The aim was to study associations between trust in regional politicians responsible for the healthcare system and mortality in survival analyses. A public health survey in southern Sweden with a 54.1% response rate based on a postal questionnaire and three postal reminders was conducted in 2008. The baseline survey was linked to 8.3-year follow-up all-cause, cardiovascular (CVD), cancer and other causes mortality register data. The present prospective cohort study includes 24,699 respondents. Relevant covariates/confounders from the baseline questionnaire were included in the multi-adjusted models. Hazard rate ratios (HRRs) of all-cause mortality were consistently lower for the rather high trust and not particularly high trust respondent categories compared to the very high trust reference category. CVD, cancer and other causes mortality did not display statistically significant results, but all contributed to the significant patterns for all-cause mortality. In some political and administrative settings with longer queueing times for investigation and treatment of some medical conditions including some cancer and CVD diagnoses than officially affirmed, rather high and not particularly high trust in politicians responsible for the healthcare system may be associated with lower mortality compared to the very high trust group.