Red states may be facing a perfect storm of illness and death from COVID-19
Republican presidential candidate Donald Trump greets guests gathered for a campaign event at the Grand River Center on August 25, 2015 in Dubuque, Iowa (AFP Photo/Scott Olson)

Rural, conservative-leaning states have so far been spared widespread outbreaks of COVID-19. But experts say that they’re simply behind the curve of denser, more urban states like New York and Florida. The New York Times reported this week that “many communities that watched the pandemic unfold in faraway places are now experiencing the crisis firsthand. More than two-thirds of rural counties have confirmed at least one case.” Forty-two states now have over 1,000 confirmed cases of the disease, and many red states are among those conducting the fewest tests.

We know red states are vulnerable to rapidly spreading outbreaks in large part because of political polarization. Polls consistently find that Republicans–especially those who watch Fox News regularly–are more likely than Democrats to believe that COVID-19 is similar to the seasonal flu, and that the media and Democrats are hyping the seriousness of the pandemic to harm Donald Trump’s prospects in November. While most of them have so far practiced social distancing and taking other measures to avoid infection despite those beliefs, this week’s spate of fake grassroots protests against various governors’ shelter-in-place orders highlights the problem.

But there’s another reason to believe that red states are likely to be hit hard as the virus spreads: Many of them are leading the country in risk factors for severe illness and death from COVID-19.

According to data from the Kaiser Family Foundation, 17 of the 20 states with the highest rates of smoking are red. Two are swing states and one, North Carolina, has only become blue in the past couple of cycles.

Twelve of the 15 states with the highest self-reported rate of diabetes are red.

Thirteen of the 15 states with the highest obesity rates are as well.

Of the 15 states with the largest share of their populations reporting being in “fair” or “poor” health, one is blue, two are swing states and the rest are solidly Republican.

Among the 15 states with the highest rates of death from heart disease, four are swing states but none are blue states.

Red states also tend to have long underinvested in public health agencies and have poorer healthcare infrastructure overall. According to The Times, “many rural doctors, leaders and health experts worry that…they will have fewer hospital beds, ventilators and nurses to handle the onslaught.” Of the 20 states with the highest rates of uninsured, 16 are safely Republican.

These factors explain at least in part why eight of the 10 states with the highest rates of death from pneumonia and influenza in 2018, the most recent year for which data are available, were heavily Republican.

Hopefully, all of this talk of reopening local economies before we have sufficient capacity to test and isolate the infected and trace the people they’ve been in contact with is just political bluster, and wiser heads, looking at the mounting death toll in places like New York, New Jersey and Louisiana, will prevail. Because with poorer underlying health, on average, weaker health care systems and a lot of citizens who believe Trump and the bobbleheads on Fox News over epidemiologists and public health experts, conservative communities may be facing a perfect storm of serious illness and death.