Health and Voting in Rural America

Abstract

This research explores the impact of health on voter turnout, with the goal of uncovering important variation in dynamics across rural communities. Drawing on the results of county and individual-level analyses, including novel survey data from an Appalachian community, this study finds that health matters less for rural voters. Models using county-level data indicate that poor health is significantly and negatively related to voter turnout across counties, even when controlling for educational attainment, poverty, diversity, and political competition. However, health loses its explanatory power in rural counties once a control for religiosity is introduced. Health is also a less important predictor in rural places where there is a high cost of voting, a finding counter to the notion that high costs would uniformly amplify the negative effects of health disparities. Models using individual-level data provide support for many of these findings, while also generating new insights into the complexity of rural political behavior. Overall, this study suggests that place has an important role in understanding the engagement of American voters.