Election campaigns are grueling and combative pitched battles that now grind on for years in an exhausting 24-hour news cycle. The effects of this pressure-cooker environment on the candidates are well-documented – but what of the voters in this highly-polarized United States, circa 2017?

The supporters of President Donald Trump, elected last November, can reasonably expect to have increases in psychological wellbeing, pride and hope for the future, according to a new study. Positive health benefits could come with that optimism, if history is prologue.

But the reverse is true – an increase in stress for Trump opponents that could trigger negative health effects, adds the study, in The New England Journal of Medicine.

The “post-election side effects” meta-analysis looks at more than two dozen studies in major journals looking at the effects of dramatic societal events. A handful looked at the election of Trump, including an assessment conducted in January, which found that Democrats and minorities were much more likely to report lingering stress from the election, according to the American Psychological Association.

But the parallels from the medical literature of past events form most of the basis of the study:

  • A study showing that communities with a higher proportion of Google searches using a slur for blacks predicted higher all-cause mortality, as published in PLoS ONE in 2015.

  • A series of studies claiming adverse health effects among the Middle Eastern communities of the U.S. in the wake of the September 11, 2001 terrorist attacks.

  • A study showing elevated levels of baseline cortisol and stunted responses in laboratory settings among black students at Duke University, in the wake of the 2006 lacrosse scandal that eventually resulted in exoneration of the accused players – and a perceived racial backlash.
  • Lingering health effects among a local Hispanic population, including low birth weights, in the wake of a major 2008 immigration raid in the community of Postville, Iowa.

  • A series of studies in the 1980s documenting the health effects of large cuts in health and social services beginning with the first term of President Ronald Reagan in 1981. The cuts included 1 million people dropped from the food stamps program, 1 million children cut from the reduced-price school lunches, and the reduction of the Women, Infants and Children (WIC) program. Some of the studies documented higher infant mortality, and negative effects among children, pregnant woman, and adults with chronic disease.

  • A 38-state survey of Hispanics found increased rates of mental illness in states that have more exclusionary policies toward immigrants.

These conclusions mean hard times for certain people in the new Trump era, they conclude. The new meta-analysis counsels doctors and other health professionals to be aware of the care they need to provide in the years to come.

“This research predicts that the current sociopolitical climate will negatively affect the mental and physical health of marginalized groups,” they write. “At a minimum, it’s important that health care providers actively work to create safe spaces, where patients’ fears and concerns are listened to and met with compassion and support.”