Voting and Health: an Exploratory Analysis of the Relationship Between Voter Participation and County-Level Health Using a Pooled Cross-Sectional Time-Series Design in Two States (Oregon and Texas)
Open Access DepositedThere has been a growing interest in the relationship between voter participation, representative democracy, and community health. Previous research has shown that there is a relationship between electoral policies and overall health at the state level, county levels of COVID case and mortality rates, Black infant mortality, and health insurance access. However, there has yet to be a pooled-cross sectional time-series study that examines the relationship between voter participation and several measures of community health within a single state policy context. This exploratory research expands the current knowledge and understanding of the relationship between voter participation and health in two states (Oregon and Texas) by using pooled cross-sectional time-series analysis at the county level. Using data from Behavioral Risk Factor Surveillance System, Election Administration and Voting Survey, and the American Community Survey, this dissertation aims to answer the following primary research question: Are voter participation rates associated with county level health outcomes, health behaviors, and healthcare access over time and across counties when controlling for insurance, race, income, education, housing tenure, housing quality, and population density in Oregon and Texas? Results indicated that voter participation is related to health insurance access in Oregon and in Texas voter participation was associated with better health (fewer poor health days, fewer poor mental health days, fewer adults that smoke, and fewer uninsured adults) even when controlling for race, income, education, homeownership, housing quality, population density, and time in a county fixed effects model. While these findings are exploratory, it adds to the current literature and understanding on the relationship between voting and health. Future work should focus on additional measures of community power, electoral administration and resources, alternative community segmentations, and the role electoral and health policy plays in this critical relationship.
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