Which state has been more effective at dealing with Covid-19, New York or Texas? Who has done better at stemming the spread of the virus and keeping businesses afloat, California or Florida?
The answer to these questions depends on how we define and measure ‘effectiveness.’
As shelter-in-place orders began, many states’ goals were to protect vulnerable populations and minimize deaths, while maintaining economic activity and employment levels. Covid-19 fatalities relative to the population could be used as one indicator of public health effectiveness, with a lower fatality rate indicating greater effectiveness. The unemployment rate, averaged over the pandemic months, serves as a measure of economic health, with lower unemployment rates indicating higher economic effectiveness.
How, then, do we define effectiveness? Borrowed from the misery index of economist Arthur Okun and popularized by Ronald Reagan in his campaign against Jimmy Carter, our Pandemic Misery Index or PMI is a simple addition of the average unemployment rate in percent starting in March and the total number of deaths per 10,000 of the population. How to balance the health risk and the economic risk, how to weigh these two often conflicting goals in making policy decisions, are difficult issues that each state has had to face. As is true of the original misery index, this Pandemic Misery Index is a simple approach that weighs these two features equally.
What is the result? As shown in the bar chart in the dashboard below, there is a wide range of experiences with both the unemployment rate and the fatality rate during the pandemic. Some states have been hard hit under both measures, while some have been relatively unscathed by one or both measures. So, Texas or New York? California or Florida?
New York’s fatality rate from March to July, 16.6 deaths per 10,000, was second highest only to New Jersey. Combined with the state’s average unemployment rate of 13.1%, this produces a PMI value of 29.7. Texas has both a far lower mortality rate of 2.5 per 10,000 and a lower average unemployment rate of 9.6%, giving Texas an index value of 12.1. Florida’s index value was higher at 13.9 due to a higher average unemployment rate of 10.7% and a mortality rate of 3.2 deaths per 10,000. California’s PMI stands at 15.6, as its March-to-July average unemployment rate was 13.3%, the fifth highest, although its 2.3 deaths per 10,000 residents was lower than both Florida and Texas.
To be fair, New York faced its biggest test early in the pandemic, and its decisions and experiences have been instructional to others. Medical professionals are better able to handle cases today in part because of the events in New York. Still, the Lone Star State has handled the crisis better than New York, and that at least with respect to the PMI, Texans will be happy to admit that everything is not always bigger in Texas. As for Florida, it has performed better than New York despite having 20.5% of its population over 65, compared to New York with 16.4%. California has done better than Florida, and marginally better than Texas, in terms of deaths per capita, but has paid a high price in unemployment.
Which states have done exceedingly well in one or both measures? The scatter plot in the dashboard above plots the average unemployment rate from March-to-July on the horizontal axis and the March-to-July cumulative death rate on the vertical axis. Hawaii has certainly achieved a low fatality rate, but at the cost of massive unemployment. Only Nevada’s 18.3% average unemployment rate beat Hawaii’s 15.2%. Nebraska has the lowest average unemployment rate of 5.7% and its 1.7 deaths per 10,000 was 19th lowest, winning the lowest PMI spot. Other states with low unemployment and low death rates include Utah, Idaho, and Wyoming. Two-thirds of all states had fewer than 5 deaths per 10,000 and an average unemployment rate of less than 12%.
It is important to note that all states are a far cry from a pre-pandemic normal. In February, only a few Covid-19 deaths had been reported and the index values would essentially just be their unemployment rates, ranging from 2.2% to 5.8%.
Changes have come quickly during this pandemic, and future events may lead to changes in these rankings. But our states function as laboratories of democracy, and it is important to keep in mind the experiences of each state’s citizens with respect to both physical and economic health during this pandemic and the policy responses to the pandemic. We might also raise a toast to Nebraska and Utah, or maybe to Wyoming and Idaho.
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Endnote: For example, during the months of March to July, 15,819 people in New Jersey died from the coronavirus, or 0.00178 of the 8.9 million residents. For the pandemic misery index we multiply the deaths as a share of the population by 10,000, resulting in 17.8 per 10,000. Adding the March to July average unemployment rate of 13.2%, yields an index value of 31.