There is a “substantial association” between measures of poor public health and shifts toward Trump in last November’s balloting, from voting patterns in the 2012 election, according to a paper from researchers at Massachusetts General Hospital at Harvard Medical School and the Massachusetts Institute of Technology’s Department of Political Science, published Monday in the journal PLOS ONE.
“What we found is that the communities that shifted most strongly towards the Republican candidate in 2016, relative to 2012, are less healthy from a public health perspective than communities that shifted the other way,” said Jason Wasfy, the lead author of the study, a cardiologist and the director for outcomes research for the Mass General Heart Center.
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The researchers measured U.S. counties’ “net voting shift” from Mitt Romney, the Republican candidate in 2012, to Trump, defined as the percentage of votes that Trump got minus the percentage Romney got. They then looked at a number of public health measures, including food insecurity, teen birth rates and the incidence of diabetes, to create an overall public health score. They controlled for such various demographic factors as gender, age, education, race and income. In about 88% of American counties, Trump beat Romney.
“I don’t want to attribute causality, but it’s fair to say that all other things being equal, sicker communities shifted more towards Republican voting,” Wasfy said. The authors write in the paper that “our results suggest a possible role of public health in determining the ultimate outcome of the overall election.”
Where states shifted all the way from blue in 2012 to red in 2016—including Iowa, Pennsylvania, Wisconsin, Michigan, Ohio and Florida, as well as the 2nd Congressional District of Maine—the association between poor public health and a pro-Trump shift was exceptionally strong, the researchers found.