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By Hannah Millington
Health Reporter
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Voting behavior in elections and an individual’s future risk of death have a "strong association." In fact, it’s a stronger determinant of mortality than education, according to researchers from the University of Helsinki in Finland.
While voting in national and local elections has already been recognized as a social determinant of health—with voters generally thought to have better health profiles than non-voters—the link between electoral participation and death has not been established.
With this in mind, the researchers analysed data on participation in the 1999 Finnish parliamentary elections and associated registers by Statistics Finland containing sociodemographic and mortality information.
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“The mortality difference between voters and non-voters was larger than between those with basic and tertiary education. Such an observation suggests a strong association between voting and mortality, given that a substantial education gradient in mortality is among the most robustly established sociodemographic mortality patterns,” the study authors wrote in the paper.
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The study included more than 3,185,500 people (with voter turnout of 71.5 percent among men and 72.5 percent among women), tracking their survival from election day on March 21, 1999 to the day of death or the end of 2020, whichever came first.
In total, 1,053,483 people died; 95,350 deaths from external causes (accidents, violent and alcohol-attributable causes), and 955,723 from other underlying causes. 2,410 people whose cause of death was not known were excluded from the final analysis.
Not voting was consistently associated with a 73 percent heightened risk of death from any cause among men and a 63 percent heightened risk of death among women, the researchers discovered.
After adjusting for their education level, this was reduced to a 64 percent heightened risk among men and a 59 percent heightened risk among women.
The difference in mortality between non-voters and voters was stronger than between those with basic and higher education. These differences were strongest for external causes of death and for younger age groups.
When adjusting for age, the risk of death was twice as high among both men and women who did not vote than it was among those who did.
The disparity in relative mortality between voters and non-voters was most pronounced among men under 50. Meanwhile, among 75 to 94-year olds, women who did not vote had a higher risk of death than men who voted, but the opposite was the case for younger age groups.
Among men in the lowest 25 percent of household income, the risk of death associated with not voting was 9–12 percent higher than for other income groups.
With this being an observational study, the study authors acknowledged that “a limitation of this study is that it cannot adequately distinguish the direction of causation, health and the risk of death. Additionally, individuals may encounter obstacles preventing voting or choose not to vote in any one election.
“Thus, future longitudinal studies with repeated measurement of participation in multiple elections and of health could better establish causal associations and reduce noise in detecting stable voting habits.”
However, regardless of the exact causes, “the strong association between voting and mortality that acts independently of education supports the claim that voting is a valuable complementing factor in the social determinants of health research.”
And, explaining how these findings might affect future research or policy, they added, “Owing to a strong association between electoral participation and future mortality, information on voting may be valuable in clinical settings and in monitoring population wellbeing, health and health disparities.”
Newsweek has reached out to the researchers for additional comment.
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Reference
Lahtinen, H., Yang, I., Tarkiainen, L., & Martikainen, P. (2025). Voting is a stronger determinant of mortality than education: A full-electorate survival analysis with 21-year follow-up. Journal of Epidemiology & Community Health. https://doi.org/10.1136/jech-2025-224663
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