Health and the Presidency: Does It Really Matter?

Jeanne Abrams, PhD, is a professor at the University of Denver and the author of "Revolutionary Medicine: The Founding Fathers and Mothers in Sickness and in Health" (New York University Press, 2013). Here she shares an historical perspective on how the physical health of past presidents affected their presidencies.

Presidential candidates Hillary Clinton and Donald Trump have recently been hurling accusations at one another about their respective states of health. Intuitively, one would think that personal health and fitness would play a critical part in determining potential presidential performance in office. But does it really matter? History tells us the answer to the question is: probably not.

James Madison, our nation’s fourth president, was a frail and often sickly man, who also appears to have been at times a hypochondriac. When he was only 21, he confided to a friend that he was unable to formulate firm plans for his future because his experiences led him “not to expect a long and healthy life.” Yet when Madison died in 1836 at the age of 85, he exceeded the life expectancy for males of his era and even for men today. Despite many real health challenges, likely including some form of epilepsy, Madison summoned the stamina to serve two grueling terms in office. He was the first American president to suffer a severe health crisis during a war. Yet, he was a dedicated, brilliant and workaholic president, who emerged from his presidency with a positive image.

In the summer of 1813, as the infamous War of 1812 continued, a worn-down Madison experienced a serious life-threatening illness, probably an acute attack of his recurrent malaria. He was bedridden for three weeks and nursed back to health by his very anxious marital and political partner, Dolley Payne Todd Madison. History came to look favorably on Madison’s tenure. Regardless of their many political differences, in 1817 John Adams wrote Thomas Jefferson that James Madison’s administration, “despite a thousand Faults and Blunders … has acquired more glory and established more Union, than all his three Predecessors [Washington, Jefferson, and Adams] … put together.”

On the other hand, later presidents who were in apparent good health when they took office did not fare as well as Madison. William Henry Harrison caught pneumonia and died on April 4, 1841, only 31 days after taking office. Zachary Taylor died as a result of acute gastroenteritis in 1850, just a little more than a year after his election. And both President Warren G. Harding and President Franklin Delano Roosevelt succumbed to cerebral hemorrhages. Harding had only served two and a half years of his term. Roosevelt died in 1945 during his unprecedented fourth term — but after years of battling the debilitating effects of polio, which had certainly been a significant health disability.

Looking back in history, initial good health did not necessarily confer longevity for our past presidents, nor did chronic illness spell political disaster. Given the uncertainty surrounding personal health issues even in today’s world of modern medicine, it behooves us to spend more time examining the political positions about major issues proposed by our current presidential candidates than worrying about their health.