The number of Georgia counties recording more deaths than births jumped again in 2021, due largely to a rising death toll that owed primarily to a combination of Covid-19 fatalities and lethal drug overdoses, according to data published Friday by the Georgia Department of Public Health (DPH).
The total number of Georgia’s 159 counties reporting more deaths than births rose to 123, up from 118 in 2020. That continued a trend that started about a decade ago. Up until 2010, the number of counties reporting more deaths than births had never reached 20, but since then — with a couple of exceptions — that number has climbed steadily. Pre-Covid, it appeared to have peaked at just under 80 counties in 2018 and ’19, then jumped to 118 in 2020, the first Covid year.
Statewide, the difference in the number of births and deaths narrowed to 11,618, the smallest gap ever recorded by DPH, as the chart at right illustrates. The total number of births actually ticked up slightly, but that gain was more than wiped out by the much bigger increase in deaths.
That gain took place almost entirely in TIGC’s Metro Atlanta region and on the Georgia coast, as this table shows.
Net Births by TIGC Region: 2019-2021
2019
2020
2021
Metro Atlanta
29,092
21,050
18,889
Coastal Georgia
3,099
1,926
1,269
Middle Georgia
3,734
-787
-2,881
North Georgia
3,129
-1,316
-2,996
South Georgia
1,555
-1,608
-2,693
Totals
40,609
19,265
11,618
This table shows the difference between births and deaths for all five Trouble in God’s Country regions for the past three years. That difference has shrunk across the state, and a combination of Covid-19 and drug overdoses produced more deaths than births in predominantly rural areas of Middle, North, and South Georgia starting in 2019. The net gain in births was cut in half from 2019 to 2020, then nearly in half again in 2021. (Data Source: Georgia Department of Public Health)
While the counties reporting more deaths than births were mostly sparsely-populated rural counties, more than a half-dozen significant regional counties suffered more net deaths. Floyd and Walker counties, neighbors in northwest Georgia, reported the largest numbers of net deaths, 374 and 303, respectively. Other important regional population centers reporting more deaths than births included Bibb County (280), Glynn (261), Laurens (211), Thomas (192), and Dougherty (99).
Covid-19 claimed 15,790 Georgia lives in 2021, 14 percent of the state’s total deaths and an increase of 67.2 percent over 2020’s Covid death toll of 9,406. Fatal drug overdoses totaled 2,390, a 25.3 percent increase over 2020 and a 72 percent increase over 2019.
The Georgia Department of Public Health (DPH) is up with its 2021 county-level birth data and the good news is that the number of births last year rebounded a bit from the Covid dip in 2020. The less than good news is that the rebound was well short of the 2019 numbers and it looks like the state’s long-running baby bust is continuing.
Altogether, Georgia recorded 123,971 new births in 2021 — up nearly 1,600 from 2020 but still nearly 2,300 under pre-Covid’s 2019 totals. Nearly 98 percent of those added births took place generally north of the gnat line, in TIGC’s 12-county Metro Atlanta region or its 41-county North Georgia territory. Combined, the 106 counties in Georgia’s Middle Georgia, South Georgia and Coastal Georgia regions added only 38 births to their 2020 totals.
However, those high-level numbers mask some interesting racial and localized differences — principally a big difference in the number of White and Black births. Statewide, White births were up 2,742 in 2021, an increase of 4.0 percent over 2020 and, in fact, a slight increase over 2019. Black births, however, were down 1,422, or 3.1 percent versus 2020.
This represents something of a change from recent years, although it’s impossible to know whether it’s simply a one-year anomaly or perhaps the beginning of a trend. Whites, with a larger population in Georgia, have always produced more births than Blacks, but the trend lines have moved in rough parallel throughout the quarter-century for which DPH has data — with a couple of notable exceptions.
As the graph below shows, between 1994 and 2006, the gap between White and Black births had gradually widened — peaking at about 45,000 for several years in the early 2000s. But White births declined dramatically in 2007 and ’08, probably at least partly due to the Great Recession, and then continued to decline at a slower pace for several years. Black births also declined, although not as precipitously, with the result that the difference in the number of White and Black births has narrowed dramatically in recent years. That difference peaked at 45,553 in 2004; by 2020, it had been cut in half, down to 22,563.
Of the total 123,971 births recorded in Georgia last year, just under two-thirds took place in the 53 counties that comprise TIGC’s Metro Atlanta and North Georgia regions — 81,421 versus the 42,550 in the 106 counties in TIGC’s Middle, South and Coastal Georgia regions.
This map illustrates the percentage change in the number of births for each county. The darker the green, the greater the increase; the darker the red, the greater the decline. As a region, Southwest Georgia suffered the biggest drop in the number of births, but the strip of northwest Georgia counties along the Alabama line wasn’t far behind.
These numbers — in combination with the aforementioned fact that nearly 98 percent of the births over and above 2020’s totals took place in Metro Atlanta and North Georgia — are in line with the long-running shift in population to the northern half of the state.
The 2021 numbers include some unexpected anomalies. The largest percentage increase in births, for instance, took place in tiny Montgomery County, a slice-of-pie-shaped county in southeast Georgia. The number of births there increased to 124 from 87, an increase of 37, or 42.5 percent. About three hours to the west, Calhoun County was at the opposite end of the spectrum. The number of births there fell to 31 from 52, a drop of 40.4 percent.
Another somewhat surprising development is the unbroken string of counties along the Alabama line in northwest Georgia that saw the number of births fall in 2021 — Dade, Walker, Chattooga, Floyd, Polk, Haralson, Carroll and Heard on the Alabama line, plus Whitfield and Gordon just to their east.
For several years now, TIGC has monitored county-level births and deaths and reported on the rising number of Georgia counties recording more deaths than births. Last year, that number jumped to 118 counties, up from 78 in 2019, thanks in part to Covid. The state’s county-level mortality data for 2021 should be published by DPH in July or August.
Research spotlighting the differences in how Red and Blue America are responding to virtually every aspect of Covid-19 continues to pile up: the Kaiser Family Foundation (KFF) went up yesterday with a report declaring that its polling had found “that political partisanship is a stronger national predictor of vaccination than other demographic factors.”
I haven’t attempted to do an analysis that looks at the full spectrum of demographic factors — race, gender, age, etc. — but I certainly don’t doubt KFF’s findings. Its national polling and findings are very much in line with what TIGF has been watching take shape here in Georgia for well over a year, although there are a couple of minor differences.
KFF reports that, nationally, the vaccination gap between counties that voted for Democrat Joe Biden over Republican Donald Trump has widened slightly from about 12 percent toward the end of last year to 13.2 percent as of January 11th. Nationally, KFF found, the Biden counties were 65 percent vaccinated as of that date versus 52 percent for the Trump counties.
Here in Georgia, as of data published yesterday (January 19th) by the state Department of Public Health (DPH), the split was right at 10 points — 51.9 percent in the Biden counties to 42.0 percent in the Trump counties — and that’s about what it’s been for the past few months.
In terms of raw numbers, however, the Biden counties continue to grow their advantage of vaccinated and virus-resistant residents. As of yesterday, the Biden counties had fully vaccinated just shy of 875,000 more people than the Trump counties — 2.97 million to 2.09 million. Lately the gap has been widening by an average of just over 850 people a day. If that pace continues, the difference will hit one million in mid-June.
Another difference involves booster shots. KFF found that nationally “the share of fully vaccinated individuals who have received a booster dose is the same (37%)” in the Biden and Trump counties. Here in Georgia, the Biden counties are doing better in this category as well: 40 percent of the fully-vaxxed residents of the Biden counties have gotten boosters versus 37.4 percent in the Trump counties.
As regular readers of TIGF know, I’ve been watching a broad range of Covid data through a political prism for more than a year now (see stories here,here, and most recently here). The obvious question is whether the differences between Red and Blue Georgia in vaccination and death rates — which increasingly favor Blue Georgia — will be sufficient to have an impact on this fall’s election outcomes.
In my last post, I wondered aloud if Covid would kill so many more Republicans than Democrats that it might actually influence Georgia’s election results this fall. Since then, a couple of things have happened.
One is that I’ve gotten a couple of pretty thoughtful notes suggesting my projected body count was low. As a result I’ve been fiddling around with various chunks of data to see if I could come up with a credible way of fleshing out my last estimate.
The second thing that happened is that I got scooped.
Yesterday, Donald G. McNeil, Jr., a former New York Times health and science writer who now blogs about the pandemic, went up with a terrific post that basically did what I was working toward.
McNeil’s whole piece is well worth reading, but here are just a few of the money grafs:
“As of this week, about 1,800 Americans a day are dying of Covid; the C.D.C. expects that number to rise above 2,600.
“Virtually all are adults. If 95 percent were unvaccinated and we assume that 75 percent of those were Trump supporters, that’s 1,300 to 1,900 of his voters being subtracted from the rolls every single day.
“Donald Trump lost Arizona by a mere 10,000 votes. He lost Georgia by 12,000, He lost Wisconsin by 21,000. He lost Nevada by 33,000.
“Right now, about 60 Arizonans, 36 Georgians, 34 Wisconsinites and 14 Nevadans are dying of Covid each day. Seventy five percent of 95 percent of that would be minus 103 Trump voters per day — just in those four swing states. Week after week. That adds up.”
Obviously, these kinds of projections can get to be a little dicey. There are a lot of moving parts and the data is obviously very fluid. But your humble scribe here at TIGC would wager that data-crunchers and strategists in Democratic and GOP campaigns alike are paying attention to it. It’s going to be a significant part of this fall’s political story.
This is the time of year when most journalists look back at the previous year and recap its major stories. Here at Trouble in God’s Country, I’ve decided to look to the future and take on the major question that will probably hang over Georgia politics for most of the rest of the year.
Specifically: Will Covid kill so many more Republicans than Democrats that it might actually influence the election results in November?
I know, I know. You’re thinking it’s impossible to know whether Covid victims voted red or blue. You’re probably also thinking the question is rude, insensitive and in poor taste. You may be right on both counts. But bear with me.
I took a first pass at this question back in September. At the time, I was looking at the laissez-faire approach Governor Brian Kemp was taking on Covid and linking that to the differing death and vaccination rates that were already taking shape between the state’s red and blue counties.
My thinking then was that the numbers were interesting but that the possibility that they might actually impact future election results was a little far-fetched.
Now, I think I can report that the possibility is a good bit less far-fetched.
First, one data point I used in that initial report probably understated the difference in the Covid death rates in red and blue Georgia. Back then — on September 10th — the Georgia Department of Public Health’s daily Covid report revealed that the Trump counties had suffered 10,545 deaths from the virus versus 9,468 for the Biden counties.
In that analysis, however, I ignored one column in the Georgia Department of Public Health’s daily reports: “Probable Deaths.” I did that in the interest of being cautious and conservative in the way I analyzed the data. I’ve since decided that was unnecessary and, frankly, wrong. Whatever the final cause of death is ruled to be, those “probable” Covid victims are still dead and, presumably, won’t be able to vote.
Add those “probables” to the tally and the body count in the GOP counties jumped, as of last September 10th, to 12,597 versus 10,361 for the 30 Democratic counties — a difference of 2,236. More interesting, I thought, but probably still not a big enough number to get worked up about.
So, what’s happened since then? Well, as of December 31st, the total Covid death toll in the Trump counties — for confirmed and probable deaths — was 17,119 versus 13,157 in the Biden counties, a difference of 3,962.
The bottom line arithmetic on this is that, for the 112 days between September 10th and the end of the year, the Republican counties, on average, lost an average of just over 40 people (virtually all of them voting age) to Covid versus just under 25 people in the Biden counties — a difference of 15.4 deaths per day.
Extrapolating from December 31st until the November 8th General Election would obviously be a risky exercise, but if — big if, I know — the current trend holds, the gap between the Republican and Democratic counties would swell to more than 8,700.
In a state where former President Trump got himself tape-recorded pleading with Georgia Secretary of State Brad Raffensperger to “find 11,780 votes” so he could reverse Biden’s Georgia victory, that’s probably a big enough number to merit a little attention.
And, yes, I know: I may be on shaky ground in suggesting that the geographic differences are a proxy for the political split. But at this point there’s enough data available that I’m comfortable doing just that: I’d wager the law of large numbers is kicking in and that, overall, the geographic and political splits are pretty close.
I’d bet that’s especially true once we factor in the vaccination differences. As of September 10th, the Democratic counties had already given two Covid shots to nearly 800,000 more of their residents than had the GOP counties. As of the end of the year, the vaccination advantage in the Biden counties had grown by another 60,000.
This picture comes into much sharper focus when you look at political universes that are overwhelmingly red or blue. Twenty-five largely rural or exurban counties gave Trump at least 80 percent of their 2020 vote; collectively they hit 83.6 percent for the incumbent president. As a point of comparison, urban DeKalb County gave Biden 84.1 percent of its vote.
This table summarizes the key data points.
With a much smaller population, the 25 Trump counties had nonetheless posted 1,129 more Covid deaths than DeKalb County at year’s end; indeed, the collective Covid death rate for those counties is substantially worse than Mississippi’s, which is currently the worst in the nation.
DeKalb, meanwhile, had fully vaccinated 52.6 percent of its population and gotten boosters in the arms of 19 percent. The 25 Trump counties lag badly in both categories.
Will these trends really ripple into Georgia’s political waters and influence the electoral tides this fall? We won’t know until the night of November 8th, but I think the numbers have gotten big enough that they’re worth watching.
And I’ll add this: If the former president has to come back to Georgia this winter in search of more supposedly missing votes, I’ll have a suggestion about where he should look. I’ll also offer one other piece of advice: bring shovels.
With less than 14 months to go before Georgia’s 2022 statewide elections, TIGC has decided it’s time to tackle the obvious political question that other observers and commentators are too polite and high-minded to address, namely: Are Republicans killing their own voters?
This is admittedly tough to prove. But it’s difficult — nay, impossible — to compare the state’s Covid-19 performance with recent election results and not at least wonder. As of this past Friday, the 129 counties that sided with Donald Trump in the 2020 presidential election had significantly higher Covid-19 case rates and death rates — and much lower vaccination rates — than the 30 counties that went for Joe Biden.
Some raw numbers: Covid-19 data published Friday, September 10th, by the Georgia Department of Public Health (DPH) tells us that the Trump counties had suffered 1,077 more deaths than the Biden counties while vaccinating nearly 800,000 fewer people. Perhaps even worse for the Trump counties, their combined 14-day case rate — a measure of current rather than long-term trends — is a solid 41 percent higher than the rate in the Biden counties.
Of course, these numbers alone don’t prove anything. The virus is, as far as we know, politically agnostic, and neither death certificates nor vaccination records list political party preference. Further, it’s probably mathematically possible that an actual body count (an audit, perhaps, that compares death certificates with primary voting histories) would tell a different story. But a look at various bits and pieces of anecdotal data makes it difficult to conclude that Democrats are suffering a bigger Covid-19 hit.
Take, for instance, Brantley County. Located in deep southeast Georgia, Brantley gave Trump his biggest Georgia margin — 90.9 percent of the vote — but, as of Friday’s DPH report, it had the fourth-worst vaccination rate in the state at 20.8 percent. This could be purely coincidental, but your humble scribe here at TIGC is skeptical of that. Of the 51 Covid-19 deaths Brantley had reported by this past Friday, 43 were white, and all but three were 50 or older.
It is, of course, possible to find counternarratives in county-specific data. As an example, dirt-poor and heavily-black Hancock County, which gave Biden one of his biggest margins (72.1 percent) also had the state’s worst Covid-19 death rate as of Friday. That said, Hancock Countians seem to be taking the hint: 42.2 percent had been fully vaccinated as of last Friday, according to DPH data, one of the state’s highest rates, especially among rural counties.
Indeed, any attempt to find county-level correlations between Trump-Biden vote splits and, say, case or death rates is doomed to failure — thanks to a host of other variables that come into play, including race, poverty and educational levels, probably among others.
But at a macro level, fairly clear patterns begin to emerge, as this table shows.
Against the backdrop of those kinds of numbers, you’d think Georgia’s GOP leaders would be doing more to promote vaccinations and other Covid-19 mitigation measures, including masking. While Governor Brian Kemp, a Republican, has gotten vaccinated and publicly encouraged others to do so, it seems fair to say his support for anti-Covid policies has been less than full-throated. He has overridden attempts by local governments to impose masking mandates and other mitigation measures, and he’s up on Twitter today with (so far) three tweets attacking President Biden’s plan to require all businesses with more than 100 employees to ensure they’re vaccinated or at least tested weekly for the virus.
Kemp’s lack of enthusiasm on the anti-Covid front may have trickled down and infected the state’s bureaucracy. DPH has made a good bit of Covid material available to the media on its website and produced at least one television ad earlier this year, but it’s not clear how much play that ad got — or how effective it was. It does seem fair to suggest that the state-level effort left a vacuum that at least some local governments and health departments have felt compelled to try to fill.
As an example, Gwinnett County earlier this year launched a campaign built around “listening to moms” to encourage Covid-19 mitigation measures, including vaccinations, and has reportedly spent more than a half-million dollars on the campaign. It may be getting a decent return on that investment. While Gwinnett went through a Covid “hot spot” phase several months ago and has one of the state’s higher overall case rates, its Covid death rate is one of the lowest in the state and its vaccination rate, at 48.5 percent, ranked 6th best in the state as of last Friday. Its also the largest of the Metro Atlanta counties that was solidly Republican a decade ago but has shifted from red to blue since then: it went nearly 60-40 for Biden in the 2020 election.
TIGC won’t attempt to use these numbers to extrapolate over the next 14 months and estimate an impact on the 2022 elections, but it’s difficult to imagine that any of the state’s Republican politicians or operatives would find much good news — or comfort — in them. If the current 1,077-death difference between the Trump and Biden counties just happens to parallel the difference in voters lost by each party to Covid so far, that alone probably won’t spell the difference in next year’s elections.
But then you have to figure out how to factor in the difference in vaccination rates and recent Delta variant case rates — and layer that onto that the fundamental health differences between the state’s overwhelmingly rural Republican areas and its largely Democratic urban climes, including, specifically, higher rates of lethal comorbidities such as obesity and diabetes. Will those conditions, in combination with Covid-19, compound the premature death rates that are already higher in predominantly Republican rural Georgia?
Governor Kemp’s management of the state’s Covid plague may not quite rise to the level of criminal negligence or manslaughter. But it might yet turn out to be political suicide.
(Couple of notes on my methodology in this piece. In crunching the presidential votes, I’ve ignored Libertarian votes, as I usually do. In analyzing various pieces of DPH data, I’ve found that different units of the department use different population estimates to calculate the various case, death and vaccination rates. The vaccination rates published by DPH are pegged to 2018 population estimates, according to its own “Data Descriptions” published with the daily reports. It’s not clear to me what population estimates DPH uses to calculate daily case and death rates; the numbers don’t quite match any of the annual estimates I can find. In the interest of consistency, I have used 2020 population estimates pulled directly from the Department’s OASIS database (I haven’t had time to get into the actual county-level census counts yet). My use of the 2020 estimates produces slightly different case, death and vaccination rates than those shown on the various DPH reports. Also, many thanks to several Facebook friends who helped me crowdsource information about state and local Covid communications programs, especially old friend Terry L. Wells.)
The number of Georgia counties reporting more deaths than births jumped to 118 in 2020, up dramatically from 78 in 2019, according to new county-level mortality data published Monday by the Georgia Department of Public Health (DPH).
The increase was generally expected. DPH reported in June that 2020 births were down 3.1 percent from 2019, and the Covid-19 death toll seemed certain to drive a big increase in the number of counties where burials outnumbered births.
All told, births still outnumbered deaths in Georgia, but by the narrowest margin recorded in the quarter-century DPH has been reporting county-level birth and death data. The 19,265 surplus of births over deaths was less than half the 40,000-plus surplus recorded in 2018 and ’19, and not even a quarter of the 83,051 surplus record set in 2007.
As the graph at the right shows, the birth and death lines have been converging for nearly 15 years now. One curiosity in the 2020 death numbers is that Covid-19 accounted for only a little over half of the total increase in the number of deaths over 2019.
Statewide, the total number of deaths skyrocketed from 85,641 in 2019 to 103,114 in 2020 — and Covid-19 was cited as the cause of death in only 9,446 of those 2020 cases.
Even without the Covid-19 deaths, 2020 would have set a record for the total number of deaths and the percentage increase over the previous year. With the Covid-19 deaths included, the number of deaths rose 20.4 percent over 2019; without the Covid-19 deaths, the increase was 9.4 percent. In the 25 years DPH has been reporting data, the number of deaths had never hit five percent in a single year — and the increase was usually much less.
(A cursory review of the DPH data failed to turn up a big chunk of deaths attributable to a single cause of death — although a number of categories appeared to be up by somewhat higher percentages. TIGC will continue to sift through the data for a more complete explanation.)
Also unsurprising: the surplus of births over deaths was concentrated primarily in and around Metro Atlanta and, to a lesser degree, the Georgia coast, as this map illustrates:
Indeed, TIGC's North Georgia, Middle Georgia and South Georgia regions all posted more deaths than births. TIGC's 12 Metro Atlanta counties reported 21,050 more births than deaths while TIGC's seven Coastal Georgia counties posted a surplus of 1,926 births -- this despite the fact that Glynn County suffered the biggest death-to-birth deficit in the state. It posted 313 more deaths than births, and 2020 was only the second time in the past quarter-century that it hasn't recorded more births. Gwinnett County posted the biggest surplus of births over deaths -- 5,331.
Few if any of these numbers are surprising, and they are in line with county-level 2020 Census data that was released last week.
The number of counties reporting more deaths than births began to rise about a decade ago, and was first reported by TIGC several years ago. The big jump from 78 to 118 counties -- more than two-thirds of Georgia's total of 159 counties -- was far and away the biggest one-year increase since the current trendline started rising in the wake of the Great Recession.
The table below shows 2020 births and deaths for all 159 Georgia counties, along with the number of Covid-19 deaths and the percentage of total deaths caused by Covid-19.
The American Journal of Preventive Medicine (AJPM) earlier this week published a new statistical study which basically found that American states led by Democratic governors have fared better through the worst of the pandemic than those governed by Republicans.
Opined the authors: “Gubernatorial party affiliation may drive policy decisions that impact COVID-19 infections and deaths across the U.S. Future policy decisions should be guided by public health considerations rather than political ideology.”
Gee, you think?
Actually, I’m glad to see this kind of big academic study. As eye-glazing as it can be in places, it reinforces a lot of the observations I’ve made here at Trouble in God’s Country since Covid-19 rolled in a year ago. Early on, I started noticing differences between between Georgia, where Republican Governor Brian Kemp was famously loathe to impose restrictions because of the pandemic, and North Carolina, where Democratic Governor Roy Cooper acted pretty quickly and decisively to begin closing down his state.
The two states have a lot in common, including demographics, economics, educational levels, and population size. Pretty much from the get-go, North Carolina was performing more Covid-19 tests and reporting more confirmed cases but fewer deaths.
Based on the latest data available from the CDC’s COVID Data Tracker, North Carolina has since significantly out-performed Georgia. As of Thursday, March 11, Georgia, with a population of 10.6 million, had more than a million confirmed and probable cases and 18,117 Covid-19 deaths; North Carolina, whose population is only slightly smaller at 10.4 million, has recorded 879,825 such cases and 11,622 deaths.
A week or so after that first Georgia-North Carolina comparison last March, I posted a new piece that broadened the focus and compared a half-dozen Old South states led by proudly conservative Republicans (Alabama, Florida, Georgia, Mississippi, South Carolina and Tennessee) to three deep blue West Coast states led by liberal Democratic governors (California, Oregon and Washington).
The two regions had very comparable populations — 51.4 million for the three West Coast states versus 51.9 million for the six Old South states. But the regions’ governors were taking very different approaches in fighting the virus. The governors on the West Coast, which bore the brunt of the virus’s initial attack, took early, dramatic actions to shut down their states and limit the virus’s spread, while the Old South’s GOP governors were openly resisting most public health-driven actions.
At the time of that initial report — not even a month into the pandemic — the West Coast had suffered 543 deaths versus 500 for the Old South, but the Old South was already piling up more cases: more than 24,000 versus just over 18,500 for the West Coast.
I pulled fresh numbers from the CDC’s Covid-19 Data Tracking website on Friday, and the Old South’s performance now looks much worse in comparison to the West Coast (where, again, the virus initially turned Seattle into the public health equivalent of Chernobyl and has continued to savage the California coast) than it did last April. The Old South states have racked up 25,000 more deaths than the West Coast and a million more confirmed and probable cases, as this table details:
The AJPM study found that the Republican-led states had lower case and death rates for the first several months of the pandemic, but that those trend lines crossed — on June 3, 2020, for case rates and a month later, on July 4, for death rates.
That’s generally in line with another TIGC observation. I tracked county-level case and death rates on an almost daily basis for the first several months of the pandemic by the political party each county sided with in the 2018 Georgia gubernatorial election. Early on, the virus did most of its damage in urban areas that were heavily populated and largely Democratic, such as Metro Atlanta; the virus was indeed slow to show up in sparsely-populated rural areas of Georgia that largely sided with Governor Kemp and other Republicans.
But it did get there — and, just as the authors of the AJPM study found, the trend lines eventually crossed. By my calculations, the death rate in counties that went for Democratic gubernatorial nominee Stacey Abrams had been higher — that is, worse — from the opening days of the pandemic through most of August; they crossed on August 25, 2020. The case rate trend lines were a little slower to intersect, but finally crossed on September 9.
I took another look at this phenomenon following last year’s presidential election and found the same pattern, as this table to the right shows. By election day, President Donald J. Trump’s Georgia counties had significantly worse case rates, death rates and 14-day case rates than his then-Democratic challenger, Joe Biden.
The authors of the AJPM study were careful to avoid asserting causality in the statistical relationship between the governors’ party affiliation and their states’ Covid-19 results. And, indeed, there are a variety of factors other than politics that probably contribute to different outcomes. In an early piece speculating that rural Georgia might eventually be harder hit than the state’s urban areas, I cited the facts that rural Georgians were generally in poorer health than their city cousins and had access to much frailer health care delivery systems. At that point, the political differences were just beginning to come into focus.
But, statistical limitations aside, it now seems silly to ignore the obvious political relationships and implications. It’s often said that the 50 states function as laboratories for American democracy. For a year now, that’s clearly been the case where America’s response to Covid-19 is concerned. But it’s a shame we all wound up being used as human guinea pigs.
(c) Copyright Trouble in God’s Country 2021
Long-time friend and long-ago colleague Terry L. Wells contributed to this article. He first spotted and posted to Facebook an article about the AJPM study, without which I probably would have missed the whole thing.
Last weekend TIGC reported that 70 Georgia counties qualified as Covid-19 “red zones” and that the bug appeared to be mounting a new assault on Metro Atlanta from its fortifications in the North Georgia mountains.
Today we can report that the number of counties whose seven-day rates exceed 100 cases per 100,000 people — the “red zone” threshold set by the White House Coronovirus Task Force — is up to 96, and all 12 Metro Atlanta counties are now included in that group.
This is, obviously, part of a national trend. The AJC reported this morning that Georgia is one of 48 states that qualify as red zones. But, as usual, virus’s attacks are far from uniform, and it seems to move from one region to another in an almost deliberate manner. These two maps show its progression out of the North Georgia hills over the past week.
At the same time, the virus seems to be giving much of rural Middle and South Georgia a bit of a breather. This doesn’t mean that the virus has gone away, just that — for the moment — the seven-day case rate has fallen below the 100 cases per 100,000 people level.
But that could change, and quickly. As the bug has re-invaded Metro Atlanta, it also seems to be knifing its way back down I-75 and could easily branch off into the rural counties to the east or west.
At the moment, Whitfield and Murray counties, side-by-side neighbors on the Tennessee line, jointly constitute the hottest spot in the state. Combined, their seven-day case rate is 511.27 per 100,000 people — more than five times what it takes to qualify as a Covid-19 “red zone” — and their combined seven-day death rate is 7.59 per 100,000. The state average for the past seven days was 1.56 deaths per 100,000. The state’s three largest counties — Fulton, Gwinnett and DeKalb — had seven-day death rates of .45 per 100,000 people, .72, and .76, respectively.
The cause of the Whitfield-Murray outbreak isn’t clear. The Daily Citizen-News, the newspaper in the Whitfield county seat of Dalton, has covered the outbreak — including stories on the reluctance of local officials to impose a mask mandate — and editorialized about it. But a limited scan of its online stories (before the paywall came up) failed to find anything about what might be driving the outbreak.
In an editorial published today (November 21), the Daily Citizen-News noted Whitfield’s unhappy standing at the top of the new case-rate list and lamented the lack of citizen observance of recommended public health practices.
” … (M)any of us ignore the advice of the U.S. Centers for Disease Control and Prevention as we refuse to wear masks and/or practice social distancing. The lack of masks and social distancing is evident all over town. We have to do better,” the newspaper added.
I noted back in September (here and here) that Covid-19 case and death rates in Georgia’s Republican-voting rural counties had squeaked past those in the state’s more heavily-populated Democratic counties.
I’ve been keeping an eye on that trend, but haven’t bothered to write much about it since then. Last week’s presidential election results, however, seem to invite a fresh look.
As a little more preface, it seems worth noting that the virus did the vast majority of its early damage in major urban areas, including Metro Atlanta, while rural areas seemed skeptical it would ever find its way to them. It did, of course, and has been exacting its heaviest toll on most of those rural areas for a couple of months now.
For this update, I’ve pulled the Georgia Department of Public Health’s (DPH) Covid-19 status report for election day, November 3rd, and sorted it by counties that went (according to the latest election results published by the Secretary of State’s office) for President Trump versus those that went for the Democratic nominee and apparent president-elect, Joe Biden.
This table summarizes that data sort.
As of November 3, the 30 Biden counties had better overall case rates, death rates and 14-day case rates than the 129 Trump counties. Even with a significantly smaller population, the Trump counties have now suffered more total deaths than the Biden counties — 4,017 to 3,814. Perhaps even more worrying are the 14-day case rates, which are a leading indicator of things to come. In the combined Trump counties, that rate was, as of November 3rd, 27.6 percent worse than the Biden counties.
Because the virus is oblivious to county lines, it’s difficult to demonstrate county-to-county correlations between Covid-19 rates and Trump-Biden voting splits.
And, indeed, there are any number of examples of counties whose Covid-19 performance doesn’t match its politics. Glascock County, for instance, gave Trump 89.6 percent of its total vote (second only to Brantley County) but has the fourth-best case rate in the state. (At the same time, and consistent with the 14-day case rate pattern referenced above, Glascock’s 14-day case rate is just under 300 cases per 100,000 people, easily enough to put it in the White House Coronovirus Task Force’s red zone.)
Just to the west of Glascock, though, Hancock County delivered nearly 72 percent of its vote to Biden but, as of November 3rd, had far and away the state’s worst death rate (549.25 per every 100,000 people) and one of the worst case rates.
If, however, clear county-level correlations are difficult to find, mapping the data does bring regional pictures into some focus. First, this map (at right) shows Trump-Biden split as of the general election results available Sunday, November 8th, on the Georgia Secretary of State’s website. (These results appear to be nearly complete, but haven’t been officially certified yet.)
Now compare that general election map with maps below of election-day Covid-19 data from DPH. In these maps, I’ve used the same red/blue color scheme I used in the political map, but here they tell different stories. In each case, counties shown in blue had Covid-19 case rates, death rates, or 14-day case rates that were better (lower) than the state average reflected in the November 3rd DPH data; counties in red had worse (higher) rates. The darker the shade of blue or red, the better or worse they were compared to the state average.
None of the Covid-19 maps is a perfect match for the political map above, obviously, but a comparison does tell several stories. Probably the most obvious is that heavily-Democratic Metro Atlanta is now beating the state average on all three Covid-19 metrics mapped above. Early on, it bore the brunt of the virus’s attack, and still isn’t out of the woods, but now has easily the best overall case rate, death rate and 14-day case rate numbers in the state.
A second is that the swath of heavily-Republican counties in east-central and interior southeast Georgia is now suffering higher than average Covid-19 case and death rates, with more of a mixed picture on 14-day case rates. The virus took its time getting to this part of Georgia, but has now been raging there for several weeks.
Southwest Georgia, though, seems to be cooling off. This politically-mixed region of the state still carries high case and death rates, the results of an early Covid-19 attack that at one time gave this part of the state some of the worst virus numbers on the planet. But it’s 14-day case rates — reflecting current trends — are now among the lowest in the state.
The northwestern corner of the state, meanwhile, seems to be on fire, as the map to the left illustrates. Perhaps the most conservative and Republican region of the state, Northwest Georgia had for the most part avoided the worst of the virus, until recently. As of election day, 18 contiguous counties in that part of the state had 14-day case rates of 200 per 100,000 people or more.
Does any of this demonstrate a cause-and-effect relationship between local political inclinations and the impact of Covid-19? It’s probably a little early to draw that conclusion, although the question certainly seems a fair one to raise.
Early on, it was possible to foresee (even without considering politics) that rural areas might well suffer more from the virus than their city cousins, primarily because they were home to older, less healthy populations that had less access to healthcare and whose healthcare systems were often frail and sometimes non-existent. (TIGC said as much in this post back in March.)
But the virus has clearly become one of the most heavily politicized issues in America in the months since the pandemic rolled in. President Trump has openly feuded with his public health experts and for the most part refused to wear a mask or encourage Americans to do so, while former Vice President Biden and state and local Democratic leaders have taken the opposite tack. (Trump, of course, contracted the virus, but recovered after several days at Walter Reed National Military Medical Center, and a significant number of his close aides have also come down with the bug.)
It’s also worth noting that Georgia is part of a national trend. The Daily Yonder, which covers rural issues, has documented Covid-19’s spread across rural America (see maps below) as well as the political overlap.
“Counties that voted by a landslide (more than a 20-point margin) for Trump in 2016 have a recent infection rate 75% higher than counties that voted by a landslide for Democrat Hillary Clinton in 2016,” The Yonder reported in this piece last week.
It remains to be seen whether a President Biden can prevail upon rural citizens and their leaders to follow conventional public health counsel on practices like wearing masks and social distancing, let alone how long that might take to have an effect. But it’s clear now that changes will be required to bring the virus to heel in the state’s — and nation’s — rural areas.
