IM ALL RIGHT, JOHN - VOTING-PATTERNS AND MORTALITY IN ENGLAND AND WALES, 1981-92

Objective-To investigate the association between voting patterns, depr ivation, and mortality across England and Wales. Design-Ecological stu dy. Setting-All the electoral constituencies of England and Wales. Mai n outcome measures-Combined and sex specific standardised mortality ra tios.Results-For the years surrounding the three elections of 1983, 19 87, and 1992 overall standardised mortality ratios showed substantial negative correlations of -0.74 to -0.76 with Conservative voting and s ubstantial positive correlations of 0.73 to 0.77 with Labour voting (a ll P<0.0001). Correlations were higher for male than female mortality. Conservative voting was strongly negatively correlated (r = -0.84) wi th the Townsend deprivation score, while Labour voting was positively correlated (r = 0.74) with this. Labour and Conservative voting explai ned more of the variance in mortality than did the Townsend score. In multiple regression analyses for the 1992 election Labour voting (P<0. 0001), Conservative voting ((P<0.0001), the Townsend score (P = 0.016) , and abstentions (P = 0.032) were all associated with mortality. Labo ur and Conservative voting explained 61% of the variance in mortality between constituencies; when Townsend score and abstentions were added this increased to 63%. Conclusions-Conservative and Labour voting are at least as strongly associated with mortality as is a standard depri vation index. Voting patterns may add information above that provided by indicators of material deprivation. People living in better circums tances and who have better health, who are least likely to require une mployment benefit and free school meals or to rely on a state pension in old age, and who are most able to opt out of state subsidised provi sion of transport, education, and the NHS, vote for the party that is most likely to dismantle the welfare state.