Voting is an important determinant of health, states the American Medical Association Voting rights in the US

Voting access is now considered a health issue, according to the nation’s largest group of doctors.

The American Medical Association (AMA) House of Delegates passed a resolution calling voting the social determinants of health, a term used to describe non-medical factors that affect health and well-being. Co-sponsored by the National Medical Association, the resolution also recognizes that manipulation limits access to care and leads to poorer health outcomes.

The AMA’s move follows the 2020 election, in which Republican campaigns cast doubt on election results, and a redistricting cycle in which hyperpartisan districts were proposed in several states.

Recent Supreme Court decisions have also forced abortion, climate change, and other health-related policies onto the states. Alia Bhatia, executive director of citizen health organization Vot-ER, said this made it “even more important for communities to vote in local races in the upcoming elections”. But health organizations have long shied away from civic engagement work in their communities.

In the past, the AMA has not focused much politics on voting. In 2010, he advocated for voting rights for people with mental illness, and in 2021, he supported safe and fair voting conditions. “It takes it a step further,” said Luis Seiha, MD, an internal medicine and pediatrics specialist at Mount Sinai in New York who introduced the resolution in the House of Delegates, “and really gets down to the basics and principles of it all.”

Another advocate, Jasmine Eatman, who is a doctoral candidate at Emory University in Atlanta and helped draft the resolution, pointed out that voting has been consistently linked to better health, across history and dozens of studies. It has been estimated that women’s suffrage reduced infant mortality by 8-15%, while the Voting Rights Act reduced economic inequality and increased health care costs.

A recent study found that increasing barriers to voter restriction were associated with a 25% higher likelihood of not having health insurance. In another, researchers linked higher voter turnout to a significantly reduced risk of dying from cancer. Finally, after following adolescents for 14 years, voting was found to be associated with improved mental health as well as higher socioeconomic status. “Voting can affect a lot of different health outcomes,” Eatman said, “whether it’s through access to resources in the community, whether it’s through insurance.” The sickest patients are the least likely to vote, but need the most good health policy.

Bhatia believes that health care workers are in a unique position to restore the broken trust in democracy because they are considered some of the most honest and ethical professionals in America. “Your doctor, your nurse, your social worker has a different type of voice than someone you would meet every ten years at the DMV,” she said, the agency where voter registration often takes place. The law, Bhatia noted, allows for nonpartisan voter registration wherever public funding is provided, such as Medicare and Medicaid.

Despite its declaration of voting as a social determinant of health, the AMA is not sure how the new resolution will be put into action. The association’s media and editorial director, Josh Zembic, said the actual steps have yet to be determined.

But Seija and Bhatia have some ideas. For one thing, both believe the AMA should partner with civic health organizations that are already engaging the community and encouraging patients to vote. This August, for example, Vot-ER is hosting Citizen Health Month. Hospitals across the country are participating in the Healthy Democracy Campaign, with teams of healthcare workers competing to register as many patients as possible to vote.

In addition to supporting community-based organizations, Seija believes the AMA must also speak out against systems of power and oppression to protect voting rights.

Bhatia, however, is more hesitant about institutional announcements. “There are historical incidents of mistrust,” she said, “where black and brown communities in America have very real reasons to worry about what Health is telling them to do.” Instead, the message around voting can be delivered more well from the patients’ health care providers who are more familiar and representative.

“In our work, we would not recommend that the AMA be a direct messenger for patients,” Bhatia said. “That probably wouldn’t be an efficient use of their time and energy.”

With the 2022 midterms fast approaching, Sage is concerned “that we will continue to politicize Blackness, that we will continue to politicize people of color and the communities that we serve, that we will never say that voting is a right.”

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