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More or less the same data as yours, but I prefer this format: To first order: Initially (early 2020), more mixing in the blue/urban population from international travel bringing the virus to U.S., on top of not knowing what we were dealing with, but then the combination of adapting behavior (masks, distancing) and vaccination statistics skewed deaths towards rural America/Trumpland. To second order: There are probably more old people in Trumpland, and maybe the medical care is of poorer quality? I also suspect that if you were able to correct for the higher population density and corresponding lifestyle, perhaps most notably the use of public transport, that would overwhelm the "second order" effects. X-posting: