NEW YORK: Voters in counties with poor community health may be possible contributors to the surprising results of the 2016 US presidential election, researchers say.
The findings showed that across all counties there was an average 5.4 per cent shift from Mitt Romney in 2012 to Donald Trump in 2016 -- with 88 per cent of the counties shifting towards Trump while 12 per cent shifted away from him.
Counties shifting towards Trump had higher teenage birth rates and age-adjusted mortality, but lower rates of violent crime.
Further, counties shifting towards Trump also appeared to have fewer health care resources, including the number of primary care physicians and income allocated, than did counties shifting away from Trump.
This association between public health and voting patterns was strongest in the West and particularly in the Midwest, where major voting shifts contributed to the Republican victory.
"Even after adjusting for factors such as race, income and education, public health seems to have an additional, independent association with this voting shift towards Trump," said lead author Jason H. Wasfy, assistant professor at the Harvard Medical School.
"I think these results demonstrate that health is a real issue that can affect people's lives and their decisions. We all need to focus on improving public health as a means of improving people's lives."
For the study, published in the journal PLOS ONE, the team investigated data covering both the 2016 and 2012 US presidential elections for 3,009 counties, more than 95 per cent of the 3,142 counties or equivalent regions in the US.
They analysed public health factors, including days of poor health, the prevalence of food insecurity, obesity and diabetes, teenage birth rates and the age-adjusted mortality rate.