Viewing the US presidential electoral map through the lens of public health

Tymor Hamamsy, Michael Danziger, Jonathan Nagler, Richard Bonneau

Research output: Contribution to journalArticlepeer-review


Health, disease, and mortality vary greatly at the county level, and there are strong geographical trends of disease in the United States. Healthcare is and has been a top priority for voters in the U.S., and an important political issue. Consequently, it is important to determine what relationship voting patterns have with health, disease, and mortality, as doing so may help guide appropriate policy. We performed a comprehensive analysis of the relationship between voting patterns and over 150 different public health and wellbeing variables at the county level, comparing all states, including counties in 2016 battleground states, and counties in states that flipped from majority Democrat to majority Republican from 2012 to 2016. We also investigated county-level health trends over the last 30+ years and find statistically significant relationships between a number of health measures and the voting patterns of counties in presidential elections. Collectively, these data exhibit a strong pattern: Counties that voted Republican in the 2016 election had overall worse health outcomes than those that voted Democrat. We hope that this strong relationship can guide improvements in healthcare policy legislation at the county level.

Original languageEnglish (US)
Article numbere0254001
JournalPloS one
Issue number7
StatePublished - Jul 2021


  • Federal Government
  • Geography, Medical
  • Government Employees
  • Health Expenditures/statistics & numerical data
  • Health Policy
  • Health Status Indicators
  • Humans
  • Morbidity
  • Mortality
  • Politics
  • Public Health
  • United States


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