Health visibility in electoral candidate programs: Insights from the ballot box in an Arab Gulf country

Publisher abstract

Gulf Cooperation Council (GCC) countries face substantial burdens from noncommunicable diseases along with high public expectations of health services, yet little is known about whether health is visibly represented in candidates’ declared election programs in this region. This study examined publicly identifiable candidates’ programs from the Kingdom of Bahrain’s Council of Representatives 2022 elections and assessed among candidates with identifiable programs whether the presence of explicit visible health content and candidates’ characteristics are associated with positive election outcomes. A cross-sectional study was undertaken using the complete cohort of candidates in Bahrain’s 2022 elections (N = 336). Election programs were identified from publicly declared materials, and health visibility was coded as present when a program contained an explicit pledge, priority or proposal addressing health services, public health, prevention, health issues, or health related social support. Descriptive data analysis used full cohort of candidates (N = 336) where applicable, whereas analysis of health visibility was conditional on 108 candidates with identifiable programs. Of the 336 candidates, 262 (78.0%) were men and 40 (11.9%) were elected to the council. Among candidates with a publicly identifiable program (108), 88 (81.5%) candidates had visible health content in their identified programs. In Firth penalized-likelihood analysis, women had higher odds of visible health content than men (OR=3.826, 95% profile-likelihood CI 0.943–15.522, p = 0.060). Among program identified candidates (N = 108), the association between visible health content and electoral success was inconclusive (two-sided Fisher’s exact test p = 0.188). This study has systematically quantified the health content visibility in a full candidate cohort from Bahrain’s Council of Representatives 2022 elections. Although exploratory, these findings provide evidence on how health issues are represented in electoral discourse in this Arab Gulf setting and may inform future comparative studies across GCC countries.