By winning the presidential election, Donald Trump has achieved one of the greatest comebacks in history. Comparable with the return of Napoleon after his exile to Elba, or the ascension of Divus Julius to Caesar of Rome despite being captured for forty days by pirates off the island of Pharmacussa a few years prior, the return of Donald Trump in spite of being convicted of thirty four felonies, facing two impeachments, and currently facing four criminal charges, including conspiracy against the rights of US citizens is nothing short of astronomical.

In the courts, Donald Trump claimed 301 Electoral College votes and even won the popular vote, the first time a Republican presidential candidate has done so since 2004. Factors behind his success are diverse, ranging from discontent over the border crisis and illegal immigration (with the Center for Migration Studies estimating there to be 11.7 million undocumented people residing in the United States as of July 2023) to the issues surrounding foreign policy, particularly US support for Israel’s war on Gaza and involvement in the Russia–Ukraine war.

Intriguingly, unlike previous elections, the age and general wellbeing of the candidates was not front-and-centre for either campaign, nor was it an issue which mattered to American voters. This is in sharp contrast to the previous two presidential races where the wellbeing and overall conditions of the candidates played a crucial role in whom the American electorate would bestow power upon. In 2020, a recurring theme of the Trump campaign was to focus on the age of Biden, with Trump often referring to the former vice-president as “Sleepy Joe” alongside other demeaning descriptions to belittle Biden for his age. Similar tactics were utilised in 2016 to diminish Hillary Clinton’s prospects, such as the sharing of the theory that Clinton was suffering from Parkinson’s Disease, when in fact it was pneumonia which was plaguing her on the campaign trail.

However, this weaponisation of health and wellbeing as a political tool is not a 21st-century phenomenon. Many will remember the response from Ronald Reagan during the 1984 presidential debate with Walter Mondale, when Reagan was faced with the question over whether he, at the age of 73, was too old to be president of the United States, to which Reagan retorted: “I will not make age an issue of this campaign. I am not going to exploit, for political purposes, my opponent’s youth and inexperience.” While still standing as one of the greatest moments in American presidential debate history, it also speaks volumes to the important role that a candidate’s age, and thus wellbeing and health, has on electoral outcomes. Evidently, for the voters of 1984, the health of Reagan mattered less than the health of Clinton mattered to voters in 2016. While Reagan won every state except Minnesota and Washington DC, Clinton’s campaign ended in abject failure.

Alongside age and health, cognitive stability and mental fortitude persist as important factors in presidential races. Not only does the mental wellbeing of the candidates themselves matter—with Biden’s perceived mental decline the catalyst for his decision to step down—but so too does the perceived health of the running mates chosen by the candidates.

An example which illustrates the importance of this can be seen in the 1972 race between Richard Nixon and George McGovern. As a means of appealing to working-class Catholics, Thomas Eagleton was selected as McGovern’s running mate, largely as a result of his devout Catholicism and record as Attorney General in Missouri. After two weeks, he was replaced, after it was uncovered that he had received electroshock therapy for clinical depression in the 1960s. Despite the McGovern–Nixon election being over fifty years ago, the health and wellbeing of candidates remains a vital factor for many American voters, though its influence can vary significantly. In the age of spin and rolling news, a key test of Trump’s team will be how they deal with the issues around the president-elect’s health, as how they answer questions relating to it may serve to define the public perceptions of Trump’s presidency.