Voting Republican Can Kill You

Voting Republican could pose a risk to your health, particularly if you live or work in a Trump-winning county.  

That’s the latest contribution to junk social scienceThis one was provided by the distinguished British Medical Journal.

According to the authors, there were smaller reductions of age-adjusted deaths in counties that voted Republican presidential candidates between 2000 & 2016. This was compared to counties that backed Democratic rivals.

Before the Biden administration requires presidential ballots to bear a surgeon general’s warning (“Voting Republican kills!”), it’s worth giving the study a closer look.

The first and most obvious flaw of the system is that hundreds of states switched party preferences during the five presidential elections. Although Al Gore, then-Vice President, may have carried a particular county in 2000, followed in 2004 by John Kerry and Barack Obama, the GOP column would receive the age-adjusted mortality reduction from the 2001-2019 period.

This is a serious defect. This is a significant defect. Democrats held 673 counties in 2000; only 490 in 2016. Trump had 2,622 votes in 2016According to the study, it is. Thus, the study  classifies 183 counties that voted for Gore in 2000 as Republican in 2019 in measuring mortality changes over the 2001-2019 period.

Over the five election cycles the list of counties who backed one party or another changed. Democrats won 673 and 874 counties in 2000, respectively, before plummeting to 490 in 2016. The list of counties that the study compares is therefore inconsistent, making its findings suspect.

The authors also examined a subset of countiesThey voted for Republicans or Democrats in each of the five presidential elections. These results were not impressive.

Between 2001 and 2019, the age-adjusted deaths in large metro counties dropped by 1.4%, regardless of whether they voted Democratic or Republican in five of their five elections. The decline in small to mid-sized metro areas that backed Democrats for these five races was 0.9%, compared to 0.8% for similar areas that voted Republican.

That difference isn’t statistically significant. Rural counties have larger differences, but the confidence intervals, which are similar to the margin of error and +/- in public opinions polls, intersect, suggesting that these differences could be due to chance.

The increased urbanization of the Democratic Party and the GOP’s growing appeal to rural America might well explain the differences in mortality rate changes.

Despite the fact that Democratic nominees carried 183 fewer counties in 2016 compared to 2000, Joe Biden won a greater number of large urban counties than Gore. Biden won 156 large urban counties, with nearly 134 million residents. This compares to just 46 million in Trump-backed counties. This gave Biden a 3-1 advantage.

A greater proportion of residents in the counties that backed Biden stayed in large metropolitan areas than Trump’s 32%.

Trump won rural counties almost 8 to 1 over those in rural Biden. Only 3% of the population lived in rural counties that backed Biden.

In short, the differences the authors cite may well be explained by something we already know; namely, that Trump’s strength is in rural counties, where health status is poorer and life expectancies are shorter, while Biden’s power base is in urban centers, where medical care is generally state of the art.

Other anomalies can be found when we look at the counties who voted consistently for the same party in all five presidential election cycles. The average age-adjusted death rate for blacks fell by 1.4% in both Democratic counties and Republican counties. Hispanics’ mortality declined by 1.6%, while it was just 1.3% for Democratic counties. However, the confidence intervals overlap.

The only statistically significant difference was in mortality rates reductions among whites. This fell by 1.0% in Democratic counties compared to 0.6% in Republican.

Are the authors of this article adamant that voting patterns can lead to reverse health inequalities?

Design flaws and anomalies aside, the study is—at best—silly. To make a political point, it uses dodgy statistical legerdemain.

Absurdities are abound. Are people who vote for a Democrat less likely to die because a Republican won their county? Is it safe for a Republican to vote so long as the county backs Democrats reliably?

To their credit, the authors acknowledge that they could not “explain the link between political environment and mortality, and the direction of this association.”

Or whether there is a link at all.

Many studies published by the British Medical Journal have contributed to medical care and advanced human knowledge.

This isn’t one of them.

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