Significant increases in the death rates of white, middle-aged people over the last 15 years may have led to Donald Trump’s win in the US presidential elections in 2016, a study has found. Examining data for white people between the ages of 45 and 54, researchers found that Trump was more likely to win counties where the middle-aged white death rates increased significantly from 1999 until 2016 than his Democrat opponent, Hillary Clinton. “We believe that counties where mortality has been increasing in the last decade have seen higher degrees of social disruption – such as changes in employment availability, health care accessibility and poverty levels – leading to changes in voting patterns,” said Usama Bilal, researcher at Drexel University in the US. On average, a 15.2 death increase per 100,000 middle-aged white people was tied to a one per cent vote swing for the Republican presidential candidate in 2016, according to the study published in the journal Social Science and Medicine. Researchers, including those from Johns Hopkins University and Loyola University in the US, started thinking about a study looking into this on election night in 2016. Public health scientists have noted often that white mortality rates appear to have changed in recent years. Researchers studied this population in the context of another study that attributed these deaths to the increased availability of prescription opioids, drug overdoses and weaker public assistance programmes. “We entertain the idea that mortality itself is a marker of underlying social conditions that are often reflecting in changing political landscapes,” Bilal said.
Using data from 2,764 counties (roughly 91 per cent of the counties in the US), researchers found that counties that voted Republican, after being Democrat for 2008 and 2012, showed an average increase of 10.7 deaths per 100,000 middle- aged white residents over the last 15 years. However, if counties that voted Democrat in 2008 and 2012 stayed Democrat for 2016, the death rates there actually declined over the last 15 years by 15.7 per 100,000, on average, the study found. The researchers did not just focus on mortality rates and their potential affect on vote-swings. They also took a look at whether vote swings were more evident in counties with wider health inequalities. “In our study, health inequality refers to the difference in life expectancy between the people in the top 25 per cent of income versus the bottom 25 per cent,” Bilal said.
In any county that had gone Republican, just once, in 2000, 2004, 2008 or 2012, there were markedly higher levels of health inequality. For counties that voted Republican in 2008 and 2012, the study showed almost 30 per cent wider inequalities. However, that does not mean things were completely even in Democrat counties. On average, the difference in life expectancy was 7.23 years in Republican counties, but still 6.6 years in Democrat counties. All of the mortality and inequity results were consistent when the researchers limited their data to six of the key states that helped flip the 2016 election to Republicans: Iowa, Ohio, Pennsylvania, Michigan, Wisconsin and Florida.