News Release 

Major political events linked to mood decline among young US doctors

Findings support left leaning political affiliation among physicians in recent years

BMJ

Major political events, such as the 2016 presidential election and inauguration, were associated with declines in mood among young US physicians, finds a study in the Christmas issue of The BMJ.

Events with outcomes in line with conservative political ideologies were associated with a mood decrease, while those with outcomes in line with liberal political ideologies were followed by a mood increase, supporting evidence that young physicians may increasingly identify as liberal, particularly around factors such as gender, ethnicity, and nationality, say the researchers.

Women were particularly affected by the election results, suggesting that the political discourse surrounding issues of gender and sexism throughout the presidential campaign may have disproportionately affected women, they add.

Medical internship (workplace training after medical school) is associated with a considerable increase in stress and depression, but the potential impact of external factors - including politics - on the mood of young US physicians is unknown.

As debates about healthcare and other politicised social issues have become increasingly prominent in recent years, researchers at the University of Michigan set out to study the effects of political events on mood among young physicians.

The findings are based on 2,345 first year medical interns (equivalent to a foundation year 1 doctor in the UK) who provided daily mood data between 2016 and 2018 as part of the Intern Health Study.

The researchers identified nine political events including the 2016 presidential election and inauguration, the Muslim travel ban, and US-Mexico border wall funding, and eight non-political events including the Super Bowl, Hurricane Irma, and a mass shooting at a Florida high school.

Average mood was measured the week after each event and compared with average mood over the preceding four weeks.

After taking account of potentially influential factors, interns reported statistically significant changes in mood following six of the nine political events.

The largest declines in mood were seen after the 2016 presidential election and subsequent inauguration, with women reporting more than twice the mood decline as men after both these events.

The ban on travel from Muslim majority countries and confirmation of Brett Kavanaugh to the Supreme Court were also associated with notable drops in mood.

The drop in mood associated with the presidential election was greater than that seen with the start of internship, suggesting that even with the high demands and time constraints of internship, young US physicians were engaged with broader social events, note the authors.

However, no difference in mood was seen with the failure to repeal the Affordable Care Act in the US Senate, the deployment of troops to the Mexico border to meet a large migrant caravan, or the 2018 midterm elections.

And the non-political events included in the analysis were not associated with a change in mood.

The researchers say the results may not apply to all doctors or to other young, politically liberal populations, and they can't rule out the possibility that other events affecting mood may have had an influence.

But they say these findings "signal that politics and medicine may interact in strong ways in the current era of medicine and that we should carefully consider their implications for young physicians and their patients."

Future studies should examine whether similar dynamics are playing out for young physicians in other countries, they add. In the UK, for example, there may also be emotional consequences for physicians increasingly concerned about the ramifications of Brexit for themselves and their patients, they write.

In an accompanying article, Joanne Silberner, features editor at The BMJ, brings together some of US President Donald Trump's tweets and quotes on various health issues.

She notes his swing from being an antivaxer to promoting vaccination, his "easy fixes" for the notoriously complicated US health system, and his rally cry on curing AIDS and cancer.

According to Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, Trump's advice on health concerns "could place others at risk if they follow it."

What's more, Trump's changing views "simply create confusion and can be harmful," he adds. "We know that even when a correction of a false message comes from the same source, some people will simply believe even more strongly in the incorrect one."

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Peer-reviewed? Yes (research); No (feature)
Type of evidence: observational; opinion
Subjects: US physicians; President Trump tweets and quotes

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