Civic engagement is good for health. Research on participation in activities that improve the quality of life in communities shows positive impacts on self-reported health status, encourages continued participation in civic engagement later in life, and builds social capital in communities. While civic engagement includes a broad spectrum of nonpolitical activities like participating in or leading community groups and volunteering, engagement in the political process through voting has achieved more focused attention for its unique impact on communities.
Voting is a health issue. Multiple studies have demonstrated an association between voting and better health. Efforts to increase voter registration and voter turnout can increase opportunities for those who participate in the political process to shape the policies that improve their communities and further civic engagement. For that reason, the Healthy People 2030 multi-agency workgroup on social determinants of health has identified increasing the proportion of voting-age citizens who vote as a “high-priority public health issue.”
Given the association between voting and health, what is the appropriate role of healthcare organizations like academic medical centers, teaching hospitals, and community clinics in encouraging and facilitating voting? Recent polling conducted by the Association of American Medical Colleges (AAMC) Center for Health Justice — the full results of which will be published later this month — indicates that, for most U.S. adults, healthcare institutions are not top of mind when they think of places with responsibility for voter registration or increasing turnout. However, when those individuals were asked whether their trust in highly-trusted institutions like hospitals and pharmacies would be impacted if those institutions facilitated voter registration, respondents overwhelmingly reported that their trust would not decrease, and certain groups (Black adults, younger respondents, and those living in urban settings) reported their trust in the institution would increase.
Healthcare organizations, by nature of the role they serve, regularly interact with individuals across their communities and are thus well-positioned to increase voter registration opportunities. Some institutional leaders may be reluctant to take these steps, worried that voting-related activities would be prohibited for a nonprofit institution. Rest assured this is not the case. Increasing voter registration and turnout can be a logical and practical extension of an organization’s mission to improve health. Many healthcare organizations currently serve as sites for voter registration and actively encourage their patients and employees to vote.
The AAMC, in collaboration with Vot-ER, has developed a brief fact sheet for hospital leadership and healthcare providers to emphasize that nonpartisan voter registration activities are both allowable under federal law and encouraged by federal agencies. Discussing the importance of voting, providing resources and registration forms, or answering questions about how to register, check registration status, or complete registration forms are all acceptable and beneficial activities. As long as institutions and staff assisting with these efforts refrain from stating or implying that anyone should vote in a particular way, for a particular candidate, or in support of or against specific policy positions, facilitating voter registration efforts can strengthen the relationship between communities and the organizations that serve them.
Civic engagement is good for medical professionals too, and can be increased through the activities that a hospital or academic medical center undertakes for patients. Historically, physicians have had lower rates of both voter registration and voting than non-physicians, although this concerning trend has seen some progress in recent years. The authors of a 2022 analysis on voting behaviors of U.S. physicians noted that the most commonly reported barriers to voting were conflicting work schedules and not being registered to vote, and the most common reason for not being registered was having missed the registration deadline. When a healthcare organization encourages voter registration and voting by having resources available for patients and visitors, those resources and reminders can facilitate similar behaviors in providers, staff, and trainees. Additional efforts like providing employer-sponsored time off for voting and volunteerism can be a powerful demonstration of a comprehensive commitment to promoting civic engagement — not just a service for those who live and work outside of the institution’s walls.
While a laudable goal in itself, the benefits of taking these steps go beyond increasing local voter registration and turnout. For those institutions committed to meaningful community engagement and partnership, promoting civic engagement is one of the ways in which institutions can demonstrate they are worthy of the community’s trust. A toolkit produced to facilitate discussions of the AAMC Center for Health Justice’s community-developed Principles of Trustworthiness identifies some of the key behaviors in building trust, which could be demonstrated in part through voter registration efforts, including commitment, authenticity, and respect and responsibility.
The activities that academic medical centers and hospitals can and should undertake to promote civic engagement are bolstered by the benefits to individuals, communities, healthcare providers, and the nation. Today, National Voter Registration Day, is an ideal time to consider how much more inclusive our democracy would be if every person who came through the healthcare system had the voter registration tools and assistance they needed.
Heather H. Pierce, JD, MPH, is senior director for Science Policy at the Association of American Medical Colleges (AAMC), and director of policy for the AAMC Center for Health Justice.
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