Sociopolitical stress and acute cardiovascular disease hospitalizations around the 2016 presidential election

State-level economic uncertainty and cardiovascular disease deaths: evidence from the United States

The relationship between economic recessions and cardiovascular mortality has been widely explored. However, there is limited evidence on whether economic uncertainty alone is linked to cardiovascular disease deaths. This study examines the association between economic uncertainty and mortality from diseases of the circulatory system in the United States. We obtained monthly state-level mortality data from 2008 to 2017 and used indices capturing economic uncertainty from national/international sources and local sources. Panel data modelling was used to account for unobserved time-invariant differences between the states. Our findings suggest that economic uncertainty is independently linked to cardiovascular mortality. Uncertainty arising from national/international sources is associated with cardiovascular deaths, whereas the respective index capturing uncertainty from state/local sources is not. Deaths respond asymmetrically with respect to uncertainty fluctuations - with high levels of uncertainty driving the association. One- and two-month lagged uncertainty levels are also associated with mortality. Several robustness checks further validate the baseline findings. Overall, economic uncertainty is an independent predictor of cardiovascular mortality which appears to act as a psychosocial stressor and a short-term trigger. Public health strategies for cardiovascular disease need to consider factors driving economic uncertainty. Preventive measures and raising awareness can intensify in periods of economic uncertainty.

The relationship between mental health and public attention to the Brett Kavanaugh hearings and confirmation

RATIONALE

Researchers have rarely considered how public attention surrounding political events influences mental health. Specifically, in a politically polarized nation like the United States, it is possible that these events have a public mental health effect.

OBJECTIVE

This study examines the mental health effects associated with the 2018 U.S. Senate hearing and confirmation of Supreme Court Justice Brett Kavanaugh using public survey data.

METHODS

We use the interview date included in CDC data from the 2014-2018 Behavioral Risk Factor Surveillance System (BRFSS) to identify the effects of increased public attention on the Kavanaugh hearings and confirmation on the mental health of individuals who identify as female. We employ a triple difference model to control for possible confounding effects and target causality.

RESULTS

We find meaningful increases in both the number of "not good" mental health days reported and the probability of reporting any "not good" mental health days. On average, females reported 0.24 more poor mental health days during the one-month period surrounding the Kavanaugh confirmation and hearings than women did in the same 1-month period in 2014. This change represents a nearly 10% increase in mental health burden. The results are robust to the inclusion of a range of covariates as well as alternate specifications. In addition, we derive estimates of the societal costs associated with the increased mental health burden linked to Brett Kavanaugh's confirmation.

CONCLUSION

This study demonstrates that the Kavanaugh confirmation and hearings were associated with a notable rise in mental health challenges, especially among women. These results extend beyond personal experience and illustrate the societal costs linked to the resulting increased mental health burden. Further research on similar events is warranted.

Sociopolitical stressors are associated with psychological distress in a cohort of Latina women during early pregnancy

Research suggests that the 2016 US election was a potential stressor among Latinos residing in the United States. Sociopolitical stressors targeted toward ethnic minority communities and become embodied through psychosocial distress. The current study investigates if and how sociopolitical stressors related to the 45th President, Donald Trump, and his administration are associated with psychological distress in early pregnancy of Latina women living in Southern California during the second half of his term. This cross-sectional analysis uses data from the Mothers' Cultural Experiences study (n = 90) collected from December 2018 to March 2020. Psychological distress was assessed in three domains: depression, state anxiety, and pregnancy-related anxiety. Sociopolitical stressors were measured through questionnaires about sociopolitical feelings and concerns. Multiple linear regression models examined the relationship between sociopolitical stressors and mental health scores, adjusting for multiple testing. Negative feelings and a greater number of sociopolitical concerns were associated with elevated pregnancy-related anxiety and depressive symptoms. The most frequently endorsed concern was about issues of racism (72.3%) and women's rights (62.4%); women endorsing these particular concerns also had higher scores on depression and pregnancy-related anxiety. No significant associations were detected with state anxiety after correction for multiple testing. This analysis is cross-sectional and cannot assess causality in the associations between sociopolitical stressors and distress. These results are consistent with the hypothesis that the 2016 election, the subsequent political environment, and the anti-immigrant rhetoric and policies of former President Trump and his administration were sources of stress for Latinos residing in the United States.

Economic uncertainty and cardiovascular disease mortality

Previous studies have found a link between economic conditions, such as recessions and unemployment, and cardiovascular disease as well as other health outcomes. More recent research argues that economic uncertainty-independently of unemployment-can affect health outcomes. Using data from England and Wales, we study the association between fluctuations in economic uncertainty and cardiovascular disease mortality in the short term for the period 2001-2019. Controlling for several economic indicators (including unemployment), we find that economic uncertainty alone is strongly associated with deaths attributed to diseases of the circulatory system, ischemic heart disease and cerebrovascular disease. Our findings highlight the short-term link between economic conditions and cardiovascular health and reveal yet another health outcome that is associated with uncertainty.

Resentment Is Like Drinking Poison? The Heterogeneous Health Effects of Affective Polarization

Affective polarization-the tendency for individuals to exhibit animosity toward those on the opposite side of the partisan divide-has increased in the United States in recent years. This article presents evidence that this trend may have consequences for Americans' health. Structural equation model analyses of nationally representative survey data from Pew Research Center's American Trends Panel (n = 4,685) showed heterogeneous relationships between affectively polarized attitudes and self-rated health. On one hand, such attitudes were directly negatively associated with health such that the polarized political environment was proposed to operate as a sociopolitical stressor. Simultaneously, affective polarization was positively associated with political participation, which in turn was positively associated with health, although the direct negative effect was substantially larger than the indirect positive one. These results suggest that today's increasingly hostile and pervasive form of partisanship may undermine Americans' health even as it induces greater political engagement.

Elections have (health) consequences: Depression, anxiety, and the 2020 presidential election

In this paper, we examine the effect of the 2020 presidential election on anxiety and depression among Americans. We use data from the 2020 Household Pulse Survey (HPS), a nationally representative rapid response survey conducted weekly from April to July of 2020 and then bi-weekly until December of 2021. The high-frequency nature of the survey implies that we can identify week-to-week changes in mental health outcomes. We find that self-reported symptoms of moderate to severe anxiety and depression increased steadily up to the presidential election and declined after the election. The anxiety and depression levels are significantly higher around the 2020 election than in April 2020, when most of the U.S. was under mandatory or advisory stay-at-home orders due to the COVID-19 pandemic. Furthermore, anxiety and depression-specific office visits and usage of mental-health-specific prescription drugs show similar patterns. Robustness checks rule out alternative explanations such as a COVID-19 surge or vaccine development.

Racial and ethnic differences in blood pressure before and after the 2016 United States general election

OBJECTIVES

The 2016 U.S. presidential election was a major source of stress among many adults. Psychosocial stress can manifest physiologically in elevated blood pressure (BP). Little is known regarding the association of macro-level sociopolitical events with BP changes at the population-level. This study sought to characterize population-level changes in BP following the 2016 U.S. presidential election.

METHODS

Using 2015-2018 National Health and Nutrition Examination Survey, we included participants aged ≥18 years during the same periods prior to (May to October 2015/2016) and after (May to October 2017/2018) the election. Survey-weighted data were analyzed to compare population-level systolic BP (SBP) and diastolic BP (DBP) pre- and post-election, stratified by race/ethnicity. Sex differences were also investigated.

RESULTS

We observed significant increases in SBP among non-Hispanic (NH) Asian participants (+3.4 mmHg; p = .046), but not among other racial/ethnic participants. DBP increased among NH Black participants (+2.3 mmHg; p = .049) and Mexican American participants (+2.9 mmHg; p = .007), but not among other racial/ethnic participants. These changes appeared attributable to differential BP changes by sex.

CONCLUSIONS

At the population-level, variable changes in BP were observed by race/ethnicity following the 2016 U.S. presidential election, possibly driven by SBP elevations among women.

Election-related sociopolitical stress and coping among college students in the United States

Objective: The present study examines sociopolitical stress, coping, and well-being among college students. Participants: Young adult college students (N = 588; ages 18-29; 72% cisgender women) from 10 universities in the USA participated in this study. Methods: Participants completed a 45-minute online survey with closed-ended and open-ended questions, administered via Qualtrics. Results: Election-related sociopolitical stress was high with notable differences across students' demographic backgrounds (e.g., Hispanic/Latinx students, women, and sexual minority students reported high sociopolitical stress). Among those who reported being stressed by the election (N = 448), closed-ended and open-ended data reveal coping strategies including self-care, drugs and alcohol, and further civic action/political participation. Higher sociopolitical stress predicted more depression and many coping strategies were related with flourishing. Conclusions: Young adult college students are experiencing election-related sociopolitical stress and are coping in different ways. More work is needed to understand what coping strategies support well-being. Implications for colleges are discussed.

Association of the 2020 US Presidential Election With Hospitalizations for Acute Cardiovascular Conditions

IMPORTANCE

Prior studies found a higher risk of acute cardiovascular disease (CVD) around population-wide psychosocial or environmental stressors. Less is known about acute CVD risk in relation to political events.

OBJECTIVE

To examine acute CVD hospitalizations following the 2020 presidential election.

DESIGN, SETTING, AND PARTICIPANTS

This retrospective cohort study examined acute CVD hospitalizations following the 2020 presidential election. Participants were adult members aged 18 years or older at Kaiser Permanente Southern California and Kaiser Permanente Northern California, 2 large, integrated health care delivery systems. Statistical analysis was performed from March to July 2021.

EXPOSURE

2020 US presidential election.

MAIN OUTCOMES AND MEASURES

Hospitalizations for acute CVD around the 2020 presidential election were examined. CVD was defined as hospitalizations for acute myocardial infarction (AMI), heart failure (HF), or stroke. Rate ratios (RR) and 95% CIs were calculated comparing rates of CVD hospitalization in the 5 days following the 2020 election with the same 5-day period 2 weeks prior.

RESULTS

Among 6 396 830 adults (3 970 077 [62.1%] aged 18 to 54 years; 3 422 479 [53.5%] female; 1 083 128 [16.9%] Asian/Pacific Islander, 2 101 367 [32.9%] Hispanic, and 2 641 897 [41.3%] White), rates of hospitalization for CVD following the election (666 hospitalizations; rate = 760.5 per 100 000 person-years [PY]) were 1.17 times higher (95% CI, 1.05-1.31) compared with the same 5-day period 2 weeks prior (569 hospitalizations; rate = 648.0 per 100 000 PY). Rates of AMI were significantly higher following the election (RR, 1.42; 95% CI, 1.13-1.79). No significant difference was found for stroke (RR, 1.02; 95% CI, 0.86-1.21) or HF (RR, 1.18; 95% CI, 0.98-1.42).

CONCLUSIONS AND RELEVANCE

Higher rates of acute CVD hospitalization were observed following the 2020 presidential election. Awareness of the heightened risk of CVD and strategies to mitigate risk during notable political events are needed.

Highly public anti-Black violence is associated with poor mental health days for Black Americans

Highly public anti-Black violence in the United States may cause widely experienced distress for Black Americans. This study identifies 49 publicized incidents of racial violence and quantifies national interest based on Google searches; incidents include police killings of Black individuals, decisions not to indict or convict the officer involved, and hate crime murders. Weekly time series of population mental health are produced for 2012 through 2017 using two sources: 1) Google Trends as national search volume for psychological distress terms and 2) the Behavioral Risk Factor Surveillance System (BRFSS) as average poor mental health days in the past 30 d among Black respondents (mean weekly sample size of 696). Autoregressive moving average (ARMA) models accounted for autocorrelation, monthly unemployment, season and year effects, 52-wk lags, news-related searches for suicide (for Google Trends), and depression prevalence and percent female (for BRFSS). National search interest varied more than 100-fold between racial violence incidents. Black BRFSS respondents reported 0.26 more poor mental health days during weeks with two or more racial incidents relative to none, and 0.13 more days with each log₁₀ increase in national interest. Estimates were robust to sensitivity tests, including controlling for monthly number of Black homicide victims and weekly search interest in riots. As expected, racial incidents did not predict average poor mental health days among White BRFSS respondents. Results with national psychological distress from Google Trends were mixed but generally unsupportive of hypotheses. Reducing anti-Black violence may benefit Black Americans' mental health nationally.