Content area
Full text
Introduction
Election to public office may lead to accelerated aging due to stress of leadership and political life. A historical examination of medical records of US presidents suggested that they may age twice as quickly as the overall US population. 1 2 A subsequent study that compared survival of US presidents with life expectancy in the overall population found no mortality difference between presidents and others. 3 Although this finding could suggest that nationally elected leaders do not die prematurely, it may also suggest the opposite. Given their higher socioeconomic status, one might expect presidents to live longer than the general population on the basis of known inverse associations between social class and mortality. 4 The fact that presidents do not live longer may suggest accelerated mortality compared with others of similar socioeconomic status.
To investigate this, we compared survival of nationally elected leaders from 17 countries with runner-up candidates who never served in office. We assumed that both types of candidates would be of similar socioeconomic status and baseline mortality risk but differ in exposure to serving as head of government.
Methods
Data sources and overview of approach
We assembled data on elected and runner-up candidates for national elections occurring in Australia, Austria, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, New Zealand, Norway, Poland, Spain, Sweden, the United Kingdom, and the United States, using online sources including Wikipedia and national lists of leaders (table 1 ). Because candidates frequently ran in multiple elections, we selected the last year each candidate ran for office, producing a candidate level dataset.
Country | Elected leaders | Runners-up who did not serve in office | Total | Years | Head of government |
Australia | 21 | 9 | 30 | 1901-2013 | Prime Minister |
Austria | 21 | 32 | 56 | 1945-2013 | Chancellor |
Canada | 16 | 12 | 28 | 1867-2011 | Prime Minister |
Denmark | 15 | 9 | 24 | 1903-2015 | Prime Minister |
Finland | 6 | 8 | 14 | 1919-2012 | President |
France | 22 | 17 | 39 | 1873-2012 | President |
Germany | 7 | 10 | 17 | 1949-2013 | Chancellor |
Greece | 8 | 3 | 11 | 1956-2009 | Prime Minister |
Ireland | 14 | 6 | 20 | 1922-2011 | Taoiseach |
Italy | 17 | 20 | 38 | 1861-2013 | Prime Minister |
New Zealand | 22 | 10 | 32 | 1855-2014 | Prime Minister |
Norway | 9 | 16 | 25 | 1885-2013 | Prime Minister |
Poland | 7 | 14 | 21 | 1922-2011 | Prime Minister |
Spain | 14 | 33 | 47 | 1876-2015 | Prime Minister |
Sweden | 8 | 9 | 17 | 1911-2014 | Prime... |