Part of the wellness ethos is believing that individuals can, to some degree, control their own well-being. But so much of it is actually outside of our direct control. If the air and water is polluted, the medications we need are too expensive, or a pandemic is raging unchecked, there’s only so much we can do to protect ourselves. That’s why voting is one of the most important things individuals can do with respect to their health and happiness.

We are living through challenging times, particularly when it comes to wellness. After 10 months, a global pandemic remains far from under control, having killed more than 200,000 Americans as it continues to take its toll on the physical and mental health of millions more, all while decimating the economy; an ongoing climate emergency means natural disasters occur with ever greater frequency; and a reckoning around racial justice divides the nation. In fact, the country is as divided as it’s ever been.

Each of us most vote to choose the presidential candidate we believe is best positioned to help us overcome these obstacles. An exploration of Donald Trump’s perspectives and policies related to eight key topics reveals the immediate—and potentially continued—impact he has on your overall well-being. (Democratic candidate and former Vice President Joe Biden’s views impact your life, too.) Below, you’ll find a glimpse of how President Trump has shaped his vision for the United States as he courts your vote for re-election.

Before heading to the polls, find out how President Donald Trump views 8 issues related to your health and well-being

1. The pandemic

President Trump messaging around the pandemic is uneven at best. More often than not he has lied about its severity. Privately, on record in multiple interviews with Bob Woodward, one of America’s most venerated investigative journalists, the president expressed distress regarding the significant threat COVID-19 as early as February. (“I wanted to always play it down,” he told Woodward in March, while declaring publicly that the virus would soon “disappear.”) Trump largely left precautions up to individual choice or state and local mandate.

Though the president recently said the virus “affects virtually nobody,” to date, more than 200,000 Americans have died, and the United States has one of highest mortality rates per capita in the world. (After adjusting for population size, the U.S is faring significantly worse in terms than the majority of countries worldwide.) This can, at least to some degree, be attributed to the Trump administration’s continued efforts to minimize the risk. In fact, a study found that the president has been the “single biggest driver” of coronavirus misinformation.

The president is currently holding in-person rallies and has said there will no more shutdowns (although in many places throughout the U.S., some shutdown measures, including bar closures, have never been lifted, and most likely this will remain at the discretion of local leaders).

In March, President Trump signed a coronavirus relief effort, The CARES Act, which provided some Americans with a $1,200 stimulus check, significantly expanded unemployment benefits, and restricted evictions, among other measures. Since the act’s expiration, and in lieu of action by a divided Congress, he and his administration have provided for lesser but still expanded unemployment benefits that require the cooperation of individual states to be fully accessed, temporary student loan relief, and extended eviction bans to last through the end of this year. No support plans for 2021 have been announced.

If Trump is re-elected, it is likely he will shepherd a coronavirus vaccine through to the public. He claims one will be ready soon, possibly even before the election; however, Anthony Fauci, MD, Director of the National Institute of Allergy and Infectious Disease, has said that the earliest one could be available is the end of this year. Initial doses would go to first responders and medical personnel, so rollout to the public likely wouldn’t happen until the spring of 2021. Currently, the FDA is considering tougher guidelines for a vaccine’s release, but Trump says he can overrule them in the interest of expediency. Nine major drug companies have also pledged not to release a vaccine too early, before it’s been proven safe and effective, which could hinder Trump’s desired timeline as well (but is protective of the public).

2. Health care

In September, President Trump released his long awaited answer to the Affordable Care Act (ACA, aka Obamacare), which his administration has asked the Supreme Court to repeal. “President Trump’s Healthcare Vision for America,” however, is not a plan at all. Instead it features essentially what amount to two directives for Congress. The first is to come up with a way of protecting individuals with pre-existing conditions from losing coverage if the ACA is overturned, and the other is to end surprise billing, which happens when you visit a hospital within your insurance network but are treated by out-of-network doctors. (Obamacare already made covering pre-existing conditions the law.) The latter is an actual order, and Congress has until January 1 to figure it out (though they face no consequences for failing to do so). Congress doesn’t have to do anything for people with pre-existing conditions.

In the absence of a replacement plan, if the Supreme Court does repeal the ACA, 133 million people with pre-existing conditions could find themselves uninsurable, 21 million people could lose health coverage, and 12 million people could lose Medicaid. This would happen in the middle of a pandemic, and at a time when many are unable to access insurance through employment. Oral arguments on the case will be heard on November 10.

3. Climate change

President Trump has flip-flopped a bit on the idea of climate change. He called it “a hoax” during his 2016 campaign, later said it was probably real, and then in 2018 cast doubt on his own government’s Fourth National Climate Change Assessment, which predicted that climate change would cost the U.S. hundreds of billions of dollars and negatively affect health. Most recently, he publicly suggested that science doesn’t know whether or not the planet is getting warmer. (It definitely does, and Trump’s own government accepts science supporting that Earth’s climate is warming at an alarming rate.)

Whatever he currently believes, President Trump has prioritized growth in the fossil fuel industry—the biggest source of emissions in the U.S.—over climate change concerns. His administration has expanded oil and gas production in the United States; rescinded many Obama-era environmental regulations; withdrawn from The Paris Agreement, a pact made within the United Nations to take measures to avoid a raise in Earth’s temperature of more than 2 degrees Celsius; and repealed the Clean Power Plan, an Obama-era policy aiming to reduce U.S. emissions by 32 percent by 2030 (replacing it with the less restrictive Affordable Clean Energy Rule).

According to research, Trump’s environmental policies enacted thus far will release an extra 1.85 billion tons of greenhouse gas emissions into the atmosphere by 2035 if they remain unchanged, and at a time when it’s critical we instead reduce our impact. Trump is unlikely to reverse course on environmental policy as he’s been consistent in his support for the fossil fuel industry throughout this first term. (The industry is also a significant donor to his 2020 campaign.) With that said, actual climate change denial is increasingly less popular within the Republican party, so we may expect a shift in messaging—but almost certainly not action—at some point.

4. Equality

LGBTQ+ equality 

Trump doesn’t publicly comment often on subjects related to LGBTQ+ rights; however, the Trump administration has repeatedly moved to limit the rights of transgender Americans. Most notably, the administration banned transgender individuals from enlisting in the military in 2017. It has also allowed single-sex homeless shelters to refuse entrance to transgender individuals. Trump reversed Obama-era protections that allowed transgender students to use bathrooms corresponding with their gender identity, and assigned transgender prisoners housing according to their birth sex. The administration also revoked Obama-era protections against gender identity discrimination in the health-care system. And if the Affordable Care Act is overturned, gender dysphoria could be treated as a pre-existing condition, barring some transgender individuals from receiving health insurance. In other words, the administration has demonstrated a bias even if it has not explicitly stated one.

And when it comes to civil rights debates and protections, the courts play an important role. President Trump has appointed two conservative justices to the Supreme Court, Justice Neil Gorsuch and Justice Brett Kavanaugh, and is attempting to add another, Judge Amy Coney Barrett. This doesn’t necessarily mean that LGBTQ+ rights will be rolled back, however; in June, the conservative majority court decid that LGBTQ+ individuals are protecteded  on the basis of sex under Title VII of the 1964 Civil Rights Act, and that they therefore cannot be fired for their identity. Still, with more conservatives on the Supreme Court, the odds of rights rollbacks increase. The administration has also appointed over 200 conservative federal judges, whose future rulings may roll back rights for the LGBTQ+ community as well.

Racial equality 

As a private citizen and as president, Donald Trump has repeatedly trafficked racist theoriesabout his political opponents and consistently refused to denounce white supremacy. Most recently, he flat-out failed to disavow the Proud Boys at the first presidential debate (and after it), instead telling the extremist hate group to “stand by.” The president does not support recent protests centered around getting justice for Black Americans killed by police. In the wake of the Charlottesville white supremacist “Unite the Right” rally in 2017—where protester Heather Heyer was killed—President Trump famously said there were “very fine people” on both sides of the conflict. Trump has made many comments and held many perspectives—both prior to taking office and while in office—that are racist in nature. He has also said that he does not believe systemic racism exists.

In its first term, the Trump administration did not enact any policies to further the cause of racial equality in America, outside of the First Step Act; instead, it’s made moves that could further racial inequality. Among the many examples: The Trump administration shuttered the Environmental Protection Agency’s Office of Environmental Justice; it repealed the Affirmatively Furthering Fair Housing Act, an Obama-era program which addressed racial segregation in the suburbs; it slashed racial sensitivity training at federal agencies; and it threatened to eliminate funding for schools that taught the New York Times “1619” project, which offers a deep dive into America’s slave-owning past.

The president is credited with stoking racial tensions—through racist comments and “dog whistles” to his white supremacist supporters—throughout his 2016 campaign and first term in office. The FBI found that hate crimes reached a 16-year high in 2018, with a specific increase in anti-Latinx violence tied to President Trump’s repeated attacks on immigrants from Mexico and Central America.

Immigration

Curbing immigration was a cornerstone promise of Trump’s 2016 campaign, and on this, he has delivered. By 2021, legal immigration will have been cut by 49 percent. Admitted asylum seekers and refugees have been significantly reduced in number—for 2020, the Trump administration set a ceiling for refugees that was 84 percent lower than that of the final year of Obama’s presidency. Naturalization processes have slowed and fees for becoming an American have increased.

In 2017, President Trump issued an executive order, the so-called “Muslim ban,” restricting Syrian refugees and immigration from seven Muslim-majority countries. A newer version of this ban was upheld by the Supreme Court as legal in 2018, keeping families separated and refugees stranded. More recently, the Trump administration limited legal protections for those who were brought to America as children, also know as “DREAMers,” even though they have been shown to significantly contribute to the economy. Trump expanded funding for U.S. Immigration and Customs Enforcement (ICE) and the Border Patrol, invested billions into construction of a useless wall along the Mexican border, and expanded immigrant detention infrastructure. That infrastructure has become infamous for housing immigrant children—separated from their parents—under inhumane conditions (“cages”), a humanitarian crisis created by the Trump Administration’s family separation policy. All children were ordered by a federal judge in June of this year to be released due to the coronavirus; however, recent reporting shows that detention is still happening under a secretive new system.

Women’s equality

President Trump’s greatest impact on women’s rights to date regards abortion and contraceptive ​access, but he has also tried to roll back equal pay protections for women, though these efforts were ultimately blocked by the courts, and his administration enhanced the rights of students accused of sexual misconduct, which critics say is a roll back of Title IX protections for assault victims on college campuses. The president’s views on gender equality are not exactly modern either. He has said that parenting is women’s work, for example, and he has regularly pushed back on the #MeToo movement, at one point saying that it’s a “very scary time for young men in America,” urging them to “deny, deny, deny, and push back on these women.” The president has been credibly accused of sexual misconduct (including rape, groping, and harassment) by at least 26 women; he has broadly dismissed these allegations as “fabricated.”

5. Financial wellness

In 2017, President Trump signed the Tax Cuts and Jobs Act, effectively reducing corporate taxes from 35 percent to 21 percent and reducing household tax rates for many Americans; however, those making the most benefitted from the highest reductions (60 percent of savings went to those in the top 20 percent with respect to income) and, in 2019, 21 percent of Americans polled actually said they paid more in income taxes as a result of the Trump Administration’s policies. It also restricted estate taxes to the very wealthy, among other measures. These reductions have resulted in a significant decrease in tax revenues each year since they passed, which has resulted in an increase in the deficit. While this may seem existential, it can ultimately affect the bottom line of individual Americans.

Back in July, Trump promised to have a statement on the minimum wage within two weeks; it never came, and therefore the federal minimum wage remains at $7.25. His administration has sought to restrict Supplemental Nutritional Assistance Program (SNAP) benefits despite widespread unemployment due to the coronavirus. This past January, the administration also moved to reduce Medicaid access.

In response to the coronavirus, Trump signed an executive order allowing student loan borrowers to defer payments until 2021 without accruing interest. In the future, Trump wants to combine all income-driven repayment programs into one program. This would chop undergrad repayment windows down from 20 years to 15 years and and set rates at 12.5 percent of discretionary income (income after bills). He also wants to end existing federal loan forgiveness for public service and nonprofit employees after ten years of payment. Qualifying individuals would instead see their debt forgiven after 15 years. These canceled balances are not currently taxable, but will be under Trump’s plan.

6. Policing and prisons

Amidst unrest in June, Trump signed an Executive Order encouraging some modest police reforms; however, he is running as the “law and order” candidate and does not support calls for defunding or abolishing the police. He has pushed back on groups calling for such things verbally as well as physically, by deploying unidentified, uninvited federal agents with brutal crowd control tactics to places with ongoing protests, including Portland, Oregon. And throughout his first term, he’s expanded investments in policing.

By contrast, Trump has been more supportive of some criminal justice reform. He signed The First Step Act into law, which gave judges more leeway around mandatory minimums, shortened some mandatory sentences, increased compassionate release sentence reductions, improved conditions for federally imprisoned pregnant women, and introduced measures to reduce recidivism (return to prison), and more. He remains in favor of the death penalty, however, and got the courts to resume federal executions early this year. He also supports exploitative private (for-profit) prisons (they support him, too) and is not in favor of eliminating discriminatory cash bail.

7. Reproductive health

In early September, President Trump promised leaders of the anti-abortion movement that he would prioritize dismantling abortion access by appointing conservative judges to the courts, criminalizing doctors who perform abortions, and defunding Planned Parenthood.

In his first term, Trump appointed two conservative justices to the Supreme Court and 200 conservative justices to the federal courts. To fill the seat vacated upon Justice Ruth Bader Ginsberg’s death, Trump nominated pro-life Judge Amy Coney Barrett of the U.S. Court of Appeals for the Seventh Circuit in Chicago. There are currently many abortion-related cases working their way through the court system, and new conservative judges could continue to lead to the rulings in favor of more stringent restrictions we’ve already seen more of in Trump’s first term. Eventually, Roe v. Wade—which guarantees the constitutional right to an abortion—could be severely stripped or even overturned. In fact, significant rollbacks are already happening in many states. (Abortion remains legal in all 50 states.)

Judges appointed and nominated by Trump impact birth control access as well. A court ruling in March, for example, allowed employers to opt out of contraceptive coverage for their employees. In his first term, Trump made changes to Title X—a grant program created by the federal government designed to help increase access to family planning and reproductive health services for low-income people—which, among other things, withdrew funding from major contraceptive resource Planned Parenthood (and redirected it to anti-abortion “crisis” centers, where women receive counseling not to terminate their pregnancies). This was a huge blow for women’s reproductive health overall, as Planned Parenthood provides STI and cancer screenings as a main feature of their services.

8. Gun safety

Over 100,000 Americans have been killed by gun violence since President Trump took office. The most deadly mass shooting in modern American history—in which a gunman killed 58 people and injured at least 850 more in Las Vegas—also occurred during Trump’s first term. Still, apart from a brief stint in 2019 after two mass shootings—when President Trump said he was in favor of tighter background checks—he and his administration have acted against regulations, loosening rules around the export of firearms and the publication of technical information about guns online, for example, and reversing an Obama-era rule which regulated gun purchases for the mentally ill.

Trump is unlikely to change course to enact gun safety legislation. His 2020 campaign website reads: “The Second Amendment to our Constitution is clear. The right of the people to keep and bear Arms shall not be infringed upon. Gun and magazine bans are a total failure. The right of self-defense doesn’t stop at the end of your driveway. That’s why I have a concealed carry permit and why tens of millions of Americans do too. That permit should be valid in all 50 states.” Currently, concealed carry permits are restricted in their jurisdiction. And in an endorsement of Trump’s second-term campaign, the National Rifle Association (NRA) said that Trump had delivered on his promise to protect the second amendment in his first term. The organization donated $30 million to his 2016 campaign and has pledged millions toward his re-election.