A vital sign of U.S. democracy — voter participation — is very low, and health professionals providing holistic care can be part of the solution. Holistic care should be expanded to include civic health. U.S. voter participation ranks 28th among 35 nations with similar economies and government structures, and this low rate is only exacerbated by the recently proposed at least 250 laws in 43 states that would make voting more difficult. I propose that an effective way to encourage voter turnout is to promote the health care setting as a place to register to vote. Social factors have long been recognized as major drivers of both population and individual health, and civic engagement is no different. As a medical student in my first year of training, I have already seen the power that legislation can have on an individual’s health. I have spoken with patients who consider not applying for health insurance because of concerns regarding public charge. And I have worked with doctors to find the least expensive version of a drug whose inflated price came because companies were allowed to become monopolies. If nothing else, COVID-19 has taught us how much of an impact government policy can have on health, from shelter-at-home orders to vaccine distribution guidelines. To highlight the importance of voting, medical students and physicians should be trained to ask their patients if they are interested in registering to voting. During a visit, physicians often learn about a patient’s social history, everything from tobacco use to housing status, that greatly impact health. While the social history can reveal structural barriers such as food or housing insecurity that are nearly impossible to address in a single doctor visit, promoting voter registration is a direct, immediate action a provider can take to empower patients. Some may fear that discussing voting during a doctor visit will lead to partisan conversations, biased treatment of patients or feeling unsafe. But conversations regarding the importance of voting do not inherently have to be partisan — they can be as simple as giving an interested patient a QR code to register to vote. Doctors are trained to be good communicators and handle sensitive health topics. We can also train doctors to have respectful, non-partisan conversations about voting. An understandable concern is that health professionals will not have enough time during busy medical visits to address voting, and that added responsibilities can lead to provider burnout. However, conversations about voting can lead to productive actions such as directing patients to high-quality voter registration and mobilization resources. Burnout is often associated with situations where physicians feel their actions are futile. Because conversations about voting lead to easily actionable outcomes, instead of consuming energy, they can motivate physicians and combat burnout. Creating voter registration opportunities in clinics and hospitals will not only help heal the low voter turnout in the general population — it will also address the low voter turnout among physicians. Physicians consistently vote on average 14 percentage points lower than the general population. Because we have intimate experience with the impact that policy has on health, doctors and medical students have an added responsibility to speak up — and a direct way to do this is at the polls. Our country is facing a voting crisis with multiple layers: chronically low overall voter participation, even lower voter participation among physicians and — to add insult to injury — an increasing number of laws that make voting more difficult, especially for those with chronic health conditions. Voter registration in health care settings can be part of the solution to all these problems — problems that threaten the health of a democratic society. Through these civic health conversations, both physicians and patients will increase their awareness and be empowered to raise their voices by voting. It is time for the clinic be a place for civic health as well as physical health. Source
