Healthy citizens, healthy democracies? A review of the literature

Abstract

A growing literature over the past 10 years on health and political behavior has established health status as an important source of political inequality. Poor health reduces psychological engagement with politics and discourages political activity. This lowers incentives for governments to respond to the needs of those experiencing ill health and thereby perpetuates health disparities. In this review article, we provide a critical synthesis of the state of knowledge on the links between different aspects of health and political behavior. We also discuss the challenges confronting this research agenda, particularly with respect to measurement, theory, and establishing causality, along with suggestions for advancing the field. With the COVID-19 pandemic casting health disparities into sharp focus, understanding the sources of health biases in the political process, as well as their implications, is an important task that can bring us closer to the ideals of inclusive democracy.