Hershey, Pa. was once a one-party town – Republican.
“Way back in the early days, there was an unwritten expectation that the chocolate company workers be registered Republican,” said lifelong resident Lou Paioletti, a Democrat, local historian and Derry Township’s elected tax collector.
Like other communities in the country, the change to its voter composition toward the left has coincided with the growth of the health system headquartered there, according to POLITICO.
Today, the municipality (population 25,000) has never been bluer. “The biggest factor contributing to the change in voter registration, shifting from that ‘one-party town,’ in my opinion is the med center and the College of Medicine,” said Paioletti. “The medical community is extremely diverse, and we know how much the med center and college have grown.”
Penn State Health is the top private employer in Dauphin County, which includes Hershey, with nearly 17,000 employees. As the health system has grown, Hershey — once a Republican stronghold — now has nearly an equal presence of Democrats. From 2010 through 2022, as Penn State Health expanded, Democratic voter registration increased more than 19 percent in Hershey.
“The growth of the healthcare employees in the area is affecting the outcome of Election Day,” David Feidt, Republican Party chair for Dauphin County, told POLITICO. “You can see the shifts in the numbers.”
POLITICO points to Hershey as a microcosm for a trend playing out in Pennsylvania suburbs and across the country, in which physicians are increasingly a reliable Democratic constituency.
The profession skewed Republican in the 1990s and 2000s, when many still worked in small and private practices and shared GOP-aligned business interests. The majority of physicians now work outside of private practices and for integrated health systems, contributing to changing politics along with medical schools’ increased attention to social issues and younger physicians’ progressivism.
“It used to be that doctors were sort of entrepreneurs [who] had their own businesses,” one Hershey physician told POLITICO. “So we are well-paid, blue-collar workers, but we are more cogs in the machine and cogs in the machine prefer Democrats.”
In Pennsylvania, the health care realignment is critical to understanding the political demography of the Harrisburg area, but also Lancaster County, the Lehigh Valley, suburban Philadelphia and Allegheny County, where the anchored University of Pittsburgh Medical Center (UPMC) is the state’s largest nongovernmental employer. According to CRP data, nearly 67 percent of Pennsylvania physicians’ campaign contributions to federal candidates went to Democrats in 2022 (compared to 61 percent to Republicans in 2012).
Voter Registration – November 2016 to September 2023
- Allegheny County – 2016 (D +280,366) | 2023 (D + 253,826)
- Bucks County – 2016 (D + 9,382) | 2023 (D + 4,752)
- Chester County – 2016 (R +18,468) | 2023 (D + 7,813)
- Cumberland County – 2016 (R +29,607) | 2023 (R +26,477)
- Dauphin County – 2016 (D +10,067) | 2023 (D + 11,757)
- Delaware County – 2016 (D + 17,569) | 2023 (D + 56,959)
- Lancaster County – 2016 (R +66,193) | 2023 (R + 64,572)
- Lehigh County – 2016 (D +35,122) | 2023 (D + 28,226)
- Montgomery County – 2016 (D + 56,510) | 2023 (D + 98,766)
Physicians’ leftward shift has coincided with their increased turnout as voters, as quantified in the Journal of the American Medical Association. Historically, physicians voted at a lower rate than the general population.
Younger physicians were trending liberal before the Covid-19 pandemic and the post-George Floyd era. According to a 2019 Stanford University study, the “more recent graduates of medical schools tend to make campaign contributions to Democrats; that is, younger physicians are much more likely to be Democrats than older ones.” Among the study’s examples of this trend were women practicing in lower-paying specialties, such as pediatrics, who were more likely to donate to Democratic candidates.
Next year, when Pennsylvania will repeat its crucial role in the presidential election — in addition to hosting a pivotal U.S. Senate race — the health care suburbs of Harrisburg’s East and West Shore will factor into the final outcome. In a state where winning margins are perennially narrow, suburban communities like Hershey, which shifted from Trump to Biden in 2020, are essential for Republicans to improve their performance.
As new hospitals open in this region and across Pennsylvania suburbs, Republicans confront the reality that physicians are now typically Democrats working in health care systems.
“People in the health care industry don’t see the Democratic Party as it once did as an opponent to the industry but more often as a partner,” said Chris Borick, Muhlenberg College political scientist and pollster.