Work by Arline Geronimus, John Bound, Javier Rodriguez, and Danny Dorling indicates that excess mortality among African-Americans could be both a cause and an effect of political processes. In particular, since blacks tend to vote Democratic, a more equal mortality rate might mean that some key close elections won by Republicans might have gone to Democrats instead. And since elected officials influence policies and programs, this outcome has implications for factors that affect the disproportionate death rate in the first place. Geronimus says: “The point is not so much the specific number of elections that would have gone one way or the other. What it does tell you is that … this health inequity does help silence black voices in the electorate.”

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