> In reality it's more likely that the average Republican voter skews both lower income and rural which is the true causation of deaths.
The author's based their analysis on data; is there data for your claim? There is plenty of poverty in cities.
EDIT: Quoting another commenter who quoted the OP: "[r]egardless of whether we looked at urban or rural areas, people living in areas with Republican political preferences were more likely to die prematurely than those in areas with Democratic political preferences"