Dataset Information

Independent Relationship of Changes in Death Rates with Changes in US Presidential Voting.

ABSTRACT: BACKGROUND:The outcome of the 2016 presidential election is commonly attributed to socioeconomic and ethnic/racial issues, but health issues, including "deaths of despair," may also have contributed. OBJECTIVE:To assess whether changes in age-adjusted death rates were independently associated with changes in presidential election voting in 2016 vs. 2008. DESIGN:We used publicly available data in each of 3112 US counties to correlate changes in a county's presidential voting in 2016 compared with 2008 with recent changes in its age-adjusted death rate, after controlling for population and rural-urban status, median age, race/ethnicity, income, education, unemployment rate, and health insurance rate. DESIGN SETTING:Cross-sectional analysis of county-specific data. SETTING/PARTICIPANTS:All 3112 US counties. MAIN MEASURES:The independent correlation of a county's change in age-adjusted death rate between 2000 and 2015 with its net percentage Republican gain or loss in the presidential election of 2016 vs. 2008. KEY RESULTS:In 2016, President Trump increased the Republican presidential vote percentage in 83.8% of counties compared with Senator McCain in 2008. Counties with an increased Republican vote percentage in 2016 vs. 2008 had a 15% higher 2015 age-adjusted death rate than counties with an increased Democratic vote percentage. Since 2000, overall death rates declined by less than half as much, and death rates from drugs, alcohol, and suicide increased 2.5 times as much in counties with Republican gains compared with counties with Democratic gains. In multivariable analyses, Republican net presidential gain in 2016 vs. 2008 was independently correlated with slower reductions in a county's age-adjusted death rate. Although correlation cannot infer causality, modest reductions in death rates might theoretically have shifted Pennsylvania, Michigan, and Wisconsin to Secretary Clinton. CONCLUSIONS:Less of a reduction in age-adjusted death rates was an independent correlate of an increased Republican percentage vote in 2016 vs. 2008. Death rates may be markers of dissatisfactions and fears that influenced the 2016 Presidential election outcomes.

SUBMITTER: Goldman L

PROVIDER: S-EPMC6420486 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Independent Relationship of Changes in Death Rates with Changes in US Presidential Voting.

Goldman Lee L Lim Maribel P MP Chen Qixuan Q Jin Peng P Muennig Peter P Vagelos Andrew A

Journal of general internal medicine 20180905 3

<h4>Background</h4>The outcome of the 2016 presidential election is commonly attributed to socioeconomic and ethnic/racial issues, but health issues, including "deaths of despair," may also have contributed.<h4>Objective</h4>To assess whether changes in age-adjusted death rates were independently associated with changes in presidential election voting in 2016 vs. 2008.<h4>Design</h4>We used publicly available data in each of 3112 US counties to correlate changes in a county's presidential voting ...[more]

PMID: 30187378

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Project description:This study aimed to identify the factors influencing South Korean voters' attitudes towards increasing public expenditure on health and to identify whether the issue of healthcare expenditure influenced candidate choice in the 2012 Korean presidential election. The study used the data from a survey conducted by the Institute of Korean Politics at Seoul National University immediately following the 2012 presidential election. The survey was completed by a nationwide sample of 1,200 people aged 19 or over using a face-to-face interview method and proportional quota sampling based on sex, age, and region. About 44.3% of respondents had a positive attitude toward increasing public health expenditure. There was no significant difference by the candidate they supported (conservative Park Geun-hye or liberal Moon Jae-in). In particular, even 44.9% of conservative supporters agreed with more spending. Politically neutral respondents (OR = 1.76, 90% CI 1.22-2.54) and strong conservative party supporters (OR = 1.53, 90% CI 1.05-2.25) were more likely to support public health expenditure increase compared to strong liberal party supporters. Also, respondents who believed that the economic gap in the country was widening were 1.91 times more likely to support an increase in public health expenditures. However, the issue of health expenditure had no influence on voters' choice of presidential candidates, and in particular no negative effect of choice of the ruling (conservative) party's candidate. Our results should be interpreted with care; one possible reason for this lack of effect might be that constituents voted along partisan lines regardless of their attitude to the welfare issue; another possible explanation might be the success of the "left click strategy" of the conservative party. That is, the conservatives did not reject economic democratization or social welfare expansion. Further research should be done to explain why attitudes to health spending did not directly affect choice of candidate.

Project description:ImportanceIn the U.S. presidential election of 2016, substantial shift in voting patterns occurred relative to previous elections. Although this shift has been associated with both education and race, the extent to which this shift was related to public health status is unclear.ObjectiveTo determine the extent to which county community health was associated with changes in voting between the presidential elections of 2016 and 2012.DesignEcological study with principal component analysis (PCA) using principal axis method to extract the components, then generalized linear regression.SettingGeneral community.ParticipantsAll counties in the United States.ExposuresPhysically unhealthy days, mentally unhealthy days, percent food insecure, teen birth rate, primary care physician visit rate, age-adjusted mortality rate, violent crime rate, average health care costs, percent diabetic, and percent overweight or obese.Main outcomeThe percentage of Donald Trump votes in 2016 minus percentage of Mitt Romney votes in 2012 ("net voting shift").ResultsComplete public health data was available for 3,009 counties which were included in the analysis. The mean net voting shift was 5.4% (+/- 5.8%). Of these 3,009 counties, 2,641 (87.8%) had positive net voting shift (shifted towards Trump) and 368 counties (12.2%) had negative net voting shift (shifted away from Trump). The first principal component ("unhealthy score") accounted for 68% of the total variance in the data. The unhealthy score included all health variables except primary care physician rate, violent crime rate, and health care costs. The mean unhealthy score for counties was 0.39 (SD 0.16). Higher normalized unhealthy score was associated with positive net voting shift (22.1% shift per unit unhealthy, p < 0.0001). This association was stronger in states that switched Electoral College votes from 2012 to 2016 than in other states (5.9% per unit unhealthy, p <0.0001).Conclusions and relevanceSubstantial association exists between a shift toward voting for Donald Trump in 2016 relative to Mitt Romney in 2012 and measures of poor public health. Although these results do not demonstrate causality, these results suggest a possible role for health status in political choices.

Dataset Information

Independent Relationship of Changes in Death Rates with Changes in US Presidential Voting.

Publications

Independent Relationship of Changes in Death Rates with Changes in US Presidential Voting.

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