Expand the Vote, Advance Health Equity

By Martha Ockenfels-Martinez

Access and support for full voter engagement is key for our collective health.

As of March 24th of this year, 361 bills have been introduced in state legislatures around the country that would restrict voting. The bills range in methods, yet the consequences would be the same: voting rights destroyed and widespread voter disenfranchisement. Thankfully, communities, voting rights advocates, and elected officials are working on passing two federal bills, the For the People Act and the John Lewis Voting Rights Advancement Act, to ensure the people’s right to vote. So what does this have to do with public health?

Voting creates the conditions for our health

Voting matters for our collective health. The representatives we vote into office have the power to design laws to regulate the safety and health of our air, our water, and our food. Elected officials also make laws about housing, education, employment, and immigration; as well as policies related to voting rights, and the criminal legal system — all elements that shape health. Who we elect into office also has wide-ranging impacts on the health of children and families globally, as we are seeing play out in devastating real-time right now.

Voter turnout in 2020 and subsequent attempts at voter suppression impact health equity

In the past year, voting rights have been under attack. On January 6, we saw the assault on the Capitol with a reactionary contingent’s failed attempt to reject the country’s democratically elected president. Now, our country faces 361 bills aimed at voter suppression.

But we’ve also seen powerful displays of community mobilizing to protect the vote. In 2020 more people turned out to vote in a presidential election than ever before. Nearly 160 million people voted, with two-thirds of eligible voters turning out — the highest turnout rate since 1900. This is due to the work of Black, Indigenous, Latinx, people of color, immigrant community organizers, voting rights activists, as well as years of community-led work to create important voting rights practices like same-day voter registration and mail-in ballots.

Voting matters for individual health

The act of voting itself is important for our individual health. Voting is one way we can practice our power as individuals. When we practice our power and agency and are able to make choices about how we live our lives, we benefit mentally, emotionally, and physically. Some researchers call this self-efficacy, others call it autonomy, and my mentor calls it control over destiny. And voting is one way we can put these concepts into practice.

Researchers have found evidence of the health-boosting effects of personal agency in various studies. One famous study by Sir Michael Marmot found that people in the same social class had different health outcomes based on how much agency and choice they had at their jobs. People that had more autonomy in their jobs had better health.

On the flip side, research has also shown that people with too much power lose critical emotional skills. Their mental health and emotional health suffers with the excess unchecked power, even causing their brains to change.

This is why power is best shared — and why community organizers and researchers alike uplift the concepts of community empowerment, collective agency, and the power of the people — as these are all practices that create shared power throughout a community.

Voter disenfranchisement is a tool of racism and oppression

Voter suppression and disenfranchisement have historically been tools of racial oppression and white supremacy. To this day, various voter suppression tactics, including voter roll purges, redistricting, voter ID laws, and the way incarcerated people are counted in the census (sometimes called prison gerrymandering) suppress and erase the vote of Black people, Native Americans, immigrants, and other people of color.

It’s estimated that 5.2 million Americans were disenfranchised in the 2020 presidential election due to laws restricting voting rights for those who are currently or formerly incarcerated. As the criminal legal system targets Black, Brown, Native, and poor communities, these same communities experience high levels of disenfranchisement which in turn deepens and perpetuates health inequities. Taking away someone’s right to vote when they are currently or formerly incarcerated is a continuation of the racist and sexist legacy of voter disenfranchisement in this country.

It doesn’t have to be this way. States can support the enfranchisement of their communities by strengthening voter protection laws. For example, in Vermont and Maine, as well as in many other countries like Canada and Norway, a person never loses their right to vote while incarcerated.

Disenfranchisement affects our health

Studies have found that disenfranchisement affects our collective society. One study analyzed the impact that voting inequities — differences in voting participation based on family income and education — had on voter turnout. In states that voting participation rates differed greatly based on income and education, residents were more likely to have poorer self-rated health. In states that had more equality in voting participation, people had better self-rated health.

Another study found that the disenfranchisement of the Black community can reduce voting participation of eligible Black voters overall — which is why voting rights and enfranchisement for everyone is key for voting equity and health equity. And in states with more inequity in power (with voter turnout as one of the measures of power), there was more environmental degradation and worse health impacts for people.

Creating access and support for full voter engagement is key for our collective health. Public health professionals are tasked with creating a world where every person has what they need to thrive — and crucial to this vision is making sure everyone has access to the vote.

How public health can support voting rights and our collective health

• Register people to vote in public health spaces like hospitals, community centers, and clinics. In 2008 the nonpartisan Rx: Vote Campaign registered twenty-six thousand voters at clinics and community health centers nationwide. Alameda County Votes Initiative was conducted to learn about what the county public health department could do to increase voter participation rates in the 2016 elections, especially among low income communities, communities of color, and historically disenfranchised groups. Current community health COVID-19 vaccination strategies could also include voter registration and civic engagement awareness.
• Learn more about HR1/SR1, the For the People Act, being considered in Congress. The Act includes automatic voter registration, expanded voter access, an end to partisan congressional gerrymandering, and campaign finance reforms. The Act would also help fight the 361 voter suppression bills across the country. If you’d like to volunteer with West Virginians for Democracy, Focus 2020, Common Cause, and Represent Us to pass this bill, check out volunteer info here.
• Learn more about HR4, the John Lewis Voting Rights Advancement Act, being considered in Congress which would protect voters from voter suppression and racial discrimination.
• Read about 5 Ways Health Departments Can Help Ensure Healthy Voting.

Support voting rights in your state

• Vote against voter ID laws that disenfranchise people. And if you live in a state with strict voter ID laws, support organizing efforts to make sure everyone can vote.
• Vote for state and national candidates that will restore the vote for currently and formerly incarcerated people.
• Make sure all people in your community have the resources they need to fully participate in voting. This includes access to ballots, the polls, voter guides, etc. This also includes making sure folks in jail or prison who are eligible to vote, have access to voting resources and polls. Check out what Chicago is doing to make sure all folks who can vote have access by making a local jail a polling place.
• Support the District of Columbia’s statehood. The entire District of Columbia is disenfranchised. Learn more here about how this is a matter of racial justice for the 50% Black district, and call your congressperson to voice your support for legislation D.C.

This post contains some reflections on the social epidemiology of voting and health covered previously in Restore the Vote for Health Equity.

Martha Ockenfels-Martinez is a Research Associate at Human Impact Partners. She supports the research needs of community partners across the country that are advancing equity and justice. She brings her background in local and state policymaking, community organizing, and advocacy to her work at HIP.

📌 Did you know? Human Impact Partners provides health equity capacity building to public health organizations. Contact us to learn more about our offerings at info[at]humanimpact.org