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Primary Submission Category: Policy
Germs and Sovereign Sheriffs: How Local Rebellion Against Public Health Policy Shapes Population Health
Authors: Brayden Dawson, Jack Wippell, Morgan McPartland,
Presenting Author: Brayden Dawson*
Recent literature links sub-national democratic backsliding to higher U.S. mortality, yet whether similar dynamics operate at the local level remains underexplored. This study asks: do sheriff refusals to enforce COVID-19 public health mandates worsen county-level COVID-19 mortality outcomes?
Using a novel dataset of 65 county sheriffs (out of 1,905 in lockdown states) who publicly refused to enforce COVID-19 mandates, we merge these with weekly CDC county-level COVID-19 death counts across all pandemic waves (January 2020–May 2023). We estimate state fixed-effects Gamma regression models with three-way clustered standard errors (county, state, wave), controlling for age, income, poverty, race, education, population size, and vaccine hesitancy. Interaction terms between sheriff refusal and COVID-19 wave (both ordinal and nominal) test whether rebellion moderates mortality trajectories over time.
Descriptively, rebellious and adherent counties show broadly similar death profiles in early waves; however, rebellious counties trend higher in later waves, particularly during Omicron and the late pandemic stage—a pattern consistent with the hypothesis that institutional legitimacy erodes over time in counties where sheriffs openly undermined public health mandates. Regression results confirm no significant direct association between sheriff refusal and death rate, but reveal a significant positive interaction between refusal and later pandemic waves. Pairwise models identify Omicron and the late stage as the primary drivers. County fixed-effects robustness checks confirm the interaction’s stability.
These findings suggest sheriff rebellion amplifies mortality divergence over time—operating through weakened institutional legitimacy and behavioral deterrence rather than immediate effects—extending the democratic backsliding–mortality literature to the local level.