A Journal of the University of Malta Medical School

Volume 29, Issue 1    (go to table of contents)

Original Article

Life expectancy, mortality and elections: their association during elections in Malta

Elaine Claire Lautier, Kathleen England, Natasha Azzopardi Muscat, Neville Calleja, Dorothy Gauci

Malta Medical Journal, 2017: 1; 5

Introduction: While life expectancy has increased over the past thirty years, such increases have not been constant around election times in Malta. This study seeks to explore the relationship between the time of elections in Malta and specific mortality rates.
Aim: To determine if there is an association between mortality and elections in Malta.
Method: Yearly age specific death rates for all-cause mortality, mortality from ischaemic heart disease, cerebrovascular disease, other heart diseases and all circulatory diseases as well as suicides were calculated from the Malta National Mortality Register for the period between 1985 and 2013. Years when elections and referenda were held between 1985 and 2013 were obtained from the Electoral Commission.1 The years 1985 – 2013 were coded using dummy variables to categorise them into pre-election, post-election, election year or any other year. Data was analysed using Poisson’s regression technique in STATA with Mortality Rate Ratio (MRR) presented as the outcome measure.
Results: A significant increase in overall mortality during election years resulted for circulatory disease MRR 1.058 (p<0.001; 95% CI 1.029-1.087), cerebrovascular disease MRR 1.09 (p=0.002; 95% CI 1.032-1.155) and other heart diseases MRR 1.36 (p<0.001; 95% CI 1.276-1.449). A significant increase was also noted during pre- election years in circulatory disease MRR 1.046 (p=0.002; 95% CI 1.017-1.075) and other heart diseases MRR 1.33 (p<0.001; 95% CI 1.248-1.422) and post-election years for cerebrovascular disease MRR 1.08 (p=0.009; 95% CI 1.020-1.150) and other heart diseases MRR 1.19 (p<0.001; 95% CI 1.108-1.273)) relative to the other years.
Conclusion: This ecological study provides an indication that mortality patterns may be associated with the electoral cycle in Malta. Further research on individual physical and psychological responses to political events, particularly around election time is warranted.


cerebrovascular disorders, heart diseases, life expectancy, Malta, suicide

Full content in pdf