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How voter turnout varies between different chronic conditions? A population-based register study
  1. Reijo Sund1,2,
  2. Hannu Lahtinen1,
  3. Hanna Wass3,
  4. Mikko Mattila3,
  5. Pekka Martikainen1,4,5
  1. 1Department of Social Research, University of Helsinki, Helsinki, Finland
  2. 2Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
  3. 3Department of Political and Economic Studies, University of Helsinki, Helsinki, Finland
  4. 4Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden
  5. 5The Max Planck Institute for Demographic Research, Rostock, Germany
  1. Correspondence to Professor Reijo Sund, Department of Social Research, University of Helsinki, P.O. Box 18, Helsinki FI-00014, Finland; reijo.sund{at}


Background While poor self-rated health is known to decrease an individual's propensity to vote, disaggregation of the components of health on turnout has thus far received only little attention. This study deepens on the understanding of such relationships by examining the association between chronic diseases and voting.

Methods The study uses an individual-level register-based data set that contains an 11% random sample of the entire electorate in the 1999 Finnish parliamentary elections. With information on hospital discharge diagnoses and reimbursements for drugs prescribed, we identify persons with chronic hospital-treated diseases (coronary heart disease, chronic obstructive pulmonary disease (COPD) and asthma, depression, cancer, psychotic mental disease, diabetes, cerebrovascular disease, rheumatic disease, epilepsy, arthrosis, alcoholism, dementia, atherosclerosis, Parkinson's disease, other degenerative brain diseases, multiple sclerosis and kidney disease).

Results After adjusting for gender, age, education, occupational class, income, partnership status, cohabitation with underaged children and hospitalisation during Election Day, neurodegenerative brain diseases had the strongest negative relationship with voting (dementia OR=0.20, 95% CI 0.18 to 0.22; others up to OR=0.70). Alcoholism (OR=0.66) and mental disorders also had a negative association (depression OR=0.91; psychotic mental disease OR=0.79), whereas cancer and COPD/asthma had a positive association (both OR=1.05). Having more than one condition at a time further decreased voting probability.

Conclusions By showing how different health conditions are related to voter turnout, this study provides essential information for identifying gaps in the potential for political participation and for further inquiries aiming to develop models that explain the link between health and voting probability.

  • Epidemiology of chronic diseases
  • Social activities

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  • Contributors RS, HL, HW, MM and PM were involved in conception of the study. HL, HW, MM and PM were involved in acquisition of data. RS and HL were involved in analysis of the data. RS was involved in drafting the manuscript. HL, HW, MM and PM were involved in revising the manuscript critically for important intellectual content. RS, HL, HW, MM and PM were involved in approval of the version of the manuscript to be published.

  • Funding Suomen Akatemia (grant numbers 266844, 273433).

  • Competing interests None declared.

  • Ethics approval Statistics Finland. Permission to use the data for research purposes: TK-53-1519-09.

  • Provenance and peer review Not commissioned; externally peer reviewed.