Our Unhealthy Democracy

The report argues that a negative feedback loop exists in the United States where restrictive voting laws and partisan gerrymandering insulate legislators from accountability, leading to the adoption of policies that exacerbate public health disparities. Using data from America's Health Rankings and the Cost of Voting Index, the author finds that states with greater partisan bias and higher barriers to voting are associated with lower life expectancy and more severe health declines between 2010 and 2017. Specifically, the report links extreme gerrymandering to higher increases in opioid deaths among African Americans in high-poverty states and higher infant mortality for non-Hispanic black communities. To break this cycle, the document recommends reforms to reduce the costs of eligibility (such as automatic voter registration), reduce the costs of casting a vote (such as early in-person voting), and protect the equal value of votes through independent redistricting commissions and public campaign financing.

• There is a positive correlation between electoral integrity and life expectancy in the United States, where greater life expectancy is associated with less electoral bias.
• Partisan bias in redistricting increased significantly after the 2010 Census, particularly in states with unified party control of the legislature, while independent or bipartisan commissions produced less biased plans.
• Health declines between 2010 and 2017 were more severe in states with extreme gerrymandering, as insulated legislatures were less likely to implement equitable health policies such as the expansion of Medicaid.
• In high-poverty states, extreme partisan bias is associated with higher increases in opioid deaths from 2010 to 2017, with the ratio for African Americans being twice as high as for non-Hispanic whites in the most gerrymandered states.
• Infant mortality for non-Hispanic black communities is significantly higher in the most gerrymandered states compared to other populations in higher-poverty states.
• Restrictive voting laws and gerrymandering create a negative feedback loop where less healthy people are further excluded from the political process, preventing the passage of evidence-based health policies.
• The report identifies specific states where life expectancy is declining and voting has become harder, including Alabama, Louisiana, Mississippi, Tennessee, and Wisconsin.
• The 2020 decennial Census is identified as a critical point of vulnerability, with warnings that attempts to include a citizenship question or use administrative data to identify non-citizens could dilute the political power of immigrants and people of color.

APA

Latner, M. (2019). Our Unhealthy Democracy. Union of Concerned Scientists. https://www.ucs.org/sites/default/files/2019-10/our-unhealthy-democracy-white-paper-2019.pdf

Chicago

Latner, Michael. Our Unhealthy Democracy. Union of Concerned Scientists, 2019. https://www.ucs.org/sites/default/files/2019-10/our-unhealthy-democracy-white-paper-2019.pdf.

Wikipedia

{{cite report |last1=Latner |first1=Michael |title=Our Unhealthy Democracy |publisher=Union of Concerned Scientists |date=November 2019 |url=https://www.ucs.org/sites/default/files/2019-10/our-unhealthy-democracy-white-paper-2019.pdf |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{latner2019our, author = {Latner, Michael}, title = {{Our Unhealthy Democracy}}, institution = {Union of Concerned Scientists}, year = {2019}, month = nov, url = {https://www.ucs.org/sites/default/files/2019-10/our-unhealthy-democracy-white-paper-2019.pdf}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }