Voting as social determinant of health

Voting as social determinant of health

Second-year medicine student Ashonti Wright, president of the student group Affecting Social Justice in Medicine, shared the following essay:

The 2024 general election is scheduled for Tuesday, Nov. 5, with early voting beginning in October. The election is especially significant citizens will vote for the next president of the United States.

Voting is not merely a civic duty or a political right; it is also a critical social determinant of health that significantly impacts well-being and equity within societies. The ability to participate in the electoral process and have a voice in shaping policies and leadership directly correlates with various aspects of health outcomes and access to health care services.

In the 2020 election, roughly 12.8 million eligible voters were registered but did not cast their votes. The non-voters primarily reflected marginalized groups, including people of color, youth, low-income and those without a bachelor's degree. These groups often experience poorer health due to limited access to resources. Research shows that reduced voting access correlates with worse health outcomes, leading to inadequate representation for vulnerable and chronically ill individuals. This cycle perpetuates health disparities, diminished political influence and policies that neglect marginalized communities.

In 2022, the American Medical Association recognized voting as a social determinant of health, emphasizing the need for health care systems to address voting access. To address this social need, health systems must comprehend how voting influences downstream social determinants and explore strategies to enhance voting access within healthcare settings.

Voting influences the implementation of health policies and initiatives. Elected officials who prioritize public health issues such as access to affordable health care, disease prevention and health equity can significantly improve the overall health of communities. By electing representatives who champion health care reforms and allocate resources to address social determinants of health like poverty, education and housing, citizens contribute to creating healthier environments for everyone.

The democratic process plays a crucial role in addressing health disparities and promoting health equity. Marginalized communities, including racial and ethnic minorities, low-income individuals and those with limited access to health care services, often face disproportionate health challenges. Through voting, these communities can advocate for policies that address systemic inequalities, promote inclusivity in health care services, and work towards eliminating barriers to accessing quality care.

As a member of NEOMED's Affecting Social Justice in Medicine (ASJM) student group, our objective is to empower its members to champion culturally sensitive care by establishing a platform that educates on social determinants of health in order to enrich students' pre-professional preparation with valuable experiences. Health systems are in a prime position to tackle disparities, aided by federal laws that authorize such actions. Health care professionals can initiate nonpartisan discussions about voting within their clinical settings. They can assist both their peers and patients in registering to vote, and utilizing resources provided by nonprofit organizations like Vot-ER, which is a nonpartisan, nonprofit organization that works with health care workers directly, providing them with tools necessary to register their patents to vote with a scan of a QR code.

Empowering those who are unrepresented is of upmost importance. Voter engagement and participation can lead to increased awareness and education about health-related issues and initiatives to raise public awareness about various health concerns, such as mental health stigma, chronic disease prevention and reproductive rights. This awareness can empower individuals to make informed decisions about their health, seek preventive care and actively engage in health-promoting behaviors. We should also acknowledge that these same marginalized groups do vote but remain underrepresented, according to the U.S. Census Bureau's Current Population Survey's (CPS) November Voting and Registration Supplement for the 2022 election. This highlights the necessity for enhanced voting initiatives targeting our patients, aiming to improve voter representation within marginalized communities as part of our health care institutions' efforts.

Voting is not just a political act but a fundamental social determinant of health. By exercising their right to vote, individuals contribute to shaping policies, addressing health disparities, promoting health education, and fostering healthier and more equitable communities for everyone. Encouraging voter engagement and ensuring equitable access to the electoral process are essential steps towards improving public health outcomes and creating a fairer society.

Suggested reading

Bajaj, S.S., Martin, A.F. & Stanford, F.C. Health-based civic engagement is a professional responsibility. Nat Med27, 1661-1663 (2021). https://doi.org/10.1038/s41591-021-01523-2

Barrere-Cain, Rio1; Garriga, Meera2; Kaki, Dahlia A.3; Lawrence, Carlton MD, MPP4; Reardon, Alexander MD5; Martin, Alister MD, MPP6. Why and How Civic Health Should Be Incorporated Into Medical Education. Academic Medicine 97(12):p 1760-1764, December 2022. | DOI: 10.1097/ACM.0000000000004765

Shapiro, I., Namjoshi, S., & Morris, O. S. (2024, February 20). How medical systems can help people vote. Scientific American.