Executive Summary  

Many people are aware of the social determinants (or drivers) of health – the conditions in the places where people live, learn, work, and play. But fewer people are familiar with political determinants of health, which are the systems and structures that control the distribution of resources and power and create opportunities to make progress towards health equity or worsen health inequities. Politics has a direct impact on a population’s health, for better or for worse. Elected officials have the power to decide how resources are allocated, specifically who gets access to health care, the price of health care, and who bears the cost. Voters across party lines consistently cite healthcare affordability as a top priority that they expect those in office to address.  

Democracy is a form of government that thrives from the participation of the people governed. Barriers to participation, including disenfranchisement and poor health, and the imbalance of power between the healthcare industry and consumers must be addressed through civic engagement. There are many forms of civic engagement, including voting, volunteering, demonstrating, donating, and advocating. This paper focuses on voting specifically and examines the connection between voting and health as well as the political landscape related to health care. While the research is limited, it does establish a link between voting and health, which goes both ways: voting affects health and health affects voting. Past and current efforts to disenfranchise people, particularly people of color, contribute to longstanding health inequities. These inequities are perpetuated in a cycle where “worse health leads to lower voting rates, leading to policy that does not prioritize addressing inequities, leading to worsening health inequities.” When people are able to participate in government and be competently represented by their elected officials, they gain influence over the policies that affect their health and well-being.  

Voting is an important tool to advance health equity at the local, state, and federal level. Healthcare providers can play a key role in their communities to promote voter engagement efforts. Voters should engage with the political system and advocate for new laws that are equitable to reverse the damage caused by inequitable laws. It is imperative that voters organize and amplify their voices so that leaders are held accountable to put people over politics and money and to advance equitable policies, like Medicaid expansion, that are supported by the majority and would improve health.