Socioeconomic inequality in voting participation and self-rated health

Am J Public Health. 2001 Jan;91(1):99-104. doi: 10.2105/ajph.91.1.99.


Objectives: This study tested the hypothesis that disparities in political participation across socioeconomic status affect health. Specifically, the association of voting inequality at the state level with individual self-rated health was examined.

Methods: A multilevel study of 279,066 respondents to the Current Population Survey (CPS) was conducted. State-level inequality in voting turnout by socioeconomic status (family income and educational attainment) was derived from November CPS data for 1990, 1992, 1994, and 1996.

Results: Individuals living in the states with the highest voting inequality had an odds ratio of fair/poor self-rated health of 1.43 (95% confidence interval [CI] = 1.22, 1.68) compared with individuals living in the states with the lowest voting inequality. This odds ratio decreased to 1.34 (95% CI = 1.14, 1.56) when state income inequality was added and to 1.27 (95% CI = 1.10, 1.45) when state median income was included. The deleterious effect of low individual household income on self-rated health was most pronounced among states with the greatest voting and income inequality.

Conclusions: Socioeconomic inequality in political participation (as measured by voter turnout) is associated with poor self-rated health, independently of both income inequality and state median household income.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Education*
  • Female
  • Health Status*
  • Humans
  • Income*
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Politics*
  • Social Identification
  • Social Justice
  • Socioeconomic Factors
  • United States / epidemiology