problems with instability of geographic units for population data due to reliance on frequently changing and gerrymandered ward boundaries.
30 At issue instead is providing data relevant to informed democratic governance, which requires enabling monitoring improvements, declines, or stasis of population health and health inequities over time in relation to key units of political geography, political ideologies, and concentrations of party political power, which in the US requires attention at both the federal and state-levels.
It could accordingly be useful for US data dashboards that routinely report population health data by county to do likewise by US CDs and, by extension, state and local political districts as well, in conjunction with metrics pertaining to the political ideology of the elected representatives (based on voting records) and the concentration of political power at the state-level (i.e., trifecta). Analogous approaches could be implemented in other countries in relation to their relevant units of political geography and metrics of political ideology and power. Finally, from a policy standpoint, our study and kindred research highlight the necessity of engaging with the politics of health, which is distinct from being "partisan."
2,
3,
4,
8,
28,
29,
30 Instead, what is needed is ongoing monitoring and rigorous analysis of the connections between the actions and votes of elected officials and the health profiles of their constituents and the total population.
