A Healthy Democracy? Evidence of Unequal Representation Across Health Status

Abstract

Research on the link between health and political behavior has flourished, yet there have been no analyses regarding the political consequences of health inequalities. Using data from the 2012 CCES, we find that health is associated with representation. Healthy individuals are better represented compared to unhealthy citizens; this positive association is particularly true for individuals in the top third income group and when citizens are represented by Republicans. We explore two mechanisms that may account for this association. The participatory mechanism suggests that healthy individuals are better represented due to differences in political participation while the preferential mechanism suggests that differences are due to shifts in policy preferences. Overall, we find little evidence that either mechanism fully accounts for the association between health and representation. While the results clearly suggest that political clout is not just about income, but also health, scholars are encouraged to further explain this association.