Public Mental Health and Voting Outcomes in the U.S. Presidential Elections

• In Event: Health and Public Opinion

Abstract

Does public mental health condition affect electoral outcomes in democracies? What’s the role played by candidates’ ideologies, given that deteriorating mental health is documented as an important predictor of support for radical ideologies like populism. I investigate these questions in the U.S. context with a fine-grained dataset encompassing county-level voting information, mental health condition and ideologies of the candidates in the 2012, 2016 and 2020 presidential elections. I demonstrate that: In general, vote shares of the Republican presidential nominees significantly increase in counties with poorer mental health conditions compared with those of their Democratic competitors; However, this effect is modulated by political ideology, as the presidential nominees from both parties may suffer from diminished vote shares in the mentally unhealthy counties if they carry polarized ideologies. Using temperature anomaly as an instrumental variable to mitigate the endogenous problem, I provide justifications for the causality that underlies my empirical findings. Further analyses indicate lower turnout rates in counties with deteriorating mental health as a possible mechanism. This research enriches our understandings of how overall mental health of the public may interact with political polarization and the outcome of elections.

Author

• Zezhong Wang, Peking University