Smoking and (Not) Voting: The Negative Relationship Between a Health-Risk Behavior and Political Participation in Colorado

Determinants of trust in times of crises: A cross-sectional study of 3,065 German-speaking adults from the D-A-CH region

Interpersonal trust declined worldwide during the COVID-19 pandemic; strategies are needed to restore it. We surveyed 3,065 quota-sampled German-speaking adults residing in the D-A-CH region. Using multinomial logistic regression models and backward elimination for variable selection, we calculated multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95% CIs) to appraise correlates of interpersonal trust using the Interpersonal Trust Short Scale (KUSIV3). Participants with high levels of interpersonal trust (top KUSIV3 tertile (T3)) tended to be older, male, residents of Switzerland, university degree holders, and workers with higher income and work satisfaction (all Pdiff<0.01) compared to those in the lowest KUSIV3 tertile (T1). Optimism was most strongly associated with high interpersonal trust (ORT3vsT1 = 5.75, 95%CI = 4.33-7.64). Also significantly associated with high interpersonal trust were: Having voted in the last national election (for the opposition, OR = 1.39, 95%CI = 1.02-1.89 or the governing party, OR = 1.61, 95%CI = 1.23-2.11) versus non-voters; perspective taking (ORT3vsT1 = 1.46, 95%CI = 1.11-1.91); being more extraverted (ORT3vsT1 = 1.99, 95%CI = 1.53-2.59) and more agreeable (ORT3vsT1 = 1.95, 95% CI = 1.46-2.61); and scoring higher on complexity thinking (ORT3vsT1 = 1.32, 95%CI = 1.01-1.72). Participants scoring significantly lower for interpersonal trust did not regularly participate in religious meetings (OR = 0.61, 95%CI = 0.44-0.84, versus participation at least monthly); were more conscientious (ORT3vsT1 = 0.68, 95%CI = 0.51-0.91) or current smokers (OR = 0.68; 95%CI = 0.53-0.87, versus never smoking); had sleep problems >5 times a week (OR = 0.48; 95%CI = 0.36-0.66, versus none); and scored high on conspiracy belief (ORT3vsT1 = 0.53; 95%CI = 0.41-0.69). Results differed minimally by gender and country. These findings may be helpful in devising targeted strategies to strengthen interpersonal trust and social engagement in European societies, especially during times of crises.

Association between cigarette smoking status and voting intentions: Cross sectional surveys in England 2015-2020

BACKGROUND AND AIMS

Cigarette smoking takes place within a cultural and social context. Political views and practices are an important part of that context. To gain a better understanding of smoking, it may be helpful to understand its association with voting patterns as an expression of the political views and practices of the population who smoke. This study aimed to assess the association between cigarette smoking and voting intentions and to examine how far any association can be explained by sociodemographic factors and alcohol use.

METHODS

Pooled monthly representative repeat cross-sectional household surveys of adults (16+) in England (N = 55,482) between 2015 and 2020 were used to assess the association between cigarette smoking status and voting intentions, and whether this was accounted for by age, occupational grade, gender, region and alcohol use. Voting intention was measured by asking 'How would you vote if there were a General Election tomorrow?' Respondents chose from a list of the major English political parties or indicated their intention not to vote.

RESULTS

In adjusted multinomial regression, compared with intending to vote Conservative (majority party of government during the period), being undecided (aOR1.22 [1.13-1.33] <0.001), intending to vote Labour (aOR1.27 [1.16-1.36] <0.001), to vote "Other" (aOR1.54 [1.37-1.72] <0.001), or not to vote (aOR1.93 [1.77-2.11] <0.001) was associated with higher odds of current relative to never smoking rates. Intending to vote for the Liberal Democrats was associated with a significant lower odds of current smoking prevalence (aOR0.80 [0.70-0.91] <0.001) compared with intending to vote Conservative.

CONCLUSIONS

Controlling for a range of other factors, current as compared with never-smokers appear more likely to intend not to vote, to be undecided, to vote for Labour or a non-mainstream party, and less likely to vote for the Liberal Democrats, compared with the Conservative party.

A cross-sectional national survey to explore the relationship between smoking and political abstention: Evidence of social mistrust as a mediator

Rationale

Smoking prevalence is well known to vary socioeconomically but has been less studied in relation to political participation. Growing evidence suggests that health disparities and political nonparticipation are intertwined, but the underlying mechanism is unclear.

Objective

We investigated the relationship between smoking and voter registration, testing various forms of trust as possible mediators, in U.S. national survey data collected around the 2012 presidential election.

Methods

A random half (n = 9757) of adults who completed The Attitudes and Behaviors Survey on Health (TABS) in 2012 (response rate was 58.4% for landline and 24.3% for cell phone) also answered a section on voter registration, voting behavior, and trust in people and selected institutions. Multivariable logistic regression was used to examine the association between smoking and registering to vote and potential mediation by trust in people and various institutions, adjusted for covariates known to be associated with both. Analyses used design-based methods with weights to account for sampling probabilities, nonresponse, and calibration to the U.S. adult population in 2012.

Results

Compared with nonsmokers, daily smokers had significantly lower adjusted odds of being registered to vote (aOR: 0.33, 95% CI: 0.21–0.52) and higher adjusted odds of having low trust in people (aOR: 2.50, 95% CI: 1.29–4.83). Low trust in people predicted lower odds of registering to vote (aOR: 0.55, 95% CI: 0.36 to 0.84) and partially mediated the smoking-registration relationship.

Conclusion

Lower electoral participation among daily smokers is partly attributable to lower trust in people, a factor that could also affect willingness to use cessation support resources such as quitlines. Low trust and low political participation among daily smokers may have important political and public health consequences.

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Smoking behavior and political participation are closely related.

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Daily smokers were less likely to register to vote and to vote.

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Lower electoral participation is partly attributable to lower trust in people.

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Smokers' abstention from electoral decisions may bias public health policymaking.

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Cessation programs should reduce stigmatization and promote trust among smokers.

Equity at the ballot box: Health as a resource for political participation among low-income workers in two United States cities

Objective: The purpose of this study is to identify health resources associated with propensity to vote at the local-level among low-wage workers in two United States. cities. Literature confirms individuals of lower income have a lower propensity of turning out to vote, yet few studies have focused on low-income populations to identify the variation in factors associated with voting within this group. Furthermore, few studies have investigated health and voter turnout at the local-level. In this study, we examine factors related to political participation at the local-level within a low-wage sample, examine mental, physical, behavioral, and social health and their association with voter turnout, and assess if these relationships differ by city.

Methods: We use cross-sectional survey data from a sample of 974 low-wage workers in Minneapolis, MN and Raleigh, NC. We computed descriptive statistics and employed a logistic regression to predict their likelihood of local voter turnout, with the key independent variables being health resources, such as self-rated health, body mass index (BMI), mental disability, smoking status, and health insurance status. We employed a logistic regression fully interacted with a city indicator variable to assess if these associations differed by city.

Results: In both cities, less than 50 percent of respondents reported voting in the last election for mayor or city council. About three-quarters of the sample reported food or housing insecurity and the majority of respondents reported utilizing some government assistance, such as supplemental nutrition programs. BMI greater than 30 was significantly associated with lower likelihood of voter turnout compared to those of lower BMI status (marginal effect = −0.10, p = 0.026). Never smoking or quitting was significantly associated with higher likelihood of voter turnout compared to those who reported being a current smoker (marginal effect = 0.10, p = 0.002). Those with health insurance were significantly more likely to report voting compared to those without any insurance (marginal effect = 0.10, p = 0.022). These results did not significantly differ by city.

Conclusions: Our research suggests low-wage workers face significant health burdens which may impact their propensity to vote at the local-level, and these associations do not significantly vary by city despite demographic and political differences between two jurisdictions.

Voting, health and interventions in healthcare settings: a scoping review

BACKGROUND

In democracies, voting is an important action through which citizens engage in the political process. Although elections are only one aspect of political engagement, voting sends a signal of support or dissent for policies that ultimately shape the social determinants of health. Social determinants subsequently influence who votes and who does not. Our objective is to examine the existing research on voting and health and on interventions to increase voter participation through healthcare organizations.

METHODS

We conducted a scoping review to examine the existing research on voting, health, and interventions to increase voter participation through healthcare organizations. We carried out a search of the indexed, peer-reviewed literature using Ovid MEDLINE (1946-present), PsychINFO (1806-present), Ebsco CINAHL, Embase (1947-present), Web of Science, ProQuest Sociological Abstracts, and Worldwide Political Science Abstracts. We limited our search to articles published in English. Titles and abstracts were reviewed, followed by a full-text review of eligible articles and data extraction. Articles were required to focus on the connection between voting and health, or report on interventions that occurred within healthcare organizations that aimed to improve voter engagement.

RESULTS

Our search identified 2041 citations, of which 40 articles met our inclusion criteria. Selected articles dated from 1991-2018 and were conducted primarily in Europe, the USA, and Canada. We identified four interrelated areas explored in the literature: (1) there is a consistency in the association between voting and health; (2) differences in voter participation are associated with health conditions; (3) gaps in voter participation may be associated with electoral outcomes; and (4) interventions in healthcare organizations can increase voter participation.

CONCLUSION

Voting and health are associated, namely people with worse health tend to be less likely to engage in voting. Differences in voter participation due to social, economic, and health inequities have been shown to have large effects on electoral outcomes. Research gaps were identified in the following areas: long-term effects of voting on health, the effects of other forms of democratic engagement on health, and the broader impact that health providers and organizations can have on voting through interventions in their communities.

Factors related to health civic engagement: results from the 2018 National Survey of Health Attitudes to understand progress towards a Culture of Health

Background

Civic engagement, including voting, volunteering, and participating in civic organizations, is associated with better psychological, physical and behavioral health and well-being. In addition, civic engagement is increasingly viewed (e.g., in Robert Wood Johnson Foundation’s Culture of Health action framework) as a potentially important driver for raising awareness of and addressing unhealthy conditions in communities. As such, it is important to understand the factors that may promote civic engagement, with a particular focus on the less-understood, health civic engagement, or civic engagement in health-related and health-specific activities. Using data from a nationally representative sample of adults in the United States (U.S.), we examined whether the extent to which individuals feel they belong in their community (i.e., perceived sense of community) and the value they placed on investing in community health were associated with individuals’ health civic engagement.

Methods

Using data collected on 7187 nationally representative respondents from the 2018 National Survey of Health Attitudes, we examined associations between sense of community, valued investment in community health, and perceived barriers to taking action to invest in community health, with health civic engagement. We constructed continuous scales for each of these constructs and employed multiple linear regressions adjusting for multiple covariates including U.S. region and city size of residence, educational attainment, family income, race/ethnicity, household size, employment status, and years living in the community.

Results

Participants who endorsed (i.e., responded with mostly or completely) all 16 sense of community scale items endorsed an average of 22.8% (95%CI: 19.8–25.7%) more of the health civic engagement scale items compared with respondents who did not endorse any of the sense of community items. Those who endorsed (responded that it was an important or top priority) all items capturing valued investment in community health endorsed 14.0% (95%CI: 11.2–16.8%) more of the health civic engagement items than those who did not endorse any valued investment in community health items.

Conclusions

Health civic engagement, including voting and volunteering to ultimately guide government decisions about health issues, may help improve conditions that influence health and well-being for all. Focusing on individuals’ sense of community and highlighting investments in community health may concurrently be associated with increased health civic engagement and improved community and population health.

Perception of the Effectiveness of Health-related Campaigns among the Adult Population: An Analysis of Determinants

BACKGROUND

Social campaigns focusing on health are commonly used within an attempt to change behavior. To date, there has not been a targeted analysis of societies' general perception about social campaigns. The aim of this study is to assess citizens' opinions on the effectiveness of health-related social campaigns.

METHODS

The data set used in the analysis was obtained from Poland's nationwide "Social Diagnosis" study. The determinants of public opinion were assessed using a multivariate logistic regression. The independent variables included socio-demographic characteristics, lifestyle, social participation, and the use of digital media.

RESULTS

The logistic regression model was developed using 23,593 cases. Opinions about the effectiveness of campaigns depended on all the predictors included in the socio-demographic cluster, smoking, self-declared excessive alcohol consumption, physical activity, the use of mobile phones, and watching TV. A significant impact was found in all but one variable related to social participation.

CONCLUSIONS

The analysis revealed that opinions about social campaigns present in the media "landscape" are influenced by many factors. Interestingly, persons exhibiting unhealthy behaviors are more resistant to health-related campaigns and surprisingly the need to make use of healthcare resources is not accompanied by an acceptance of the interventions.

Tobacco Use as a Health Disparity: What Can Pediatric Clinicians Do?

Tobacco use is a global health crisis, and has a tremendous and negative impact on health and wellbeing. Tobacco use disproportionately affects members of vulnerable populations, and by acting on multiple socioecological levels, serves to perpetuate and reinforce cycles of poverty. Members of the pediatric medical community can play a key role in interrupting cycles of tobacco use. Providers can serve as powerful allies to vulnerable communities by treating tobacco use in caregivers, counseling youth against using tobacco products, protecting children from the impact of secondhand smoke exposure, and advocating for economic, social, and health policies to disrupt intergenerational smoking.