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- A study of voting patterns across the US from 2008 to 2016 revealed that in counties where Donald Trump picked up swing votes, death rates were 15% higher than in counties where Democrats made gains.
- Researchers believe that hopelessness and fear impacted voter preferences in counties where more people are dying "deaths of despair" from causes like suicide, drugs, and alcohol.
- The finding aligns with other research about the psychology of conservative voters, which shows fear can be a motivator.
- The researchers believe better life expectancy rates might have tipped the scales in favor of Hillary Clinton in states including Michigan, Pennsylvania, and Wisconsin.
The US is one of the richest countries in the world, but death rates for middle-aged, white, working-class Americans are rising. That's especially true when it comes to causes like suicide, drugs, and alcohol.
The phenomenon has given rise to a troubling new term in public health: deaths of despair.
Such deaths are most common among white, non-Hispanic men in their early 50s who don't have a college degree. That group is increasingly dying earlier from causes like alcohol and drug poisoning, suicide, alcoholic liver disease, and cirrhosis (liver failure).
New research suggests the trend might have impacted the 2016 election.
In a study released Wednesday, researchers from Columbia University found a link between higher rates of these so-called deaths of despair and more swing votes cast for President Donald Trump.
The researchers behind the study, which was published in the Journal of General Internal Medicine, analyzed US counties where Trump picked up votes in 2016 as compared to John McCain in 2008. It revealed that in places where death rates went up, so did voters' tendencies to choose the Republican candidate.
"Although life expectancy is increasing in many parts of the country, especially in urban areas, we're not seeing nearly the same gains in rural and middle America," lead author Lee Goldman, chief executive of Columbia University Irving Medical Center, said in a release. "We shouldn't underestimate the degree to which some portions of the country have been left behind in terms of their health."
Higher death rates, more Republican votes
For their research, Goldman's team used publicly available voting data from all 3,112 US counties. They compared voting patterns in 2008 and 2016 with changes in death rates from 2000 to 2015. The results showed that counties where more votes went Republican in 2016 than 2008 had a 15% higher age-adjusted death rate than counties that gained Democratic votes.
What's more, counties where Trump picked up more votes in 2016 than McCain did in 2008 had increases in death rates from suicide, alcohol, and drugs that were 2.5 times higher than in counties where Clinton picked up more votes than Obama did.
These elevated death rates were linked with votes for Trump even when the researchers controlled for other socioeconomic and demographic factors like age, race or ethnicity, income, education, unemployment, and health insurance rates.
"Reduced health prospects are an important marker of dissatisfaction, discouragement, hopelessness, and fear, sentiments that may have resonated with voters who sided with President Trump," Goldman said in the release.
The researchers did not suggest that deaths of despair directly caused people to favor Trump, but their finding lends credence to the idea that feelings of fear and despair were predictive of Republican support.
"Although death rates are not the only marker of health and well-being, they might be a marker of relative despair," the researchers wrote. "If so, it is not surprising that deaths related to alcohol, drugs, and suicides rose by 2.5 times as much in counties with a Republican percentage gain, compared with counties with a Democratic percentage gain."
Fear and hopelessness can sway voters to pick Republican candidates
The new findings align with other data researchers have collected about the psychological differences between liberal and conservative voters.
Feeling scared, for example, has been shown to make voters more conservative. That's what happened in the US after September 11, and the link has been seen in other countries around the world as well. People may also embrace conservative views as a way to "explain, order, and justify inequality among groups and individuals," as one 2003 review of studies put it.
Fear isn't the only factor at play in a voter's choice. Other surveys have found that personal values also play a huge role in how we vote, and are better predictors of support for a candidate than political ideologies.
In 2016, for example, Trump supporters were more likely to agree with statements like "people who are poor just need to work harder" and "vacations are for weaklings," suggesting a pull-yourself-up-by-your-bootstraps mindset is alive and well in his base.
But psychologists have also demonstrated how malleable those partisan views can be.
In one recent study, a team of researchers from Yale University temporarily swayed some conservatives to express more liberal views on social issues by having them imagine they were imbued with superhuman powers of survival.
"We have one mind, and it can operate consciously and unconsciously," John Bargh, the author of that study, told Business Insider.
A team of researchers from Harvard also found that people's stance on Syrian refugees can shift just from imagining themselves in the refugees' shoes.
Based on the new county-specific data, the Columbia researchers said the 2016 election could have tipped in Hillary Clinton's favor if death rates had dropped, even modestly, between 2000 and 2015 in the battleground states of Michigan, Pennsylvania, and Wisconsin.
Of course, it's impossible to say what would have happened if those states had become healthier and saw fewer deaths of despair. But there's no denying that our feelings of safety, health, and hopelessness can impact our decisions about political candidates.