Last month, JAMA Health Forum published our nationwide study examining the impact of over 700 hospitals and clinics involved in voter registration during the 2020 election. The findings underscore a transformative approach to voter registration through healthcare networks. Our research demonstrated that healthcare-based initiatives, such as our program Vot-ER, are not just effective but crucial for reaching populations often overlooked by traditional political campaigns. The results were striking: approximately 12,441 patients facilitated by our network of sites voted on election day, representing a younger, more racially and ethnically diverse demographic than the typical electorate.
As we inch closer to the 2024 general election, it’s clear that the healthcare community is uniquely positioned to have a profound influence on our civic landscape. Institutions ranging from Northwell Health, which has integrated voter registration into its patient care system through Epic’s MyChart, to pediatricians in the American Academy of Pediatrics, who are guiding adults in recognizing voting as a right and responsibility, are already making significant strides at the critical intersection of our health and our democracy.
In our work as leaders in the healthcare space, we have worked to raise awareness and inspire action on what we call “the political determinants of health.” Through our efforts and the leadership of so many in the space, our initiatives have been part of a broader “civic health” movement that has sparked a nationwide dialogue on the critical connection between civic engagement and health outcomes. Now, the American Medical Association, the American College of Physicians, and HHS have all recognized voting as a critical social determinant of health.
Particularly over the last 4 years, there has been exponential growth in healthcare-based civic engagement. Through leading and observing these efforts, we have learned what works to help engage health professionals and patients in voting. We recognize that so many more clinics, hospitals, physicians, nurses, and others will be interested in this work as November approaches, so we’re sharing a few pointers for navigating the months ahead.
First, non-partisanship and patient agency are the bedrock of effective healthcare-based voter engagement efforts. We live in a world where we are constantly bombarded with messages from campaigns, PACs, and more. To effectively navigate the complex intersection of health and civic engagement, we need to ensure that every voice is heard and that communities have the power and choice to shape their collective health outcomes. Based on our experience, we recommend healthcare systems leverage tools like TurboVote, which provides consistent nonpartisan election reminders and points people straight to their Secretary of State website to complete the voter registration process.
Second, civic holidays provide a time-bound spotlight for voting as a determinant of our health. Civic Health Month — celebrated during the month of August and recognized by bipartisan proclamations from Governors in Massachusetts and New Jersey — transforms hospitals and clinics across the country into centers of democratic engagement. Health professionals can weave in a simple voter registration question while taking a patient’s social history. Then, on National Voter Registration Day — this year celebrated on September 17 — hospital CEOs can make a direct and personal appeal to their staff at every level to check and update their voter registration.
Third, we advise hospitals, clinics, and associations to lean into seamless tools and programs that fit into the systems and culture of healthcare. Hospitals and clinics with Epic can use a free module that adds voter registration questions straight into the intake process and after-visit summaries. Healthcare spaces that support Medicaid enrollment can train navigators to offer their patients the same voter registration resources that are provided in state agencies. Medical students or residents who want to make a difference can engage in a healthy competition around civic engagement through Vot-ER’s Healthy Democracy Campaign.
In the U.S., 72 million Americans are eligible to vote but remain unregistered. Even during the 2020 elections, which saw record voter turnout, only 67% of eligible voters participated. In other words, one-third of eligible Americans did not vote, with many citing non-registration as a major obstacle. Meanwhile, approximately 83% of Americans visit a healthcare professional annually. Consider the potential impact if the healthcare sector actively encouraged voter registration. By integrating voter engagement into healthcare services, where professionals are highly trusted, we have the potential to significantly surpass previous voter turnout records.
By embracing healthcare-based voter registration, we not only advocate for improved health outcomes but also fortify the democratic foundations of our nation. This integration ensures that patients and healthcare professionals alike have the necessary resources to participate in the democratic process, ultimately fostering a healthier, more inclusive society. Together, let’s prescribe a new future for democracy by helping our patients vote like their health depends on it.
Alister F. Martin, MD, MPP, is CEO of A Healthier Democracy and an emergency physician in Boston. Aliya Bhatia, MPP, is executive director of Vot-ER and Civic Health Month. Daniel E. Dawes, JD, is senior vice president of global health and founding dean of the School of Global Health at Meharry Medical College. He is the author of The Political Determinants of Health.
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