Voting Behavior of Physicians and Healthcare Professionals

Introduction: Physicians and other healthcare professionals have critical expertise and important experiences to help shape public policy, yet, historically, have been less likely to engage in the political process as measured by their propensity to vote. We examine whether previous trends in low physician voter turnout persist, contrasting to similar occupational groups and the general population. Methods: Data were from the 2004-2018 Current Population Survey (CPS) November Voter Supplement, a biennial nationally representative household survey that collects self-reported or reports by proxy (household member) voting rates and behavior from congressional and presidential elections. We identified five representative healthcare professionals (physicians, dentists, pharmacists, registered nurses, physician assistants) and five other comparison professions (postsecondary teachers, chief executives, civil engineers, social workers, lawyers) selected by similarities in income or educational backgrounds. Adjusted risk ratios (aRR) were estimated from multivariable logistic regressions comparing voting rates and behavior across occupations controlling for the year and sociodemographic characteristics associated with voting. Results: The pooled sample of US citizens age 18 and older (N=750,236) included 3,009 physicians, mean age 47.6 (SD, 14.9) years, 33.5% women. Household-level response rates ranged from 84%-92%. Physicians and other healthcare providers were significantly less likely to vote than comparison professions or the public after controlling for characteristics associated with voting. Compared to the public, adjusted physician voting rates were 12% lower than expected: aRR of 0.88 (95% confidence interval [CI], 0.83- 0.92) whereas comparison professions all demonstrated significantly higher voting rates, with postsecondary teachers showing the highest rates, aRR 1.18 (1.14-1.21). Physicians were 30% more likely to vote by mail, aRR 1.32 (1.12-1.42), and 15% more likely to vote before election day, aRR 1.15 (1.06- 1.25). Physicians who did not vote or register were 70% more likely to report this was due to being “Too busy, conflicting work or school,” compared to the public, aRR 1.7 (1.36 -1.96). Conclusion: Over 2004-2018, adjusted analysis find physicians and other healthcare professionals were significantly less likely to vote, whereas comparative professions were more likely to vote than the general public. Physicians were more likely to vote using alternatives to poll-based voting (voting early, vote by mail) and more likely to miss voting and registration due to work conflicts.