Mortality rates declined more among counties that voted Democrat in presidential elections, study says

(CN) — Does how your vote influence how long you’re going to live?

Counties that supported Democratic presidential candidates over the last five election cycles tracked larger decreases in mortality rates compared with counties that voted Republican, according to a study published in the BMJ on Wednesday.

"The widening gap in death rates between Republican and Democratic voting areas of the U.S. over the past two decades may reflect the influence of political environment on social, economic, and health policies,” the authors of the paper argue.

Researchers point out that “liberal state policies on tobacco control, labor, immigration, civil rights, and environmental protections are all strongly associated with better life expectancy, whereas more conservative state policies — such as restrictions on abortion and reductions in gun control—are associated with lower life expectancy among women.”

Investigating a trend observed in past election cycles, researchers compared age adjusted mortality rates reported by the Centers for Disease Control and Prevention from 2001 to 2019, with county level political affiliation based on party support over five presidential elections. Researchers used election data from the Massachusetts Institute of Technology’s Election Data and Science Laboratory.

Looking to the year 2000, researchers identified 673 counties across the U.S. that supported Democratic nominee Al Gore and 2,439 counties that voted for George W. Bush. In 2019, counties voting Democrat fell to 490 with 2,622 leaning Republican.

Over the last two decades, mortality decreased by 22% in Democrat-voting counties, compared to an 11% decrease in Republican counties. Gaps between health outcomes have widened since 2008 along with partisan polarization.

The largest mortality gap exists between white residents: white people living in Republican counties die at rates four times higher than in Democratic counties. Death rates decreased for Black Americans living in both Democratic and Republican counties at similar rates.

“The greatest contributors to the rising mortality gap between Republican and Democratic counties were heart disease, cancer, chronic lower respiratory tract diseases, unintentional injuries, and suicide,” researchers explained in the paper.

While the direct drivers of these trends are unknown, the paper suggests differences in political environment signal differences in public health policies, communicable disease response and access to healthcare as well as willingness to vaccinate or adopt a healthy diet and exercise routine.

Over the course of the study, larger decreases in heart disease, cancer and respiratory tract disease were reported in Democratic counties compared to Republican, while all counties reported a 40% increase in death by unintentional injuries, which includes drug overdoses.

"The association could represent the harmful effects of Republican policies, but it could also reflect a preference for Republican candidates among disadvantaged voters or characteristics outside the control of politicians,” observed Steven Woolf, a professor in the Department of Family Medicine and Population Health at Virginia Commonwealth University in an editorial.

Still, Woolf argued this research makes it harder to remain politically neutral in an environment where politics may shape health outcomes.

"To understand the implications for population health, researchers must break with custom,” Woolf wrote. “Although scientific literature has traditionally avoided discussing politics, the growing influence of partisan affiliation on policies affecting health makes this covariate an increasingly important subject of study."

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