Conservative health gap widens: study links deaths to medical mistrust

Key Takeaways

• Between 2020 and 2022, 1.34% of 'very conservative' respondents died of internal causes versus 0.2% of 'very liberal' respondents
• The health gap between political ideologies emerged after 2010 and widened significantly by 2020
• Researchers rule out COVID-19, age, geography, and demographics as explanations, pointing instead to declining trust in medicine

Conservatives in the United States are dying at significantly higher rates than liberals, and the gap keeps widening. A study published in Nature last month analyzed individual health data from a representative sample across all 50 states and found that by 2020, conservatives were measurably less healthy than liberals by biomarker measures, death rates from heart disease, cancer, and stroke.

The culprit, according to researchers: a growing crisis of trust in doctors and the medical system that has become sharply correlated with political identity.

What the study actually found

The research team tracked health outcomes over a decade using long-term data from a large, nationally representative sample. Their central finding is stark. Between 2020 and 2022, only 0.2% of "very liberal" respondents died from internal causes such as heart disease, cancer, or stroke. Among "very conservative" respondents, that figure was 1.34%. That's a sevenfold difference.

"2010 is the last year in which we can say fairly clearly that there is not this gap," Elizabeth Elder, a coauthor of the study, told Fast Company. "By 2020 we have pretty clear evidence of a gap in which conservatives are less healthy than liberals."

The timeline matters. In 2010, no gap existed. By 2016, differences began appearing in biomarker measurements like blood pressure and cholesterol. By 2020, those differences were showing up in mortality data.

Why demographics don't explain the gap

The obvious objection: conservatives tend to be older, more rural, and distributed differently across states with varying healthcare quality. The researchers controlled for all of this. They argue in the paper that the divide cannot be explained by COVID-19 deaths, demographic differences, geography, or age distribution. They ran the numbers accounting for income, education, and location. The gap persists.

This is what makes the finding unusual. Most health disparities research focuses on socioeconomic factors like wealth, education level, or access to care. Political ideology has been largely overlooked as a health determinant until now. This study suggests it deserves more attention.

Medical mistrust as a health risk factor

The researchers point to one primary mechanism: a widening ideological divide in trust toward doctors and the broader medical system. This isn't speculative. Trust in medical institutions has become increasingly polarized along partisan lines, accelerating dramatically during the COVID-19 pandemic.

The pandemic made this visible. Fights over masks and vaccines moved from social media into everyday life, with vaccination rates diverging sharply by political affiliation. Separate research found Republicans had 43% higher excess death rates than Democrats during the pandemic.

But the study suggests this distrust now extends beyond pandemic measures. It affects whether someone takes blood pressure medication or sees a doctor for chest pains. These are routine health decisions that compound over time. Skip your statins for a decade, ignore warning signs of heart disease, and the consequences show up in mortality data.

When did medical trust become political?

The 2010 baseline is significant. That year marks roughly the start of intense partisan polarization around the Affordable Care Act, which made healthcare a central battleground in American politics. Social media algorithms were beginning to create distinct information ecosystems. By 2016, when the biomarker gap appeared, alternative health information sources aligned with political identity had proliferated.

The pandemic didn't create this divide. It accelerated a trend already underway. Public health became coded as a matter of political identity rather than medical science. The researchers suggest this has real, measurable consequences for who lives and who dies.

What comes next

The gap has only widened since 2020. If the researchers' hypothesis is correct, reversing this trend would require rebuilding trust in medical institutions among conservatives. That seems unlikely in the current environment. Alternative health information ecosystems continue to grow. Partisan polarization shows no signs of abating.

For healthcare systems and insurers, this data presents a problem. Political ideology may now be a meaningful predictor of health outcomes, but it's not a variable anyone knows how to address through traditional public health interventions. Telling people to trust doctors more doesn't work when distrust has become part of a broader political identity.

Frequently Asked Questions

How big is the mortality gap between conservatives and liberals?

Between 2020 and 2022, 1.34% of 'very conservative' respondents died from internal causes compared to 0.2% of 'very liberal' respondents, a sevenfold difference.

When did the conservative-liberal health gap emerge?

Researchers identified 2010 as the last year with no measurable gap. By 2016, differences appeared in biomarkers. By 2020, they showed up in death rates from heart disease, cancer, and stroke.

Is the health gap explained by COVID-19 deaths?

No. The study authors argue the gap persists after controlling for COVID-19 deaths, demographics, age, geography, income, and education.

What causes the health gap between political ideologies?

Researchers point to declining trust in doctors and medical institutions among conservatives, affecting whether people take medication or seek care for warning signs.

Which journal published the conservative-liberal health gap study?

The study was published in Nature in 2025, based on long-term health data from a nationally representative sample across all 50 states.

Source: Fast Company / Eve Upton-Clark