University of Alberta School of Public Health, Edmonton, Alberta, Canada.
Health Professions Department, University of San Francisco, San Francisco, California, United States of America.
PLoS One. 2022 Jun 1;17(6):e0267738. doi: 10.1371/journal.pone.0267738. eCollection 2022.
Since the 2010 election, the number of laws in the U.S. that create barriers to voting has increased dramatically. These laws may have spillover effects on population health by creating a disconnect between voter preferences and political representation, thereby limiting protective public health policies and funding. We examine whether voting restrictions are associated with county-level COVID-19 case and mortality rates.
To obtain information on restricted access to voting, we used the Cost of Voting Index (COVI), a state-level measure of barriers to voting during a U.S. election from 1996 to 2016. COVID-19 case and mortality rates were obtained from the New York Times' GitHub database (a compilation from multiple academic sources). Multilevel modeling was used to determine whether restrictive voting laws were associated with county-level COVID-19 case and mortality rates after controlling for county-level characteristics from the County Health Rankings. We tested whether associations were heterogeneous across racial and socioeconomic groups.
A significant association was observed between increasing voting restrictions and COVID-19 case (ß = 580.5, 95% CI = 3.9, 1157.2) and mortality rates (ß = 16.5, 95% CI = 0.33,32.6) when confounders were included.
Restrictive voting laws were associated with higher COVID-19 case and mortality rates.
自 2010 年选举以来，美国制定了大量增加投票障碍的法律。这些法律可能会通过选民偏好与政治代表之间的脱节产生溢出效应，从而限制保护公众健康的政策和资金。我们研究了投票限制是否与县一级的 COVID-19 病例和死亡率有关。
为了获取有关投票限制的信息，我们使用了投票成本指数（COVI），这是 1996 年至 2016 年美国选举期间衡量投票障碍的州一级指标。COVID-19 的病例和死亡率来自纽约时报的 GitHub 数据库（来自多个学术来源的汇编）。多水平模型用于确定在控制县健康排名中的县一级特征后，限制投票的法律与县一级的 COVID-19 病例和死亡率之间是否存在关联。我们测试了关联是否在种族和社会经济群体之间存在异质性。
当包括混杂因素时，投票限制的增加与 COVID-19 病例（β=580.5，95%置信区间=3.9，1157.2）和死亡率（β=16.5，95%置信区间=0.33，32.6）之间存在显著关联。
限制投票的法律与更高的 COVID-19 病例和死亡率有关。
