LAUSR

Elections permit the continuance of democracy and enable economic development, but may have unintended effects on health. By applying a two-part model with regression discontinuity design to administrative health care claims, we determine that elections increased health care use during legally specified campaign periods by as much as 19% for first-time voters. Contrary to earlier studies focusing on mental health, we find higher spending on the treatment of physical health conditions, such as acute respiratory infections, gastrointestinal conditions and injuries. Levels of medical spending during campaign periods were highest in rural areas and among low-to-middle-income men. Using data on campaign spending from local elections, we identify campaign rallies as one important mechanism for the transmission of disease. Our findings provide additional rationale for policies that limit campaign spending on the grounds that it is socially wasteful.