Docs need to rock the vote in 2024

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Physicians can improve the lives of their patients and the civic life of the nation by voting.

As the United States prepares for a presidential election in 2024, the American College of Physicians (ACP) is calling for doctors to register to vote, to cast their ballots, and to help others do the same. ACP’s Health and Public Policy Committee published a new position paper, “Ensuring Equitable Access to Participation in the Electoral Process: A Policy Brief from the American College of Physicians,” by Katelan Cline, BA, David Hilden, MD, MPH, and Micah Beachy, DO, in Annals of Internal Medicine.

“Voting and health are directly connected through the institution of policies by ballot initiative and the election of officials who incorporate health into their platforms,” they said. “They are also indirectly connected, as civic participation connects persons to their community and empowers them with agency in decision making.”

Who’s voting?

The authors quantified figures about voting in general and specifically for physicians.

Four years ago, the presidential election of 2020 was contentious, yet 33.2% of eligible voters stayed home. From 2000 to 2020, the public has voted at an average rate of 63.4%, while physicians are below that with a 20-year average turnout of 57.4%.

“The most commonly cited barriers for physicians, trainees, and other health care professionals include a lack of time off to vote, low political efficacy, logistical challenges, and not registering in the location where they are training or practicing,” the paper said.

Patients may face barriers to voting ranging from lack of identification or transportation, to gerrymandered political districts that strengthen or minimize influence of particular groups of voters.

But political action – even just casting a ballot once a year – can be good for doctors and their patients by shaping access to health care services and social drivers of health, according to ACP.

The American Public Health Association argues voting and health are linked directly in health policy. An example: Medicaid expansion was approved through ballot initiatives in Maine, Missouri, Nebraska and Oklahoma.

Recommendations

ACP offered five recommendations for a healthy body politic in 2024.

• ACP recognizes that voting impacts health and health care.

University Press of Kansas maintains a “Cost of Voting Index” website that measures how much time and effort people must take to cast their ballots across the 50 states. The states with low barriers to voting tend to have better health outcomes than states that make it difficult to vote.

• Electoral policies should ensure safe and equitable access to voting, and ACP opposes barriers to voter registration and casting of ballots.

Voter restriction laws and practices can range from strict voter photo identification laws, to long wait times at the polls. Those largely make it more difficult to vote for Black, Latinx, Asian and Native American populations, and need to stop.

ACP cited examples of Colorado, which has mandated mail ballots and drop-off centers that improve turnout while reducing costs of elections, and Minnesota, which has same-day voter registration and encourages residents to maintain that state’s first-place ranking for voter turnout, among the 50 states.

• Political leaders must abandon partisan gerrymandering and draw fair, representative, nonpartisan electoral districts.

Gerrymandering on the basis of race is illegal, but political districts still end up “cracking” or “packing” certain groups or members of political parties to limit their influence. That can lead to “insulated legislative majorities … less likely to adopt equitable health policies,” and Black people generally pay the price through policy and health outcomes, according to ACP.

• Physicians, residents, medical students and other clinicians must vote and support elimination of barriers to voter participation.

There was a COVID-19 bump at the ballot box: In 2020, physicians were more likely to vote compared with the general population for the first time. Physicians are 30% more likely to vote by mail and 15% more likely to vote before election day, compared with the general population.

“Because of the cited time and work constraints physicians face when voting, increased flexibility on how one may cast a vote may be an effective way to increase physician participation in elections, and in turn, their agency in improving health on a larger scale,” ACP said.

• Health-care-sponsored voter engagement is a strategy to increase health equity for patients and health care professionals.

Under the National Voter Registration Act of 1993, hospitals and health care systems legally may facilitate nonpartisan voter registration activities. That includes making voter registration materials available on paper or electronically through scannable QR codes on employee badges, according to ACP.

Those can make a difference. In 2012, more than 200 community health centers registered more than 25,000 voters across the nation, according to one study.