Are Republicans healthier than Democrats?
Sunday, November 2nd, 2008Update: See here from Steve Kass. Apparently the researchers below made a mistake in reading the data. That sort of thing happens sometimes–that’s one reason it can be helpful to post things on a blog, so that people can catch mistakes.
My bad in not screening this more carefully before posting. In defense of Subramanian and Perkins, they sent me the paper and it was my idea to blog it. They were planning all along to do more systematic analysis of the raw data (which they haven’t yet received).
S. V. Subramanian and Jessica Perkins write:
The prevalence of poor self-rated health was substantially higher among Democrats (25.8%) as compared to Republicans (8.5%). Lower prevalence of poor health among Republicans was also observed in analyses stratified by poverty, education or race. The prevalence of self-rated poor health among poor Democrats or Black Democrats or Democrats with less than high school education were 3 – 14 times higher than comparable Republicans, suggesting that the observed differences in health status by political ideology may not be due to confounding by race or socioeconomic status:

These patterns remain in conditional linear regression models where self-rated health is modeled as a function of political ideological bent (ranging from strongly Democrat to strongly Republican) adjusted for age, sex, race, marital status, income, poverty, education, smoking and religious affiliation.
We also found that more than twice as many Democrats smoke (16.7%) compared to Republicans (7.1%). The prevalence of smoking among poor, less than high school education, or Black Democrats is 3 to 20 times the smoking prevalence among Republicans (see above).
The observation that Republicans enjoy better health status may reflect the core Republican value of individual responsibility, which could translate into increased adherence to health-promoting behaviors. It is also likely that Republicans tend to exhibit greater religiosity compared to Democrats.5 This could lead to health promoting social conditions, such as enhanced social ties and networks, in part facilitated through increased attendance in places of worship.
Our observations should not be interpreted to suggest that a Republican government necessarily equals better health. It would be erroneous to draw macro inferences based on individual-level correlations. Indeed, the question of which type of political ideology, reflected at the government-level, is better for population health or for reducing health disparities are entirely different queries. At the same time, our findings suggest that certain aspects of Republican ideology may implicitly be health enhancing for the individual. The healthier status of Republicans might also explain, perhaps, why they place lower priority on health care.
Interesting. S.V. said they’re waiting to get the raw data so they can run logistic regressions.
P.S. Let me add a few thoughts based on the comments below and at my other blog:
1. To the extent that difference in smoking rates are that large, this would be a big part of the story. But are smoking rates really so low among those groups of Republicans? Perhaps some mistake? I’d really want to look into this before going further.
2. To the extent that the above (or similar) patterns are actually occurring, I think they’re interesting, even if they’re explained by reporting bias or by experiences or by differences between people in big cities and elsewhere, or whatever. As S.V. noted in his article, differences in perceived health–even if explainable by biases–could result in differences in attitudes toward health policy in general.
Posted in Campaign contributions, Ideology, Polls | 7 Comments »

