Political Engagement and Public Health: Impact of Political Climate on Health Outcomes

Political polarization worsened significantly in the United States during the administration of President Donald J. Trump. Indeed, polls suggest that during his tenure partisan discord intensified to the point that opposing political camps disagreed not only over policy and governing preferences, but even over "basic facts."

Those deepening divisions almost certainly exacerbated a preexisting tendency for politics to affect the physical, psychological, and social health of Americans.

Between Trump’s 2016 election victory and his 2020 re-election campaign, psychotherapists reported a significant increase in patients reporting politics negatively affecting their mental health, the American Psychological Association identified politics as a major source of stress for American adults, and there were significant increases in rates of depression, anxiety, sleep loss, and emotional reactivity among groups with high levels of opposition to President Trump, such as Democrats, racial minorities, and students.

The possibility that political engagement may have serious consequences for public health and that those consequences are at historically high levels motivates the key objectives of the present study: To assess how political engagement affects physical, psychological, and social health among adults in the United States, to establish whether those health impacts increased or decreased during the period of the Trump administration, and to isolate the effect, if any, of the 2020 election and its associated shift in partisan fortunes along those same dimensions Of the health.

The results suggest that large numbers of adults (depending on the health issue, estimates range from tens of millions to more than one hundred million) attribute a variety of significant physical, psychological, and social health costs to the policy, that those numbers are remained high and some cases almost certainly increased over the course of the Trump administration, and that the 2020 election and its aftermath increased rather than decreased those negative health impacts.

While a fairly universal phenomenon, this research found that the negative health cost of politics is consistently correlated with being younger, identifying with the Democratic Party, actively participating in politics, despising political opponents, and having high levels of lower levels of political knowledge.

How politics can harm health

The mechanism by which politics can harm health is relatively well understood. Politics is a chronic stressor that saturates popular culture and permeates everyday life through social media, various entertainment platforms, and a 24-hour news cycle. Politics shapes social networks and individual identity, and is a well-documented source of negative emotions that predict self-reports of decreased physical and psychological well-being.

Elections and their associated long campaigns act as cyclical accelerators of what are already high levels of political stress. The negative effects of politics on social well-being, whether through passive attention or active engagement, are documented by a number of existing studies.

For example, one-fifth of Americans report being harassed online as a result of expressing political opinions, more than two-thirds report the recent election as a major source of stress in their lives, supporters of losing candidates engage More on stress-related behaviors such as increased alcohol consumption and greater exposure to political campaign ads also increases the chances of being diagnosed by a health professional with a psychological health condition such as anxiety or depression.

In addition to being attitudinally and behaviorally measurable, policy-induced stress is physiologically detectable . For example, political engagement is reported to correlate with baseline levels of cortisol , witnessing political conflict increases levels of skin conductance (i.e., activation of the "fight or flight" sympathetic nervous system), and Supporters of losing presidential candidates experience a drop in testosterone levels.

The negative health implications of stress, especially chronic stress, for a variety of psychological and physical conditions are well documented. The notion that politics as a chronic source of stress could take a toll on public health not only seems entirely plausible, but there is growing evidence that it manifests clinically in a variety of health conditions.

Although the mechanism by which the policy could negatively affect the health of large numbers of people seems well understood, the larger public health ramifications are not. Relatively few studies have directly addressed the cost of politics on public health, and to my knowledge, no published studies have tracked the impacts of politics on public health over significant periods of time, nor analyzed how significant changes in The political environment could change health measures in the long term.

Goals

Quantifying the effect of the policy on the physical, psychological, and social health of American adults during the four years of the Trump administration.

Methods

A previously validated health and politics scale was used to compare health markers in nationally representative surveys administered to separate samples in March 2017 (N = 800) and October 2020 (N = 700). Participants in the 2020 survey were resampled approximately two weeks after the 2020 election and health markers were compared to their pre-election baselines.

Results

A large number of Americans reported that politics significantly affects a variety of health indicators, from stress, loss of sleep or suicidal thoughts to the inability to stop thinking about politics and posting excessively on social media.

The share of Americans reporting these effects remained stable or increased slightly between spring 2017 and fall 2020 before the presidential election. The deterioration in physical health measures worsened detectably in the wake of the 2020 election. Those who were young, politically interested, politically engaged, or on the political left were more likely to report negative effects.

Average policy-related health scores 2017-2020. Relationship between the mean scores on the 32 items of the political costs for health battery by Smith et al (2019) between 2017 and 2019.

Discussion

The central conclusion of the analyzes is that virtually all of the health problems captured by Smith et al. political health impact scales remained stable or increased across the four years of the Trump administration, and that the 2020 election was not associated with any major substantive changes in this pattern. While there were some detectable health impacts associated with the 2020 election, these were fairly modest.

What is the public health relevance of these findings?

First and foremost is the fact that a large number of Americans clearly and consistently perceive that politics imposes a chronic negative cost on their health. According to 2019–20 Census Bureau population estimates, the resident population of the United States included approximately 255 million adults at the time of the 2020 survey.

Based on that number, pre-election survey findings suggest that between one-fifth and one-third of adults, roughly 50 to 85 million people, blame politics for causing fatigue, lack of sleep, feelings of anger, losing temper and triggering compulsive behaviors . (e.g., difficulty stopping thinking about politics and consuming political information) and difficulties controlling impulses (e.g., posting comments on social media that they later regretted; these estimates are calculated using the percentage agree or strongly agree with the relevant survey items).

A quarter of Americans reported that they seriously considered moving because of politics, and approximately 40 percent (more than 100 million) consistently identify politics as a major source of stress in their lives.

Surprisingly, all three surveys consistently indicate that about five percent of adults report having suicidal thoughts because of the policy—that’s an estimated 12 million people. Overall, these findings could hardly provide more support for previous research arguing that more attention should be paid to the link between politics and health.

The results here indicate that Americans view politics as significantly degrading their physical, psychological, and social health, and that, if anything, the most recent presidential election worsened these effects. Addressing this problem in any meaningful sense clearly presents a challenge. Traditionally, political engagement has been conceived as a public good, not a threat to public health. After all, a healthy and functioning democracy requires the commitment and participation of citizens.

An obvious way to minimize a public health threat is to minimize exposure, but doing so in this case seems civically irresponsible since it would prescribe not being an attentive and informed citizen. Pursuing that course of action might improve the health of the public, but it risks diminishing the democratic health of politics. It seems likely that a less contentious and polarized political climate than that of 2016 to 2020 will naturally reduce these health impacts, something future research should investigate.