Voting and health outcomes

Barriers to voting in Southern states are strongly correlated with worse health outcomes, including high infant mortality.

Voting access and infant mortality

2022

Source: Scot Schraufnagel et al., 2020 (Election Law Journal) and CDC, inspired by the Health & Democracy Index. Notes: Voting access captures ‘permanent’ changes in state electioneering practices and does not count temporary changes adopted in response to the COVID-19 pandemic. Infant mortality is the rate of infants dying within the first year of life. Vermont is missing because there was no available data on 2020 infant mortality.

Across nations, democracy and freedom are positively associated with better health outcomes, even after controlling for a country’s wealth.¹ Thus, it is no surprise that across the U.S., states with restrictive voting laws and greater barriers to civic participation also tend to have poor health outcomes.² Many Southern states are among the worst. Mississippi, Alabama, Arkansas, West Virginia, and Louisiana have the worst infant mortality rates in the country and also restrictive electoral climates. Infant mortality rates for Black communities are particularly high in these Southern states, and research indicates that better civic participation can make a difference in lowering these rates and saving infant lives.^2,3

1. “Effect of democracy on health: ecological study”. Franco, Álvarez-Dardet, and Ruiz. PubMed. December, 2004. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC535957/#:~:text=Democracy%20shows%20an%20independent%20positive%20association%20with%20health%2C,that%20seem%20to%20be%20associated%20with%20health%20status

2. “Health & Democracy Index”. Democracy Index. https://democracyindex.hdhp.us/

3. “Infant Mortality”. CDC. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm