New research indicates that communities with poorer health are shifting votes towards the Republican party. The study, which was conducted by investigators at Massachusetts General Hospital (MGH) and the Massachusetts Institute of Technology, is published in the journal Social Science & Medicine.

In the 2016 U.S. presidential election, communities with poorer health—for example, with higher rates of diabetes, obesity, teen pregnancy, and poor physical and mental health—shifted votes to the Republican party, but it’s unclear if this trend has persisted.

To investigate, researchers looked at differences between the 2016 and 2018 Congressional election results. The team found that even more counties with poorer health shifted votes toward the Republican Party in the 2018 elections, after accounting for factors such as race, education, and wealth.

This was despite an overall shift toward the Democratic Party. Therefore, although there was a rebound in support for Democratic candidates in 2018 compared with 2016, this rebound was more often seen in counties with better health.

"We had previously thought that presidential election results may have reflected more distressed communities shifting toward a non-traditional presidential candidate in 2016,"” said lead author Jason H. Wasfy, MD, MPhil, of MGH's Cardiology Division. "But they now appear to be part of a longer and enduring trend in party realignment that also is extending to Congressional elections."

More research is needed to determine why this trend is occurring, Dr. Wasfy says. "Is this shift because healthier voters are shifting toward the Democratic party, or is it something about the type of communities with better health?"

"American political parties seem to undergo repolarization every few decades, for example during the Civil Rights era. That appears to be occurring now as well—but this time, the repolarization seems associated with health. Therefore, although the cause of change in political support in the United States may be unclear, the support is going in different directions for communities with better and worse public health."

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In August 2019, the MGH was named the #2 hospital in the U.S. News & World Report list of "America’s Best Hospitals."