March 18, 2021 | Julien Beresford, President and Founder, Beresford Research
COVID-19 cases in Utah are among the highest in the nation on a per capita basis, but COVID-related deaths in the states are among the lowest.
Why are Utah residents more likely than most US residents to get COVID but are less likely to die from it? It’s as if they got the J&J vaccine before it was available for distribution. As seen on this graph, only three states have higher per-capita case rates: North Dakota, South Dakota, Rhode Island. Only five other states have lower death rates – Oregon, Maine, Alaska, Vermont and Hawaii – and these five states all have far lower case rates.
Utah stands out
Utah has been an outlier for several months, but its exceptional status became more apparent in recent weeks.
Beresford Research has been tracking COVID cases and deaths among the top 25 countries and in the US. We provide six filters for the US COVID visualizations to view each state’s changing COVID case and death rates over time. Three of these filters provide insight into what makes Utah unique. Utah is one of the most Republican-leaning states, least densely populated, and least ethnic (i.e., most white) states. Republican-leaning states have been harder hit with COVID cases than Democratic-leaning states in the last six months. The more-densely-populated northeastern states have higher death rates from COVID than other states. The less ethnically diverse (i.e., more white) states have lower death rates (except Hawaii, the most highly diverse state and the state with the lowest per-capita deaths). Utah is certainly not the only state that matches all three criteria – Idaho, Wyoming and the Dakotas come to mind – but it is the only state with such a low death rate ratio of COVID cases to deaths.
Possible explanations
So what accounts for the relative uniqueness of Utah? Health care quality is one possible factor. US News and World Report’s ranking of states based on access to health care measures four metrics for the quality of health care delivered to each state: Medicare enrollees with top-quality coverage, nursing homes rated top quality, hospital quality, and preventable hospital admissions. Among the five states that meet the three criteria (Republican-leaning, least densely populated and less diverse racially), Utah’s rating of 73.1 is significantly higher for health care quality than the other four states as seen below:
Checking the other states with relatively low death rates (fewer than 132.3 deaths per 100,000 population), Beresford Research found that all but Vermont have high Health Care Quality scores:
Another contributing factor could be the relative youth of Utah’s population. The median age in Utah is only 31.0. the lowest of the 50 states and the District of Columbia. (For perspective, Maine is the oldest state at 44.9, and the median state is Missouri at 38.7). As seen in the chart below, using data provided by the CDC‘s data, COVID-19 deaths are rare for those under 45 years of age.
What might account for Utah’s relative youth? According to the Pew Research Center, over a third of all US Mormons live in Utah, while the state is home to only 1% of the general population. Followers of the Mormon faith have significantly larger families than other Americans. Another study from Pew shows that Mormons have 62% more children than the average US family:
What makes Utah unique is not only its wide-open spaces and lack of racial diversity. It is the relative youth of its population and the superior quality of its health care system. Even when its citizens get sick with COVID, they die far less frequently. But timing plays a role, too. The excellent health care quality in the New England states wasn’t enough at the start of the pandemic when the best medical talent was learning on the fly how to cope with this new highly lethal pathogen. By the time Utah citizens became seriously ill, the global medical community had developed strategies to keep the vast majority of those infected with COVID alive, and Utah’s superior health care system is implementing those live-saving strategies.