Yes, Civic Engagement Improves Health Outcomes

On this National Voter Registration Day, I want to take a moment to commend the work done by IHS areas to support civic engagement throughout Indian Country. IHS and tribally administered health programs serve approximately 2.8 million American Indian and Alaska Native people, many of whom are not registered to vote. Over a third (34%) of voting age Native Americans are not registered to vote-approximately 1.2 million Native Americans.

In accordance with Executive Order 14019, which directs federal agencies like the Indian Health Service to pursue state designation as voter registration agencies under the National Voter Registration Act of 1993 (NVRA), IHS has worked with our area offices to identify service units, tribally run facilities, and urban Indian organizations that have a record of voter engagement to identify sites for NVRA status designation.

To date, IHS facilities in the Albuquerque, Navajo, and Phoenix Areas have achieved this status, with others in the pipeline. I am extraordinarily proud of the hard work that has gone into this accomplishment. Like other voter registration sites, staff at these locations distribute voter registration forms, offer assistance, and transmit voter registration forms to the appropriate election officials.

In community conversations, it has not been uncommon for me to be asked, "Why is IHS doing this work?"

As we know, civic engagement work like voter registration happens in community centers and other government offices like your local Department of Motor Vehicles and libraries. It follows that for Indian Country, these activities can and should occur where our people gather. IHS clinics and other facilities are such locations.

For many rural and reservation communities, other mainstream voter registration sites like DMVs, county registration offices, and public assistance agencies can be over 30 miles away. Moreover, homes on reservations often do not receive residential mail delivery and homes often do not have addresses on them. This makes receiving a registration form and filling it out correctly more difficult.

Given these challenges, unregistered Native Americans would benefit from the convenience of voter registration at the trusted IHS and tribal facilities they frequent.

However, the most important reason I cite for why I am proud of the work IHS has done in this arena is this: Civic engagement is a proven contributor to the social determinants of public health.

According to an article published by the research agency RAND, "Civic engagement can serve as a mechanism for translating changes in a health-related mindset and sense of community into tangible actions that could lead to new health-promoting partnerships, improvements in community health conditions, and the degree of integration among health services and systems for better health outcomes."

In other words, increased voter participation can enhance health outcomes for populations, aligning perfectly with the mission of the Indian Health Service to elevate the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

National Native organizations have also recognized the role IHS can serve in uplifting a health-forward and empowered perspective among our people, As the National Congress of American Indians and Native American Rights Fund explain, "…the Indian Health Service provides the most meaningful opportunity to engage with and register the most under-served eligible Native American voters."

For all these reasons, I hope you will join me in commemorating National Voter Registration Day 2024 by celebrating the good work of our areas to not only reduce unnecessary barriers to civic engagement for American Indians, but in doing so, to increase the health and wellbeing of Native Americans.

And most importantly, please register (or double check your registration), and do not forget to vote.

Resources:

• For more information, to register to vote, or to check your registration status, visit vote.gov.
• RAND's article about the connection between civic engagement and health outcomes can be found here.
• To learn more about the National Voter Registration Act of 1993, visit here.

Roselyn Tso, a citizen of the Navajo Nation, is the director of the Indian Health Service. As director, Ms. Tso administers a nationwide health care delivery program that is responsible for providing preventive, curative, and community health care to approximately 2.8 million American Indians and Alaska Natives in hospitals, clinics, and other settings throughout the United States. She previously served as the director of the IHS Navajo Area, where she was responsible for providing leadership in the administration of a comprehensive federal, tribal, and urban Indian health care system for over 244,000 American Indians and Alaska Natives throughout Arizona, New Mexico, and Utah.