No, Arizona is Not a Special Butterfly When It Comes to Pandemic Deaths
Will Humble, former AzDHS Director and current Arizona Public Health Association Director, recently tweeted an analysis showing that Arizona has extremely high COVID-19 death rates. It is first among states in increase in observed deaths by all causes during the pandemic for both 2020 and 2021.
Earlier this week there appeared an article in the Arizona Republic (paywalled; you can get a copy here if you don't mind a non-encrypted link) asking why this is so. It cites a CDC ranking that puts us at number three for COVID-19 deaths, but I'm unable to find it. Here is one from the Kaiser Family Foundation that puts us second behind Mississippi.
The Republic reporter asked state officials for an explanation, and they tried to create uncertainty about the comparisons. For instance, the AzDHS Assistant Director for Public Health Preparedness said:
I think it's really difficult to say whether we are third-worst in the country just based on the variability and the time frames for which different states collect, process and classify their data. It's hard to say.
The deputy state epidemiologist says there are just so many factors that influence the death rates—like high-risk populations, age, existing medical conditions, population density, and so on. So because of that comparing Arizona to other states is probably comparing applies to oranges.
The point being pressed here is that states with more vulnerable populations can expect higher death rates. Age is one of the vulnerability factors. But this ranking by a bioinformatics company shows that if you look at the age-adjusted death rate, Arizona is still number seven.
American Indian populations are also at high risk, as noted in Tuesday's post. And to be sure there are a lot those people living in Arizona. But on other hand, California has the largest American Indian population in the country yet it ranks 39th on the age-adjusted list.
So while these kinds of factors can make differences, they do not make for apples-to-oranges comparisons. This is reflected in the comments of experts who do not work for Doug Ducey in the Republic article. They focus on leadership failings.
"Gov. Ducey intentionally disrupted, prohibited, and publicly maligned mitigation efforts by local jurisdictions," said Dr. Matt Heinz, a physician hospitalist in Tucson. He notes that yes, there are a lot of other factors involved but:
Doug Ducey made sure that we were going to be pretty close to number one in deaths. There was just a failure in general to develop and implement any kind of data-driven comprehensive mitigation strategy. And of course, since there was no such strategy implemented, you couldn't really enforce one.
An epidemiologist I spoke with made a similar point, saying the arguments from the AzDHS employees are "horseshit. Arizona is not a special butterfly. ...If there is one reason why AZ is special, it is that Ducey hates public health programs, and we did little to respond to the pandemic."
