{
  "abstract": "Background Although voting is recognised as a social determinant of health, the association between electoral participation and subsequent mortality at an individual level has not been established.Objective To assess whether voters and non-voters differ in mortality risk.Methods We used register-based information on electoral participation in the 1999 parliamentary elections from the full electorate of at least 30-year-old Finnish citizens living in mainland Finland linked to registers containing sociodemographic and mortality information by Statistics Finland. Mortality was assessed with Cox proportional hazards regression models, with follow-up until the end of 2020 (n=3 185 572 individuals; 58 133 493 person-years; 1 053 483 deaths).Results The age-adjusted HR of non-voters compared with voters for all-cause mortality was 1.73 (95% CI 1.72 to 1.74) for men and 1.63 (95% CI 1.62 to 1.64) for women. These differences were strongest for external causes of death and for younger age groups. Among the older (age ≥75 years) population, voting men had lower mortality than non-voting women. The difference in mortality between non-voters and voters was stronger than between those with basic and higher education.Conclusion Due to a strong relationship, information on voting contributes to a more comprehensive analysis of social differentials in mortality.",
  "authors": [
    {
      "affiliations": [
        "Helsinki Institute for Demography and Population Health, University of Helsinki, Helsinki, Finland",
        "Max Planck – University of Helsinki Center for Social Inequalities in Population Health, University of Helsinki, Helsinki, Finland"
      ],
      "name": "Hannu Lahtinen"
    },
    {
      "affiliations": [
        "Helsinki Institute for Demography and Population Health, University of Helsinki, Helsinki, Finland",
        "Max Planck – University of Helsinki Center for Social Inequalities in Population Health, University of Helsinki, Helsinki, Finland"
      ],
      "name": "Isa Yang"
    },
    {
      "affiliations": [
        "Helsinki Institute for Demography and Population Health, University of Helsinki, Helsinki, Finland",
        "Max Planck – University of Helsinki Center for Social Inequalities in Population Health, University of Helsinki, Helsinki, Finland"
      ],
      "name": "Lasse Tarkiainen"
    },
    {
      "affiliations": [
        "Helsinki Institute for Demography and Population Health, University of Helsinki, Helsinki, Finland",
        "Max Planck – University of Helsinki Center for Social Inequalities in Population Health, University of Helsinki, Helsinki, Finland"
      ],
      "name": "Pekka Martikainen"
    }
  ],
  "title": "Voting is a stronger determinant of mortality than education: a full-electorate survival analysis with 21-year follow-up",
  "uid": "a61ab0d6-e93a-5557-b81e-e25010ba174a"
}