State-Level Partisanship Strongly Correlates With Health Outcomes for Us Children

Abstract Introduction:The Cook Partisan Voting Index (PVI) determines how strongly a state leans toward the Democratic or Republican Party in presidential elections compared to the nation. We set out to determine the correlation between childhood health outcomes and state-level partisanship using PVI.Materials and Methods:16 measures of childhood health were obtained from the CDC, U.S. Census Bureau, and U.S. Bureau of Labor Statistics for 2012-2016. PVI was averaged for every state for the same time period. Pearson's rho determined the correlation between PVI and each health outcome, using a Bonferroni adjustment of 0.003. Multiple regression was also conducted, adjusting for children without health insurance, primary care physicians, childhood poverty, and % non-white. We also compared childhood health in moderately Democratic and Republican states (5%-9.9% more Democratic/Republican than the national mean) and, similarly, for extremely Democratic and Republican states (10% or more Democratic/Republican than the national mean), using Kruskal-Wallis tests. Results:Democratic-leaning states had better outcomes for 7 of 16 health measures (all p<0.003, table 1). In the adjusted model, Democratic-leaning states had better outcomes for 9 of the 16 variables (all p<0.003, table 1). Among moderately-partisan states, no outcomes were statistically better in one group of states but extremely-Democratic states had superior outcomes for 5 variables (all p<0.003, table 2). No health outcomes were found to be significantly better in Republican-leaning states.Conclusions:Multiple childhood health measures were statistically better in Democratic-leaning states compared to Republican counterparts. Future research should identify which state-level policies have led to such disparate health outcomes.