# Prayer, politics, and policy related to age-adjusted cancer, heart disease, infant mortality, and COVID-19 death Rates, U.S. states 2018–2021

## TL;DR

This study explores how religion and politics in U.S. states relate to health outcomes like cancer, heart disease, and COVID-19 deaths from 2018 to 2021.

## Contribution

The study introduces a novel analysis linking daily prayer and political attitudes to health outcomes across U.S. states.

## Key findings

- States with higher daily prayer percentages had higher death rates for cancer, heart disease, and COVID-19.
- Cancer and COVID-19 death rates were significantly correlated with Trump's 2016 vote share.
- Income inequality and urban population distribution were linked to higher death rates for heart disease and COVID-19.

## Abstract

The role of religion and politics in the responses to the coronavirus pandemic
raises the question of their influence on the risk of other diseases. This study
focuses on age-adjusted death rates of cancer, heart disease, and infant
mortality per 1000 live births before the pandemic (2018−2019) and COVID-19 in
2020−2021. Eight hypothesized predictors of health effects were considered by
examining their correlation to age-adjusted death rates and indicators of health
behavior among U.S. states, percentage who pray once or more daily, Republican
attitudes and influence on state health policies as indicated by the percentage
vote for Trump in 2016, percent of household incomes below poverty, median
family income divided by a cost-of-living index, the Gini income inequality
index, urban concentration of the population, physicians per capita, and public
health expenditures per capita. Since prayer for divine intervention is common
to otherwise diverse religious beliefs and practices, the percentage of people
claiming to pray daily in each state was used to indicate potential religious
influence. Based on collinearity, inequality was chosen for inclusion over
poverty, and the prayer and political variables were analyzed separately. All of
the death rates were higher in states where more people claimed to pray daily.
Only cancer and COVID-19 were correlated significantly with Trump’s percentage
of the vote. Lower death rates from cancer and heart disease are associated with
more public health expenditures, but not for infant mortality or COVID-19
deaths. COVID-19 death rates were lower in states with more physicians per
capita, but that variable was not significantly associated with the other death
rates. Heart disease, infant mortality, and COVID-19 death rates were higher in
states with more income inequality. All rates except infant mortality were lower
in states where a greater percentage of the population resides in urban areas.
The correlation between daily prayer and smoking cigarettes, as well as the
neglect of public health recommendations for fruit and vegetable consumption and
COVID-19 vaccination, suggests that reliance on prayer is a factor in neglect of
preventive practices.