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Counties Trump Won Have Lower Rates of Life Expectancy

A new analysis finds a stark metric for the health-depleting stress of Americans who felt left behind—and who saw Trump as a possible savior.
Supporters of Donald Trump react as he speaks during a rally at Valdosta State University, on February 29th, 2016, in Valdosta, Georgia.

In the post-election analyses, Donald Trump voters were often portrayed as desperate—so much so that they took a chance on a candidate they realized was deeply flawed. But what, exactly, was the source of their desperation?

The Trump campaign's appeals to racial prejudice, pledge to somehow bring back blue-collar jobs, and insistence on a non-existent crime wave certainly played a role. But new research links their despair to an even more fundamental factor: They're dying earlier than Democrats.

"Residents of counties left out from broader life expectancy gains abandoned the Democratic Party in the 2016 presidential election, turning to Trump or not voting at all," Jacob Bor of the Boston University School of Public Health writes in a newly published study. "Residents of these counties are hurting, experiencing not just economic insecurity, but also persistently high mortality rates."

Bor examined two sets of data for his study, published in the American Journal of Public Health: county-level estimates of life expectancy at birth for the years 1980 and 2014 (a period in which life expectancy among Americans increased by 5.3 years on average); and voting results in the 2008 and 2014 presidential elections.

"Residents of these counties are hurting, experiencing not just economic insecurity, but also persistently high mortality rates."

He reports that mortality gains were highly uneven, and counties that didn't keep up were far more likely to vote for Trump. "Counties in which life expectancy stagnated or declined saw a 10-percentage-point increase in the Republican vote share between 2008 and 2016," he writes.

Further crunching of the numbers revealed that "the 781 counties in which life expectancy increased by less than three years during 1980 through 2014 saw a 9.1 percentage point increase in the Republican vote share" between the 2008 (John McCain vs. Barack Obama) and 2014 (Trump vs. Hillary Clinton) elections.

In contrast, "Democrats saw a 3.5 percentage point increase in counties in which life expectancy gains exceeded seven years," he adds.

Bor's analysis suggests "the change in life expectancy was not an independent causal factor in the shift in Republican vote share." Rather, it seems the same factors that contribute to shortened lives (loss of jobs, increased poverty, etc.) inspired people to vote for Trump.

Nevertheless, the mortality gap is real, which raises disturbing questions about the Trump administration's budgetary priorities. As Bor notes, "the new administration has proposed massive cuts to health insurance to the poor, to social programs such as food stamps, to public health and medical research, to occupational safety monitoring, and to environmental protection."

"When," he asks, "will the Trump administration and the Republicans in Congress respond to the health needs of those who put them into power?"