The relationship between the lifestyle health index and voter turnout during the 2020 United States presidential election in the context of regional cultures

Objectives: There are numerous population health challenges confronting the United States (U.S.), including the unhealthy lifestyle – chronic disease pandemics. However, the impact of unhealthy lifestyle behaviors and the increased prevalence of chronic diseases that result from them affect many facets of life outside of the health domain, and their scope remains under-appreciated. The current analysis contributes to addressing this knowledge gap by comparing the newly developed Lifestyle Health Index (LHI) to U.S. county-level voter turnout rates in the 2020 presidential election. Study design: Descriptive, cross-sectional, retrospective analysis. Methods: County-level data on the LHI, percent voter turnout, and the American Nations regional cultures model schematic was used in the current analysis. Results: Pearson correlations between county-level LHI scores and sub scores and Democratic, Republican, and overall voter turnout were all statistically significant and of similar strength (r > 0.63, p