Evidence mapPaperPMID 39664487Full record

ArticleHealth affairs scholar2024

Politicians, power, and the people's health: US elections and state health outcomes, 2012-2024.

Nancy Krieger, Soroush Moallef, Jarvis T Chen, Ruchita Balasubramanian, Tori L Cowger, Rita Hamad, Alecia J McGregor, William P Hanage, Loni Philip Tabb, Mary T Bassett

Abstract read
In one paragraph

Article in Health affairs scholar, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Observational
  5. Conceptualizing and Measuring Systemic Racism.Annual review of public health · 2025
    Review
  6. Article
  7. Threats to Democracy and the Right to Health.American journal of public health · 2025
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Nancy KriegerDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0002-4815-5947
Soroush MoallefDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0003-0339-7309
Jarvis T ChenDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0002-7412-1783
Ruchita BalasubramanianDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0002-9151-9873
Tori L CowgerFXB Center for Health and Human Rights, Harvard University, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0001-5359-8155
Rita HamadDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0003-0730-4077
Alecia J McGregorDepartment of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0003-0993-4232
William P HanageDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0002-6319-7336
Loni Philip TabbDepartment of Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, United States.ORCID https://orcid.org/0000-0002-7601-8368
Mary T BassettDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0002-7810-4163

Funding

Epidemiology of Infectious Diseases and BiodefenseT32AI007535 · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · 1998 to 2025
$1.1M
NIAID NIH HHS T32 AI007535
6 · The paper itself

Abstract

Our descriptive study examined current associations (2022-2024) between US state-level health outcomes and 4 US state-level political metrics: 2 rarely used in public health research (political ideology of elected representatives based on voting records; trifectas, where 1 party controls the executive and legislative branches) and 2 more commonly used (state policies enacted; voter political lean). The 8 health outcomes spanned the life course: infant mortality, premature mortality (death at age <65), health insurance (adults aged 35-64), vaccination for children and persons aged ≥65 (flu; COVID-19 booster), maternity care deserts, and food insecurity. For the first 3 outcomes, we also examined trends in associations (2012-2024). For all political metrics, higher state-level political conservatism was associated with worse health outcomes, especially for the metrics for political ideology and state trifectas. For example, in 2016, the premature mortality rate in states with Republican vs Democratic trifectas was higher by 55.4 deaths per 100 000 person-years (95% CI: 7.7, 103.1), and the slope of the rate of increase to 2021 was also higher, by 27.0 deaths per 100 000 person-years (95% CI: 24.4, 29.7). These results suggest elections, political ideology, and concentrations of political power matter for population health.

Indexed as

childhood vaccinationCOVID-19 boosterselectoral politicsfood insecurityhealth insuranceinfant mortalitymaternity care desertspolitical conservatismpolitical determinants of healthpolitical liberalismpolitical polarizationpovertypremature mortalitystate policiesstate trifecta

Identifiers

PMID39664487
PMCPMC11631342

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.