Netizen Watch: Voting – A Social Determinant of Health

Hello Fellow Netizens!

With less than one month until the Presidential Elections, Docnetizen will focus on the health policy issues receiving the most attention from candidates, aiming to educate and inform you about why they matter. This article will focus exclusively on voting in the United States, how it impacts health outcomes for citizens, and ways you can get involved in our nation’s democracy.

Voting is a crucial civic duty for every American, and if you ask most people, they would likely agree. Voter turnout rates in the last three major national elections (2018, 2020, and 2022) reflect this sentiment, with abnormally high turnout, according to the Pew Research Center. In fact, 70% of eligible U.S. adult citizens participated in at least one of these elections, with about half that share (37%) voting in all three.

So, you may be wondering: What does this have to do with me? After all, voting is about politics, not health or medical care, right?

Not exactly.

Voting: A Social Determinant of Health

In 2022, the American Medical Association issued a policy stance which officially recognizes voting as a social determinant of health. What does this mean? First of all, let’s define what a social determinant of health (SDOH) is. The US Department of Health and Human Services (HHS) has this definition:

Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

There are five major SDOHs that are outlined below:

  • Economic Stability: Poverty is recognized as a significant influence on health. Not having money affects the foods you eat, your ability to live in a safe home, and whether you can afford health insurance.
  • Education Access and Quality: There is a strong relationship between your level of education and potential health outcomes. One article reviewed decades of research supporting this, but there are caveats. For example, highly educated individuals also tend to be more financially well-off compared to their peers, which ties back to economic stability.
  • Healthcare Access and Quality: Need I say more? Simply put, if you don’t have access to a doctor or other medical provider, you can’t get the medical care you need. This category also includes access to health insurance and healthcare infrastructure like hospitals and pharmacies.
  • Neighborhood and Built Environment: Where you live matters. Your ZIP code is a major risk factor for health outcomes. Forbes published an article that illustrates this well. Think about it: would you be able to buy fruits and vegetables if the nearest grocery store was more than 15 miles away? Would you feel safe jogging in your neighborhood if it had frequent instances of violence or crime?
  • Social and Community Context: Your social network (family, friends) can influence your health by acting as a support system. This category can be affected by issues like bullying, neglect, and lack of local social services.

Which category does voting belong in? I would argue that voting impacts every category in significant ways and belongs to all of them. In a way, voting is a social determinant of health, not as a category of its own but as a part of all the determinants in our society. I have written several articles on the current presidential candidates and their platforms, based on the first and second debates. Who you vote for will significantly shape the course of our country’s health policy priorities, especially with the possibility of extreme agendas, like Project 2025, becoming a reality.

What Can I Do?

    The most important thing you can do (if you are a citizen of the United States) is to vote, vote, vote! Your vote matters more than you think, and if you don’t believe me, let me convince you otherwise:

    • “I live in a solid blue/red state; my vote doesn’t have any impact in any election.” – I would push back on this common misconception. There are plenty of races—federal, state, and local—that are highly competitive and determined by slim margins. The Center for American Progress has an article on this issue, outlining specific examples for readers to consider.
      • One of the most famous tight presidential races in history was the 2000 Presidential race between Al Gore (D) and George W. Bush (R). The election was decided by just 537 votes in Florida, amid significant controversy over confusing “punchcard” ballots that may have caused voters to select the wrong candidate. It took a Supreme Court ruling (along ideological/partisan lines) to eventually give George W. Bush the electoral votes he needed to win the presidency.
      • Minnesota, often considered a reliably Democratic state, has seen some surprisingly close races. In 2008, Democrat Al Franken won his Senate seat by just 312 votes over his Republican challenger, Norm Coleman—a margin of only 0.01%!
      • Indiana, a traditionally Republican state, has also had tight races. In 1984, Democrat Frank McCloskey won the election for Indiana’s 8th Congressional District by just 4 votes over Republican Richard McIntyre after a recount overseen by a special task force from the House of Representatives. Let me repeat that: he won by only FOUR votes!
    • “My vote has no effect on my daily life.” – Again, this is another common sentiment I’d like to challenge. Your vote has significant consequences for policies that affect everyday Americans. Consider these examples:
      • When Al Franken won his Senate seat in 2008, his vote was critical for passing the Affordable Care Act (ACA, also known as “Obamacare”). The Senate needed 60 votes to avoid a filibuster, and Franken’s victory helped Democrats secure that majority, making the ACA possible to be passed into law.
      • In 1984, Republican Mitch McConnell defeated incumbent Democrat Walter Dee Huddleston for a Senate seat in Kentucky by just 5,269 votes—only 0.41% of the more than 1.2 million votes cast. McConnell went on to become one of the most influential senators in recent decades, orchestrating the appointment of three conservative Supreme Court justices under the Trump administration, which ultimately led to the overturning of Roe v. Wade.
      • In Minnesota, the Democratic-Farmer-Labor (DFL) Party controls the governor’s office and both legislative chambers. This was made possible by the race in State Senate District 41, where Judy Seeberger defeated her Republican opponent by just 321 votes. Because of those votes, Minnesota passed key health policies, including protections for reproductive rights, paid family and medical leave, and “red flag” laws to address the growing epidemic of gun violence.

    “OK, OK I get it. But, I don’t have the time to vote/I have to go out of my way to vote”

    Voting can be simple if you plan early and research your state or local polling locations ahead of time. Here are some resources you can explore and share with your friends and family:

    • Vote.org – Vote.org is a non-partisan, pro-voter organization dedicated to promoting and expanding voting information and access for everyone. They provide answers to any questions you might have about voting, including resources by state. I highly recommend starting here if you’re unsure where to begin.
    • Vot-ER – Vot-ER is another non-profit organization focused on promoting voting information and access, specifically for patients during their healthcare visits. Physicians, healthcare professionals, and staff are encouraged to discuss voting, the importance of civic engagement, and how it affects healthcare outcomes. This resource is great for both providers and patients!
    • Your official local or state government websites are also excellent resources for finding information about voting in your area. If you are unable to vote in person on Election Day, look for options such as early voting or mail-in voting.

    Here’s a quick video on voting for this year’s election for you to watch at your pleasure:

    Courtesy of Youtube Channel: How to Vote in Every State.

    Stay safe and until next time, fellow Netizens!

    Featured Image: Photo by Element5 Digital: https://www.pexels.com/photo/person-dropping-paper-on-box-1550337/

    Disclaimer: This article reflects the author’s own opinions and statements. They do not reflect the opinions or stances of any organization affiliated with the author