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Poorer health is linked to a higher proportion of votes for the populist right wing political party, Reform UK, indicates an analysis of the 2024 general election voting patterns in England, published online in the open access journal BMJ Open Respiratory Research.

The findings should prompt policymakers of all political stripes to step up efforts to improve public health and tackle health inequalities, suggest the researchers.

Reform UK secured 14% of votes in last year's UK general election, winning five of the English constituency seats available. And in May this year, it won a substantial number of council seats in local authority elections in England, note the researchers.

Many countries in Europe, and elsewhere, have witnessed a surge in the popularity of similar populist parties, and it's thought that support for them may be linked to both health outcomes and satisfaction with health care services, explain the researchers.

To explore this further, they analyzed parliamentary data from the 2024 general election, including the size of the electorate, number of valid votes, and votes cast for each political party returned in every constituency in England.

They applied two measures of the strength of support for Reform UK: constituencies in England returning a Reform MP compared with those electing an MP from the Labor, Conservative, Liberal Democrats, or Green parties; and the proportion of votes for Reform UK across all constituencies.

They looked at 20 common health outcomes, provided in parliamentary data for each constituency, and based on the NHS performance data from 2022–3.

These were asthma; atrial fibrillation; cancer; chronic kidney disease; chronic obstructive pulmonary disease (COPD); coronary heart disease; dementia; depression; type 2 diabetes; epilepsy; heart failure; high blood pressure; learning disabilities; non-diabetic high blood glucose levels; obesity; osteoporosis; peripheral arterial disease; rheumatoid arthritis; schizophrenia, bipolar disorder, and psychoses; and stroke/mini stroke (TIA) combined.

Analysis of all the data showed that of the 543 constituencies in England, Labor won 347, the Conservatives 116, the Lib Dems 65, the Green Party four, and Reform UK five (total of 537) in the 2024 general election. Constituencies returning an independent MP (five), as well as the constituency of the Speaker of the House, were excluded.

Three of the five areas (60%) returning a Reform UK MP were in the most deprived fifth of the country, compared with 103 (30%) of Labor constituencies. Reform UK areas also had the highest proportions of over 65s: 24% vs. 17% for Labor and 23% for the Conservatives.

The five areas that returned a Reform UK MP had the highest average prevalence of 15 out of the 20 health conditions, the exceptions being atrial fibrillation; cancer; osteoporosis; schizophrenia, bipolar, and psychoses; and non-diabetic high blood glucose.

For example, Reform UK constituencies had an average asthma prevalence of 7.5% and an average COPD prevalence of almost 3% compared with 7% and 2%, respectively, for Labor constituencies.

And these constituencies had an average coronary heart disease prevalence of 4% compared with 3% in Conservative constituencies, and an average depression prevalence of 14% compared with 13% in Liberal Democrat constituencies.

Reform UK's vote share across the country ranged from 0% to 46% in individual constituencies, with positive associations between vote share and the prevalence of 19 of the health measures, seven of which were strong and 10 of which were moderately sized. The strongest associations were for obesity, COPD, and epilepsy.

After factoring in age, sex, and deprivation levels, statistically significant positive associations emerged between Reform UK vote share and the prevalence of 15 of the 20 conditions.

The largest of these was for obesity, where a 10% increase in Reform UK vote share was associated with a +1.5% increase in obesity prevalence.

For each 10% increase in Reform UK vote share, there was a +0.3% higher prevalence of COPD, a +0.1% greater prevalence of asthma, and a +0.1% increased prevalence of depression.

The researchers acknowledge various limitations to their findings. For example, election data came from 2024, while health indicators came from 2022–3, and both health and political sentiment are influenced by long-term trends, which their study didn't capture.

But these findings are in line with those associated with Republican party voting behavior in the U.S. and data on voting patterns for the Far Right in Italy, note the researchers.

And lung health, which is affected by obesity, COPD, asthma and cardiovascular disease, is a key indicator of health inequalities, say the researchers. While the structural determinants of health, such as medical care and housing, are likely to have a role in voting patterns, additional factors are likely to have a role in the UK, they suggest.

"In the UK, the introduction of austerity policies, aggravated by the effects of the COVID-19 pandemic, has contributed to the fact that many people with long-term lung conditions are missing out on basic aspects of care, which may fuel frustration with the status quo," they suggest.

And they conclude, "For Reform UK policymakers, the [analyses] demonstrate that there are profound health issues in their constituencies which should be addressed. For those elsewhere on the political spectrum, these results should provide a further incentive to take steps to improve public health and reduce inequalities."