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Politicians, power, and the people’s health: US elections and state health outcomes, 2012-2024
Journal article   Open access   Peer reviewed

Politicians, power, and the people’s health: US elections and state health outcomes, 2012-2024

Nancy Krieger, Soroush Moallef, Jarvis T Chen, Ruchita Balasubramanian, Tori L Cowger, Rita Hamad, Alecia J McGregor, William P Hanage, Loni Philip Tabb and Mary T Bassett
Health affairs scholar, v 2(12), qxae163
27 Nov 2024
PMID: 39664487
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1093/haschl/qxae163View
Published, Version of Record (VoR) Open

Abstract

childhood vaccination COVID-19 boosters electoral politics infant mortality food insecurity maternity care deserts political polarization political conservatism political determinants of health political liberalism poverty premature mortality state policies state trifecta Health Insurance
Our descriptive study examined current associations (2022-2024) between US state-level health outcomes and four US state-level political metrics: two rarely used in public health research (political ideology of elected representatives based on voting records; trifectas, where one party controls the executive and legislative branches), and two more commonly used (state policies enacted; voter political lean). The eight health outcomes spanned the lifecourse: infant mortality; premature mortality (death <age 65; health insurance (adults aged 35-64); vaccination for children and persons aged ≥65 (flu; COVID-19 booster); maternity care deserts; and food insecurity; for the first three outcomes, we also examined trends in associations (2012-2024). For all political metrics, higher state-level political conservatism was associated with worse health outcomes, especially for the metrics for political ideology and state trifectas. For example, in 2016 the premature mortality rate in states with Republican vs. Democratic trifectas was higher by 55.4 deaths per 100,000 person-years; 95% confidence interval [CI] 7.7, 103.1), and the slope of the rate of increase to 2021 was also higher, by 27.0 deaths per 100,000 person-years (95% CI 24.4, 29.7). These results suggest elections, political ideology, and concentrations of political power matter for population health.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#5 Gender Equality

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Collaboration types
Domestic collaboration
Web of Science research areas
Health Care Sciences & Services
Health Policy & Services
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