Conservative Protestantism and Elevated COVID-19 Mortality in the U.S.

Background: Conservative Protestant communities have exhibited various COVID-19 risks, including some evidence of elevated pandemic mortality, and have long had a lackluster overall mortality track record. Are there distinct patterns of conservative Protestant COVID-19 mortality within U.S. counties? Building on previous religion and COVID-19 research, along with insights from religious ecology and social network theories, we hypothesize that counties with greater proportions of denominational conservative Protestants (i.e., evangelicals, fundamentalists, and Pentecostals combined) will exhibit significantly higher mortality rates than those in which other religious groups and the non-religious have a more substantial market share. We further anticipate that counties populated by larger proportions of nondenominational conservative Protestants will not be subject to the same COVID-19 mortality risks because these groups exhibit network fragmentation, whereby they are outside the conservative denominational orbit. Methods: Data for this study come from multiple sources. COVID-19 mortality data were drawn from the New York Times COVID Tracking Project, 2021, and are supplemented with CDC data when needed. County-level religious market share was obtained from the 2020 U.S. Religion Census via the ARDA. Sociodemographic controls were taken from County Health Rankings, 2023, which integrates U.S. Census, ACS, NCHS, and AHRF data. County-level presidential election results were sourced from the MIT Election Data Science Lab. The final analytic sample includes 3032 counties with complete data. Results: Our findings reveal significantly higher rates of COVID-19 mortality in counties with a greater share of denominational conservative Protestant adherents, net of controls. We find similar fatality rates for counties populated by different conservative Protestant subgroups (evangelical, fundamentalist, and Pentecostal adherents). Additionally, some evidence of reduced COVID-19 mortality in counties with greater concentrations of fragmented (mostly nondenominational) conservative Protestants was observed. No significant association was observed for counties with greater isolationist conservative Protestant (Amish and Mennonite) market shares. Conclusion: The social ecology of religion proves to be an important determinant of public health in the form of COVID-19 mortality. Our findings have direct implications for ongoing research and practice concerning religion, health, and longevity.