Voting Behaviour and Health Among the Oldest-old in Germany: Results from a Population-Based Cross-Sectional Study

Abstract

Background If voter turnout reflects social or health inequalities, then these inequalities can reduce equal political representation. Research suggests that poor health impedes voting and contributes to low turnout, especially among the oldest-old (80 years and older). Therefore, we examine the determinants of voting behaviour in more detail, with a special focus on the role of health status among the oldest-old. Methods The analysis was based on a population-based sample of older adults living in Germany’s largest federal state, North Rhine-Westphalia (n = 1826). The outcome was participation in the last federal election. As determinants, we included subjective, functional, mental, and cognitive health; mobility; institutional living; education; social embeddedness; party attachment; habituation; and conformist attitudes. We used logistic regression models to calculate odds ratios and 95% confidence intervals. Results The overall turnout rate was 84.6% (95%-CI:82.9–86.3), which shows that most of the oldest-old participate in elections. Results from logistic regressions revealed that lower formal education and limitations in functional, cognitive, and mental health were associated with lower odds of voting; while habituation, party attachment, and partnership were associated with higher odds of voting. Conclusion Most of the oldest-old in Germany participate in elections. Still, our results hint at the existence of important inequalities in turnout rates. Given that older adults constitute an increasing share of the electorate, and that those who are less likely to vote are often among those most directly affected by political decisions, all individuals who are willing and able to participate in elections should be given the necessary support to actually do so.