PURPOSE: This study investigates the association of racial and ethnic composition, segregation, and 2020 presidential election voting results with COVID-19 infections and deaths in Florida counties. METHODS: Florida county COVID-19 infection and death counts reported through March 2021 were supplemented with socioeconomic characteristics and 2020 presidential results to form the dataset employed in this ecological study. Poisson regression analysis measured the association of infection and mortality rates with county demographic and economic characteristics, then assessed the moderating role of county political preferences. RESULTS: Counties with higher proportions of Black residents experience disproportionately higher COVID-19 infection and mortality rates. Disparities are further inflated in counties with larger Republican vote shares. That voting effect extends to Hispanic population proportions and segregation, both of which are associated with higher COVID-19 infection and mortality rates in more Republican-leaning counties. CONCLUSIONS: Communities challenged by pre-existing health disparities, segregation, and economic hardship before the pandemic bear disproportionate risk of COVID-19 infection and mortality. Factors associated with voter preference for the 2020 Republican presidential candidate compound those problems, worsening consequences for all county residents, suggesting deeper structural health challenges.
COVID-19 Infections and Mortality in Florida Counties: Roles of Race, Ethnicity, Segregation, and 2020 Election Results