What is the relationship between population health and voting patterns: an ecological study in England.

Background: Health is a fundamental issue in politics and an area where governments hold significant levers of influence. Countries in Europe have seen increased support for populist political parties, with some evidence linking support for these parties to health metrics. We aimed to establish if there is an association between health metrics and patterns of voting in England, particularly in relation to a recently established political party, Reform UK, in the 2024 general election.

Methods: We conducted a cross sectional ecological study with data from all constituencies in England (n=543). We conducted Pearson correlations and linear regression between the proportion of eligible votes for Reform UK and estimated prevalence of 20 common non-communicable diseases, including obesity, chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes and depression.

Results: Constituencies electing Reform members of parliament (MPs) (n=5/543) had the highest average prevalence of asthma (7.44%) and COPD (2.85%). Across the country, adjusting for age, sex and deprivation, a 10% increase in the party's vote share was associated with a +0.261% (95% CI 0.213% to 0.309%) prevalence of COPD, a +0.113% (95% CI 0.026% to 0.201%) prevalence of asthma and a +1.479% (95% CI 1.239% to 1.720%) increase in obesity prevalence.

Conclusions: At a constituency level, poor health, in particular conditions associated with breathlessness, was associated with a greater proportion of votes for Reform UK.