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Excess COVID-19 Deaths in Republican Counties Paint Voting as a Proxy for Public Health Support
On this episode of Managed Care Cast, we speak with the lead author of a paper that discovered that counties that voted majority Republican in the 2020 presidential election had 73 excess deaths per 100,000 people compared with counties that had Democratic majorities.
The pandemic highlighted deep partisan divisions in the United States over public health measures. Disputes over masking and beliefs about science and vaccines that prevent severe illness and death from infection with SARS-CoV2, the virus that causes COVID-19, affected nearly every area of life. That rancor impacted death rates in counties that voted Republican in the 2020 presidential election, according to a new study out Monday in the journal Health Affairs.
In counties where 70% or more of eligible voters chose the Republican party, there were nearly 73 additional deaths from COVID-19 per 100,000 people compared with Democratic counties (where less than 30% voted Republican).
On today’s episode of Managed Care Cast, we speak with the lead author of the study, Neil J. Sehgal, PhD, MPH, assistant professor of health policy and management in the University of Maryland (UMD) School of Public Health. He discusses the findings of the paper, co-authored with other scholars from UMD, as well as the University of California, Irvine Program in Public Health.
The analysis, which included the majority of US counties, controlled for other characteristics likely to influence COVID-19 transmission and death such as age, race/ethnicity, vaccine uptake, unemployment status, burden of chronic disease, and health care access.
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Reference
Sehgal NJ; Yue D; Pope E; Wang RH; Roby DH. The association between COVID-19 mortality and the county-level partisan divide in the United States. Health Aff (Millwood). Published online June 7, 2022. doi:10.1377/hlthaff.2022.00085
AI Meets Medicare: Inside CMS’s WISeR Model With Sanjay Doddamani, MD, MBA, Part 2
August 5th 2025In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on the future of value-based care and the promise—and limits—of AI-enabled innovation, reflecting on challenges like rising Medicare costs and patients’ growing financial burdens.
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Proposed SNAP Cuts Could Threaten Prevention for Cognitive Decline, Dementias
July 30th 2025Supplemental Nutrition Assistance Program (SNAP) benefits may slow cognitive decline in older adults, highlighting the importance of food assistance in combating Alzheimer disease and dementia risks.
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Managed Care Reflections: A Q&A With Charles N. (Chip) Kahn III, MPH
July 30th 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The August issue features a conversation with Charles N. (Chip) Kahn III, MPH, the president and CEO of the Federation of American Hospitals and a longtime member of the AJMC editorial board.
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