OPINION: It's not only politics behind the low vaccination rate in the South

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Tue, 2021-06-22 12:32 — mike kraft

Opinion: It's not only politics that's driving the low vaccination rate in the South The pandemic dramatically revealed the inequitable delivery of American health care. Now, the Covid-19 vaccine rollout is demonstrating another open secret: public distrust in all institutions, including health care, writes Dr. Kent Sepkowitz. Opinion by Kent Sepkowitz CNN

(CNN) More than half of the adults in the United States have been at least partially vaccinated against Covid-19, a remarkable accomplishment. As it has matured, the US vaccine program has revealed geographic and demographic groups that show either high or low acceptance of the vaccine, leading to a small avalanche of speculation regarding the divergent trends.

Much of the difference is being explained (complete with strong correlation coefficients) by the apparent concordance across the existing Democrat and Republican fault-line, with the ardently Republican Deep South having some of the lowest vaccination rates in the country: Mississippi, Alabama and Louisiana are at the bottom of the 50 states with rates around 35-37% (compared to US rate of 54%) with Georgia, South Carolina, Tennessee and Arkansas joining them in the bottom 10.

Further supporting this idea is the US map, which shows higher vaccination rates in states that supported President Joe Biden in the 2020 election. In addition, many surveys show Democrats have been vaccinated at significantly higher rates than Republicans.

But is being a vaccine refusenik really a symbolic act, a new way of pledging allegiance to extremely conservative principles or even fealty to former President Donald J. Trump -- who has claimed himself to be the father of the vaccine and, as a vaccine recipient himself, has endorsed its use, however tepidly.

If only it were so simple. Though the Covid-19 vaccine is indeed a central player in our ongoing turbocharged political proxy war, many other factors are at play. Political orientation is a symptom, not the cause of the problem. The voting blocs just don't align that well with the vaccine refusers. Deeper in the demographics of vaccine accepters or decliners are many facts that fly in the face of the Blue-Red supposition. ...

Covid-19 vaccine ennui is part of a much larger pattern that was evident long before 2015, when Trump descended the escalator in Trump Tower to announce his candidacy for president. But if not politics, what is driving the North-South split?

It's complicated -- perhaps impossibly complicated. But an explanation may well have started many decades ago in Appalachia, which stretches across 13 states down to Alabama and Mississippi. People living there, along with the remainder of the Deep South, have had the worst rates of almost every health indicator for decades: low rates of influenza vaccination, high rates of obesity and diabetes, high rates of cigarette smoking and shorter lifespans.

Grinding poverty also is at very high rates in the area and with it, poor schools, understaffed hospitals, distant medical care -- and often an extremely pessimistic view of whatever the government is "selling" this week. Trust in others is lowest among persons earning less than $30,000 a year -- a group seen in highest proportion in these same states. And this personal distrust could extend to elected officials and the government. ...

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