Can election stress harm health? Study links 2016 US presidential poll with uptick in heart attacks, stroke
Researchers suggest that health professionals need to pay greater attention to how stress linked to political campaigns, rhetoric, and election outcomes can impact health
Research has shown that there is an increased risk of acute cardiovascular disease (CVD) events soon after significant incidents such as earthquakes, industrial accidents, terror attacks and even sporting events. There have been, however, limited studies around sociopolitical events such as presidential elections. A research team now suggests that stress linked to political campaigns and election results may directly harm health. According to their analysis, the 2016 US presidential election is associated with an uptick in heart attacks and stroke.
The findings show that the hospitalization rate for acute cardiovascular disease events in a large southern California health system was 1.62 times higher in the two days immediately after the 2016 presidential election when compared with the same two days in the week before the 2016 election. The results were similar across sex, age and race and ethnicity groups, and the findings suggest that sociopolitical stress may trigger CVD events, according to authors from Harvard TH Chan School of Public Health and Kaiser Permanente. The analysis is timely given the polarized political climate preceding the 2020 presidential election, they emphasize.
“This is a wake-up call for every health professional that we need to pay greater attention to the ways in which stress linked to political campaigns, rhetoric and election outcomes can directly harm health,” writes David Williams, Florence Sprague Norman and Laura Smart Norman professor of public health at Harvard Chan School and corresponding author of the study. The findings have been published in the Proceedings of the National Academy of Sciences (PNAS).
Previous studies suggest that stressors may trigger the onset of acute CVD events within hours to days. An earlier Kaiser Permanente Northern California study showed that on the day of the September 11 attacks, there were 70% more evaluations for angina (chest pain or discomfort caused when the heart muscle does not get enough oxygen-rich blood) and myocardial infarction (also known as a heart attack) than expected. In a 2017 American Psychological Association survey, over half of the respondents noted the current political climate as a significant source of stress, and two-thirds of the respondents noted that concerns about the future of the nation were a significant source of stress. But little is known about how that stress may impact health. “There is limited research examining acute CVD surrounding elections, which have become increasingly divisive in recent cycles. Therefore, we compared rates of hospitalization for acute CVD before and immediately after the date of the 2016 US presidential election among patients in an integrated healthcare delivery system,” the team explains.
The authors analyzed data collected by Kaiser Permanente Southern California, an integrated health system that provides care to 4.6 million people in the region. They focused on diagnoses of acute myocardial infarction and stroke among adults, as well as emergency department diagnoses for chest pain and unstable angina. In the two days immediately after the 2016 presidential election, the rate of hospitalizations for CVD events was 1.62 times higher: 573.14 per 100,000 person-years (or 94 total hospitalizations), compared with a rate of 353.75 per 100,000 person-years (or 58 total hospitalizations) in the same two days of the week in the week before the election.
“Compared to the same two days in the week prior, the rates of CVD in the two days following the election among men and women were 1.33 and 2.21 times higher, respectively. Rates of CVD were also higher among White, Black, Hispanic, and Asian/Pacific Islander (API) individuals following the election (rate ratios 1.81, 2.33, 1.20, and 1.33, respectively). Similar results were also observed when we compared the rate in the two days following the 2016 election to the same two days of the week in each of the prior two weeks (rate ratios 1.45),” the findings state.
In secondary analyses, the team evaluated hospitalization for heart attack and stroke, separately. The rate of acute myocardial infarction in the two days following the election was 1.67 times higher compared to the same two days the week prior to the election. The rate of stroke in the two days following the election was 1.59 times higher compared to the same two days the week before the poll.
The investigators recommend that further studies are needed to understand the intersection between major sociopolitical events, perceived stress, and acute cardiovascular diasease events. “In our diverse patient population that is reflective of Southern California as a whole, we saw that the risk of heart attacks increased after the 2016 election irrespective of sex, age, and racial/ethnic groups. It is important that people are aware that stress can trigger changes in their health, and that healthcare providers help patients cope with stress by encouraging wellness strategies such as exercise, yoga, meditation, and deep breathing,” says lead researcher, Matthew Mefford of the Kaiser Permanente Southern California Department of Research & Evaluation.