trump voters are correlated to worsening health outcomes, in a world where almost everyone else has health outcomes getting better.
It is hard to say whether the trump voting is causing the worsening health outcomes, or whether the worsening health outcomes are causing the trump voting. Maybe both are caused by a third issue.
The worsening health outcomes are caused by a huge number of different bad personal health decisions. There just feels like there should be one cause of all those bad personal health decisions.