Presidential election results may impact voters’ mental health

Presidential election results may impact voters’ mental health


Written by James Kingsland on November 5, 2020 — Fact checked by Hilary Guite, FFPH, MRCGP

Analysis suggests that in states that voted for Hillary Clinton in November 2016, there were a total of 54.6 million more days of poor mental health the following month compared with October 2016.


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Healthcare providers in the United States should be alert to the possibility of deteriorating mental health among some of their patients following the presidential election. This is according to a team of health policy specialists led by researchers from the University of California, San Francisco (UCSF).

In states where Clinton won the majority of votes at the last presidential election in November 2016, the scientists found evidence of worsening mental health the following month.

There was no significant change in states where Donald Trump secured the most votes.

“It’s possible the mental health worsening in the Clinton states had been exacerbated by the largely unexpected nature of the loss — at least according to pre-election polls,” says first author Brandon Yan, a third-year medical student at UCSF.

Because individuals’ voting choices are confidential, the researchers relied upon which candidate won a particular state as a proxy to assess the possible effects of the national result on its voters’ mental well-being.

Telephone health survey

They analyzed the responses of 499,201 adults surveyed in the Behavioral Risk Factor Surveillance System between May 2016 and May 2017.

This ongoing survey involves phoning residents by random dialing to ask about their health-related behaviors, chronic health conditions, and use of preventive services.

The scientists looked at responses to questions about how many days respondents experienced stress, depression, and problems with emotions during the past 30 days.

They adjusted for demographic differences between states that might affect mental illness rates, including age, sex, socioeconomic factors, education levels, and health trends in the months leading up to the election.

After these adjustments, they found that in states won by Clinton in 2016, the mean number of days of poor mental health per adult increased significantly, from 3.35 days in October to 3.85 days in December.

The authors say this equates to 54.6 million extra days of poor mental health in December for the 109.2 million adults living in states where Clinton won a majority.

On average, every 10-percentage-point greater margin of victory in Clinton states was associated with 0.41 more days of poor mental health per adult in December compared with October.

“Clinicians should consider that elections could cause at least transitory increases in poor mental health and tailor patient care accordingly,” says one of the study authors, Dr. Renee Y. Hsia, of the UCSF’s Philip R. Lee Institute for Health Policy Studies and Department of Emergency Medicine

In states won by Trump, the mean number of days of poor mental health per adult declined from 3.94 days in October 2016 to 3.78 days in December 2016, though this change was not statistically significant.

The study appears in the Journal of General Internal Medicine.

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