Opinion: Registering voters at medical facilities would be a good Rx for democracy

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The next time you’re in a doctor’s office or clinic waiting to be seen, think about how you spend that time. Maybe checking email, playing games on your phone or watching the shared TV. What if, instead, a sliver of that time was used to ensure that you and those around you are registered to vote?

This might strike you as an odd pairing ‒ health care and democracy ‒ but as former secretaries of state from opposing political parties and an emergency physician on the front lines of health care, we have witnessed firsthand how health and civics intersect. 

Despite voter turnout reaching its highest rate in more than a century, more than a quarter of eligible Americans were not registered to vote and a third did not cast a ballot in the 2020 election.

Unfortunately, those served by safety-net health systems consistently vote at even lower rates than the general population. The same has traditionally been true for health care professionals, who face barriers to voting such as conflicts with busy schedules. This gap means that crucial decisions directly impacting health and well-being are often made without the input of the most knowledgeable and most affected people.

Patients and health care professionals need to be heard

Public health issues ‒ from air quality and public safety to opioid use prevention and housing stability ‒ profoundly influence our daily lives. If the policies impacting health are shaped without the voices of health care professionals and patients, we risk undermining the very foundation of public health and community well-being.

Hospitals, clinics and other medical facilities are uniquely positioned to bridge the gap between health care and voter engagement. By integrating nonpartisan voter registration into health care ‒ from waiting rooms to after-visit discharge instructions ‒ we can implement an elegant solution to strengthen democracy, empower patient voices and improve public health outcomes.

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This approach is similar to how DMVs assist with voter registration but with potentially greater reach: About 83% of adults visit health care facilities every year.

This creates a novel and simplified approach to keeping voter rolls clean by meeting people where they are, enabling frequent voter information updates, and lessening the burden on Boards of Elections and Secretaries of State offices.

Help voters who are medically underserved and underrepresented

We're not the first to recognize this potential.

A little more than a decade ago, in fact, family medicine doctors in New York City conducted nonpartisan voter registration drives in the waiting rooms of two federally qualified health centers in the Bronx. Recognizing that the communities who come to their clinics for care are both medically underserved and underrepresented in the electorate, the doctors aimed to start bridging these gaps ‒ and did so by successfully registering 89% of eligible voters whom they engaged. 

In addition, community health centers like AltaMed and large health systems like Northwell Health are among the many health care facilities that have successfully implemented voter registration initiatives in recent years.

The idea is increasingly in the medical mainstream, as the American Medical Association declared voting a determinant of health.

The most widespread effort may be that of Vot-ER, a nonpartisan nonprofit that coordinates with more than 700 facilities across the country. From rural clinics in North Carolina to urban health centers in Kansas and Pennsylvania, the organization, of which we advise, has helped more than 110,000 patients and clinicians register to vote.

By encouraging nonpartisan civic engagement, we're empowering patients to address the root causes of many health issues.

The intersection of health care and civic engagement presents a unique opportunity to address two critical issues simultaneously: public health and democratic participation.

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Through leveraging the health care system’s extensive reach, we can create a powerful mechanism for maintaining accurate voter rolls while increasing civic participation.

Consider the potential impact:

• If even half of all health care visits resulted in voter registration checks or updates, millions of voter records would be refreshed annually.
• Increased voter participation among health care professionals and underserved communities could lead to more informed health policy decisions.
• Regular engagement with the voting process could foster a culture of civic participation, improving long-term voter turnout rates.

Policymakers, health care administrators and medical professionals must take the next step:

• Implement nonpartisan voter registration and turnout initiatives in your health care facilities.
• Support legislation that fortifies these efforts.
• Educate your colleagues and patients about the importance of civic engagement for community health.
• And embrace civic engagement as an integral part of holistic patient care.

This matters not just for the upcoming presidential election but for the many elections that occur every year, especially the important but typically low-turnout local races.

By treating low voter turnout as the public health issue it is, we can prescribe a powerful remedy: a more engaged, representative and health-conscious democracy. The vital signs of our republic depend on it.

Trey Grayson, a Republican, served as Kentucky's secretary of state from 2004 to 2011 and also was president of the National Association of Secretaries of State. He now co-chairs the advisory board of the Secure Elections Project. Miles Rapoport, a Democrat, served as Connecticut's secretary of the state from 1995 to 1999. He has served as a fellow at Harvard Kennedy School and now leads 100% Democracy: An Initiative for Universal Voting. Dr. Ali Raja is an emergency physician, professor at Harvard Medical School, executive vice chair of the Department of Emergency Medicine at Mass General Brigham, and a veteran of the U.S. Air Force.