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"We urge both healthcare workers and community members to show up for the cause."
Quick – think back to your last visit with your healthcare provider. Whether this was an annual checkup with your primary care physician or a followup visit with a specialist, chances are your medical history included questions like, “Do you smoke?” and “How many drinks do you have each week?”
What you probably were not asked is whether you exercise one of your most fundamental rights as an American citizen: the right to vote. We argue that this question is of equal, if not greater, health-related importance than some of the other questions you were likely asked.
If the connection seems a non-sequitur, you’re not alone; many people raise a reluctant eyebrow at the mere mention of civics in medicine. But the inter-connectedness of civics and health is in the data: namely, that civic engagement has a positive impact on health and vice versa, so much so that the American Medical Association has declared that “voting is a social determinant of health and significantly contributes to the analyses of other social determinants of health as a key metric.”
Indeed, voting impacts health through several pathways. Not only can voters cast their ballots for leaders who promise to pursue favorable health policies, and participate in ballot referendums related to specific health issues, but the mere act of voting itself – along with civic engagement more generally – can directly improve one’s physical and mental well-being. Conversely, poorer physical and mental health is associated with reduced civic engagement over time, and states with poorer health outcomes also have less accessible voting practices.
Yet, according to Pew Research Center, only two-thirds of the voting-eligible population cast their votes in the 2020 presidential election – and this was with a veritably historic voter turnout, the highest of any national election since 1990. A closer look at these data over time suggests that even when they do vote, a large proportion of people do so intermittently.
Now what if you had a job that placed you front and center of the political health issues that negatively impact patient care? Such is the case for most healthcare workers, who consistently see the physical results of chronic disease, firearm injuries, and untreated mental illness. Yet, surprisingly, healthcare workers tend to vote significantly less often than the general population, and even less frequently than their colleagues in the legal and teaching professions. Now is the time to change that reality.
This election season, in a nation still rattled by the after-effects of a deadly pandemic, health is prominently on the ballot – and we urge both healthcare workers and community members to show up for the cause. It is time to reverse our troublingly low voter turnout, to protect and promote the health policies that matter to us through re-invigorated civic engagement.
We define civic engagement as all individual and collective actions designed to identify and address issues of public concern; these include voting, letter-writing, volunteering, and running for elected office. Historically, healthcare has been seen as a space outside of civic engagement efforts; yet the National Voter Registration Act of 1993, colloquially known as the “Motor Voter Act,” actually requires health centers serving Medicaid recipients to provide nonpartisan get-out-the-vote support, such as voter registration booths. In more recent years, numerous nonpartisan groups have formed to address the dearth of healthcare workers in the political sphere, such as Vot-ER and Civic Health Alliance, both of which aim to galvanize healthcare workers into increased civic engagement activities.
What can you do to help in the Philadelphia area? At the local level, you can advance your civic engagement simply by spreading the word. Research shows that face-to-face interaction is still the most effective way to convince someone else to vote – so why not use your voice to join a canvassing event in your neighborhood, volunteer with a grassroots organization, or mobilize your own team towards a civic mission that holds particular importance. For instance, in 2020, author and Montgomery County resident JG launched her Propel the Vote campaign in North Wales, an effort to spark enthusiasm for voting by running up and down the streets of the borough, covering both physical and conversational ground. She plans a similar mission this election season, with an augmented focus on health issues like reproductive rights that are acutely at stake.
So this election season, it’s time to respond to the resounding wake-up call to vote like your health depends on it. And if you happen to be a healthcare worker, honor the special role you hold in helping your colleagues and patients vote.
Jessica Grinspan and Dr. Stella Safo
Jessica Grinspan is a freelance writer, researcher, and director of research & outreach at Civic Health Alliance; she also serves as a poll worker during Montgomery County elections.
Dr. Stella Safo is an HIV internist and primary care physician who focuses on health equity and civic engagement to improve health outcomes; she is the co-founder of Civic Health Alliance.
(This letter was submitted to North Penn Now, courtesy of the authors. The views expressed are their own and are not representative of Willow Grove Now.)
