Are Republicans healthier than Democrats?

Can one's political ideology influence one's health? Aggregate studies correlating average voting patterns with average mortality levels, 1–4 or average health dissatisfaction , 3 suggest that mortality tends to be lower in areas where the majority vote for the party with conservative political orientation. This finding has usually been presented as reflecting the differences in socioeconomic deprivation between areas voting for a party with conservative values and areas voting for a party with liberal values. 1 We are not aware of any studies that examine the association between political ideology and health at the disaggre-gated, individual level. In the USA, it has been shown that individuals' political ideology correlates with the degree of importance they attach to health 'care', 5,6 with individuals who identify as democrats assigning a higher priority on issues related to health care compared with individuals who identify as republicans. 6 It is not clear, however, whether there are fundamental differences in health status and behaviours between individuals who identify with conservative and liberal political parties. We analysed the 1972–2006 cumulative General Social Surveys (GSS) data, 7 which allows an examination of health status/behaviours and political ideology at a micro level. Health status was ascertained from a question, 'Would you say your own health, in general, is excellent, good, fair, or poor?' For analysis, we created a binary variable with poor health ¼ 1, 0 otherwise. Smoking status was measured based on an affirmative response to the following question, 'Do you smoke?'. Of those reported, 5% were considered as in poor health and 35% were smokers in the weighted, pooled samples. Political ideology was based on a question , 'Generally speaking, do you usually think of yourself as a republican, democrat, Independent, or what?', with respondents' choosing one of the following categories: strong democrat (15%), not very strong democrat (22%), independent near democrat (12%), independent (15%), independent near republican (9%), not very strong republican (16%), strong republican (10%) and other party (1%). For ease of presentation and interpretation, we also grouped these into democrats (49%) comprising strong democrat/not very strong democrat/independent near democrat, republicans (35%) comprising strong republican/not very strong republican/independent near republican, and independent/others (16%). We included age, sex, race, marital status, religious service attendance, highest educational degree, total family income in the last year prior to the survey and survey year as covariates. After excluding missing values on the responses and predictors, the final analytic …