Healhy Democracy Healthy People

What We Can Do

There are many immediate and long-term opportunities to bolster health and democracy.

Strengthen Democratic Systems

Our democratic systems—including voting and public input in policy—currently leave too many Americans behind, erecting barriers that leave millions unable to exercise their right to vote.

As public health practitioners, we can examine the ways voting policies are linked to health outcomes and support policies such as vote-by-mail and early voting, inclusive registration systems and restoring rights for ex-offenders.

The number one reason people cite for not voting is simply not being being registered. We can help people update their voter registration when they sign up for other government services, just like when they renew their driver’s license. This can be expanded to include more services, including health services such as Medicaid.

Specifically, the Centers for Medicare and Medicaid Services can empower states to encourage people update their registration when they enroll in Medicaid.

Public health offices, clinics, and other settings can provide resources to people on participating in upcoming elections, reaching policymakers, and participating in community meetings on issues that impact health.

Health institutions can also identify ways to incorporate civic engagement into strategic plans, health impact assessments, and other guiding documents to address health equity.

Inform Public Policy with Scientific Evidence

We cannot improve what we cannot measure. Given the critical connection between health and voting, we must do more to measure civic engagement as a health goal at all levels.

Restore Civic Participation to Our National Health Goals

The national Healthy People initiative is a roadmap for achieving national-level health goals over 10 year spans. Measuring and tracking these goals deeply informs local and state-level health plans, including through governments and hospital systems.

We should restore civic participation as one of Healthy People’s goals. Healthy People 2020 included metrics about voter registration and the portion of people who actually voted, from data found in the U.S. Census but these metrics were dropped in Healthy People 2030. It could be immediately restored.

The National Academies of Sciences, Engineering, and Medicine — the Congressionally chartered experts who advise the government on critical science issues — recommended including voting among 34 Leading Health Indicators.

Several public health organizations have already called on the Department of Health and Human Services and the Biden administration to add these measures back in.

Promote Health Through Civic Engagement

Learn about the voting policies in your state and how they correlate with different health indicators.

Educate your community about how important civic engagement is to achieving equitable health outcomes by including voter registration in community outreach, ensuring civic engagement is centered in public policy discussions, and help your institutions support voter participation.

Make civic engagement a year-round activity. Promote participation in town halls, public meetings, volunteer activities, and opportunities to educate community members on issues that will shape local policy and strengthen community cohesion.

Support Additional Research on Civic Engagement & Health

Future research should evaluate the individual and community factors that lead to high levels of civic engagement, seek to better understand the causal relationship between civic engagement and health, and explore what these connections mean for health equity.

We should also develop our understanding of how law and policy are determinants of health and monitor where voting laws and policies have changed to assess the relationship between those changes and health outcomes in those communities.