An ecological investigation recently published in the open-access journal BMJ Open Respiratory Research reveals a compelling association between poorer population health outcomes and increased voting support for Reform UK, a populist right-wing political party in England. This study, conducted in the context of the 2024 general election, emphasizes the critical intersections of public health and political behavior. It highlights the urgent necessity for policymakers across the political spectrum to address health disparities and enhance public health infrastructure to mitigate the underlying social determinants influencing electoral patterns.
Reform UK, which secured approximately 14% of the vote share in the 2024 UK general election, successfully won five English parliamentary constituencies. This electoral success was further extended through substantial gains in local council elections during May 2025. The findings suggest that constituencies with higher Reform UK support may concurrently exhibit worse health metrics, a trend observed not just in the UK but mirrored in other European countries experiencing surges in populist party popularity. These phenomena prompt critical questions about the role health status and healthcare satisfaction play in shaping political affiliations and voting behavior.
The researchers employed a quantitative ecological study design, utilizing parliamentary electoral data alongside NHS-derived health statistics from 2022 to 2023. This comprehensive dataset encompassed detailed voting outcomes across England’s constituencies, integrating sociodemographic variables such as electorate size and valid votes, as well as health indicators spanning 20 prevalent conditions. The dual metrics of Reform UK support measured were: the actual elected parliamentary representation and the proportional vote share across all constituencies.
Among the health outcomes considered, the investigation focused on chronic and acute conditions including asthma, chronic obstructive pulmonary disease (COPD), coronary heart disease, depression, type 2 diabetes, dementia, and obesity, among others. These health indicators provide a multi-dimensional view of population well-being and chronic disease burden, drawing from the NHS performance data to map health disparities geographically against political tendencies.
A key finding of this study is that three of the five constituencies electing Reform UK MPs ranked within the bottom 20% of the most socioeconomic deprived areas in England. This contrasts with about 30% of Labour-held constituencies falling into this deprivation bracket, signifying a pronounced socio-political stratification. Furthermore, Reform UK constituencies had significantly older populations, with nearly a quarter of residents over 65 years of age, compared with lower percentages in both Labour and Conservative seats, underscoring the demographic nuances shaping political landscapes.
In these Reform UK constituencies, the prevalence of 15 out of the 20 selected health conditions exceeded the averages recorded in areas represented by other major parties. For instance, the average asthma prevalence was noted at 7.5%, and COPD near 3%, figures notably higher than those observed in Labour constituencies, which reported 7% and 2% respectively. Similarly, coronary heart disease rates in Reform UK areas reached 4%, surpassing the 3% average in Conservative strongholds, while depression affected 14% of residents, higher than those in Liberal Democrat constituencies.
The analysis further underscores a consistent positive correlation between Reform UK vote share and nearly all tested health conditions, with the strongest associations identified for obesity, COPD, and epilepsy. Notably, the data reveal that for every 10% increase in Reform UK voting share, there was a corresponding 1.5% increase in obesity prevalence, a 0.3% rise in COPD prevalence, alongside marginal increases in asthma and depression rates.
Importantly, after statistically adjusting for age, sex, and socioeconomic deprivation, these associations remained significant for 15 of the 20 health conditions studied. This adjustment underscores that the relationship between poorer health and voting patterns for Reform UK is not solely driven by demography or deprivation but is robust across several health indicators, signaling potential underlying structural and social mechanisms influencing political behavior.
The study acknowledges inherent limitations in its ecological design. Temporal discrepancies between health data (2022-2023) and election results (2024) could introduce bias, as both health and political preferences evolve over time and are shaped by complex, long-term trends that the study could not fully capture. Despite this, the findings resonate with parallel research connecting health outcomes and populist political support in international contexts, such as Republican voting patterns in the United States and far-right party support in Italy.
Central to the authors’ interpretation is the role lung health conditions—such as COPD and asthma—and their association with obesity and cardiovascular diseases, serving as sensitive barometers for health inequality. These conditions’ disproportionate prevalence in Reform UK constituencies may reflect systemic failures in healthcare access and quality, housing, environmental factors, and social infrastructure, which collectively erode community well-being and foster political discontent.
The researchers speculate that austerity policies, intensified by the COVID-19 pandemic’s multifaceted impact, have exacerbated healthcare disparities in the UK. Many individuals with chronic lung diseases reportedly face gaps in fundamental care, amplifying frustrations and potentially driving increased support for populist movements promising change. This dynamic suggests that health inequalities and political outcomes are profoundly interlinked, and addressing one necessitates engagement with the other.
Concluding their analysis, the study’s authors emphasize that Reform UK policymakers should recognize the profound health challenges within their constituencies and prioritize addressing these to improve constituents’ quality of life. Similarly, political actors across the ideological spectrum are urged to consider these findings as a clarion call for renewed commitments to public health advancement and the eradication of entrenched health inequities that not only undermine societal welfare but also shape political landscapes.
By delineating the intersection of health disparities and political behavior, this ecological study presents a nuanced perspective on the sociopolitical determinants of electoral outcomes. Its insights underscore the imperative for integrated policy solutions that bridge health and political domains to foster healthier, more equitable, and politically stable communities across England.
Subject of Research: People
Article Title: What is the relationship between population health and voting patterns: an ecological study in England
News Publication Date: 14-Oct-2025
Web References: 10.1136/bmjresp-2025-003526
Method of Research: Observational study
Keywords: Political science, Demography, Economics, Chronic obstructive pulmonary disease, Asthma, Obesity, Cardiovascular disease
