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Opinion: What the 2024 electoral map reveals about America’s mortality divide

By · Via STAT Health · Published by Everything Blog

In short

In 2024, the age-adjusted mortality rate was 19.2% higher in states that backed Donald Trump compared to those that voted for Kamala Harris. While mortality gaps reached higher peaks during the Covid-19 pandemic, unequal progress against chronic illnesses like cancer and heart disease sustains the divide. For instance, between 2016 and 2024, heart disease mortality fell by 9.1% in Harris states but dropped only 2.9% in Trump states. These health outcomes are heavily shaped by structural barriers, including rural hospital closures and decisions regarding healthcare safety nets.

Key points

  • Disparities in mortality between politically divergent states have expanded dramatically…: Disparities in mortality between politically divergent states have expanded dramatically since a minimal 2% gap was recorded in 2001.
  • Drug overdose mortality patterns reversed over eight years, shifting from higher rates in…: Drug overdose mortality patterns reversed over eight years, shifting from higher rates in Trump states in 2016 to higher rates in Harris states by 2024.
  • Diverging health outcomes are closely tied to policy choices like Medicaid expansion and…: Diverging health outcomes are closely tied to policy choices like Medicaid expansion and systemic challenges such as rural hospital closures.

Sources checked by our analysis pipeline: 1

In this 2026 midterm election season, health care ranks third on voters’ minds. That’s no surprise: U.S. life expectancy persistently lags those in comparable countries despite substantially greater spending on health care. As health and health care become increasingly political, we asked whether the leading drivers of mortality looked different by political geography in the United States.

In 2024, the mortality rate, adjusted for differences in age composition, was 19.2% higher in states that voted for Donald Trump than in states that voted for Kamala Harris. As the Make America Healthy Again (MAHA) agenda continues to shape U.S. health policy, the causes for these differences deserve close attention.

The political mortality divide in the U.S. is a relatively new phenomenon. In 2001, mortality rates adjusted for age were just 2% higher in counties where the plurality voted for a Republican presidential candidate versus a Democratic candidate.

By 2019, that relative difference had widened to 16.1%. The widening gap followed slower declines in mortality rates in Republican versus Democratic plurality counties (-11.1% versus -21.9% from 2001 to 2019, respectively).

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