Ever since the unexpected results of the 2016 presidential election, political analysts have sought to understand what factors played into voters’ decision making. Now, a new study by a Boston University School of Public Health (BUSPH) researcher shows how voting patterns correlated with the nation’s growing geographic health divides, with Donald Trump winning more votes in counties that have seen lower gains in life expectancy.
Writing in the American Journal of Public Health, Dr. Jacob Bor, assistant professor of global health at BUSPH, reviewed county-level voting data from the 2008 and 2016 presidential elections and county-level estimates of life expectancy at birth for 1980 and 2014 from the Institute for Health Metrics and Evaluation.
Dr. Bor found counties in which life expectancy rose less than three years saw a nearly 10 percentage point increase in the Republican vote share between 2008 and 2016. In counties where life expectancy rose more than seven years, Democrats saw a 3.5 percentage point increase.
Overall, from 2008 to 2016, Republicans lost 67,000 votes in counties with above-average life expectancy trends but gained 3.1 million votes in counties with below-average trends. Democrats gained 1.4 million votes in counties with above-average life expectancy gains but also lost 5.0 million votes in counties with below-average life expectancy gains—a 14 percent relative decline in the number of Democratic votes in those counties.
“In the 2016 election, in counties that had been left behind in life expectancy gains, residents abandoned the Democratic Party, voting for Trump or not voting at all,” Dr. Bor says. “What we now need to understand is why.”
Noting recent effort to repeal the Affordable Care Act and cut Medicaid, as well as proposed cuts to health research, public health surveillance, environmental protection, occupational safety, and social programs, Dr. Bor says these findings pose a critical question: “When will the Trump administration and Republicans in Congress respond to the health needs of those who put them into power, and enact policies that will support population health?”