Public health was the straw that broke the camel’s back for most swing states who voted Donald Trump, a new study has found.
Researchers at Massachusetts General Hospital analyzed county-by-county election data, compared with public health data.
In previous studies, counties with poor physical and mental health have seen poor voter turn-out.
But last year, it was quite the opposite: new data show counties in poor health saw turn-out consistent with the rest of the country, and tended to go for the rogue GOP candidate.
This association between public health and voting patterns was strongest in the West and particularly in the Midwest, where major voting shifts contributed to the Republican victory.
Counties which shifted towards Trump had fewer health care resources, a higher rate of teen births, and lower life expectancy, according to a new analysis
‘Across the country, we found that voters in counties with poor public health shifted dramatically towards the Republican candidate in 2016, compared with 2012, an effect that was particularly strong in states where the results changed Electoral College votes,’ says Dr Jason H. Wasfy, of the Division of Cardiology, who led the study.
‘Although we cannot determine causality from these results, the findings raise the possibility of a role for public health status in determining voting behavior.’
The analysis shows counties shifting towards Trump had fewer health care resources, including around half the number primary care physicians per capita than counties shifting away from Trump.
These counties also had higher teen birth rates and age-adjusted mortality, but lower rates of violent crime.
The researchers combined county-by-county election data for both elections with information from a public health database compiled by the Robert Wood Johnson Foundation, including data collected by the Centers for Disease Control and Prevention.
The public health measures used in the analysis were reported days of poor health; the prevalence of food insecurity, obesity and diabetes; teen birth rates, and the age-adjusted mortality rate.
Complete data covering both elections was available for 3,009 counties, more than 95 percent of the 3,142 counties or equivalent regions in the U.S.
They measured the difference between the percentage of voters in a county voting for Donald Trump in 2016 and the percentage voting for Mitt Romney in 2012.
Overall, there was a 5.4 percent shift from Romney to Trump – with 88 percent of counties shifting towards Trump while 12 percent shifted away from Trump.
Counties that shifted towards Trump – not all of which were won by the Republican – had higher proportions of white populations, more rural populations and lower average household incomes than those that shifted away from Trump.
The election produced some unusual outcomes, which left experts baffled.
It was the best performance for a Democratic presidential candidate in Texas in 20 years. It was also the first victory of a Republican candidate in Wisconsin in 32 years.
Now, as political scientists try to take stock of the election, it is becoming clear that Trump’s win was driven by health.
‘Even after adjusting for factors such as race, income and education, public health seems to have an additional, independent association with this voting shift towards Trump,’ explains Dr Wasfy, who is an assistant professor of Medicine at Harvard Medical School.
‘It’s critical to interpret our results as reflecting county-wide ecological associations, rather than individual voting behavior.
‘More than anything, I think these results demonstrate that health is a real issue that can affect people’s lives and their decisions.
‘We all need to focus on improving public health as a means of improving people’s lives.’