Whether it’s through voting, volunteering, or helping to arrange a community event, research suggests that people who live in communities with strong civic participation and easy access to the ballot enjoy better overall health.
Voting and civic engagement are tied to health
High levels of civic participation help communities feel connected to each other and foster a sense of belonging. Social cohesion has been linked with not just better mental health outcomes, but better physical health too.
A tool released last year, the Health & Democracy Index, explores the connection between voting and health by analyzing voting policies and health outcomes on a state-by-state basis. It found that states with more inclusive voting policies and greater levels of civic participation tend to have better health overall outcomes, from lower infant mortality rates to lower risk of chronic disease.
However, barriers to voting can become self-reinforcing—election data show that people with chronic disease, mental health concerns, and disabilities are less likely to vote. Voting is one of our greatest tools for influencing the policies and programs that shape our health and well-being. When communities or groups are unable to participate, that means their voices are not being heard, decreasing their power to shape policies that influence their health. Health disparities and voting disparities thus form a reinforcing feedback loop.
Low voter turnout exacerbates other disparities
Minnesota consistently ranks as one of the top states in health, education and many other quality of life indicators, yet it also has some of the worst racial inequities in the country. Unfortunately, voter turnout is no exception. Despite the state having the highest voter turnout in the nation in 2020, racial gaps persist. In that election, 79.9 percent of Minnesota’s White (non-Hispanic) voters turned out, while among the state’s communities of color, 66.3 percent of eligible Asian voters, 66.1 percent of eligible Black voters, and 62.7 percent of Hispanic voters cast their ballot.
Younger voters also tend to vote at a lesser rate than older voters. In 2020, 18–35-year-old voters trailed older Minnesotan age groups in voter turnout by over 10 percent. This has implications for populations of color and refugee communities, who are quite a bit younger than the white population in Minnesota. We also know that Minnesota’s youngest residents are the most diverse.
Research also shows that social and environmental conditions can affect up to 60 percent of our individual health outcomes. When communities vote, they influence policies that have a big influence on their health, even if indirectly. Voting ensures communities have a voice in policies that influence access to healthy foods, affordable housing, and safe neighborhoods—all of which are associated with positive health outcomes.
Communities that have been disenfranchised from voting and democratic participation are largely the same communities facing a variety of systemic barriers that affect their health. Civic participation is not just about improving community health, it is also key to advancing health equity in our state.
Civic participation is about representation too
Despite disparities in voter turnout, some Minnesotan communities are determined to ensure their voices are being heard in the democratic process. For example, tribal nations in northern Minnesota increased their voter turnout by 11 percent from 2016 during the last presidential election. This aligns with nationwide data captured through the Indigenous Futures survey (IFS). The IFS, created by and for Indigenous people, was designed to better understand critical issues impacting Indian Country that can be used to motivate change. While Indigenous people face significant barriers to voting, the survey found that 77% of respondents voted in their last local, state, or national election.
Other civic engagement trends show that Minnesotan voters are looking to send diverse voices to the capitol in St. Paul. Since 2014, the number of legislators of color in the Minnesota Capitol has more than tripled, from eight to 25. Through civic participation, communities can elect legislators who bring the lived experience of communities of color, immigrants and other underrepresented groups to the capitol, amplifying the voices that often don’t get heard in the political process and the issues they’re facing.
Fostering civic engagement is key to addressing racism as a public health crisis
Blue Cross sees civic engagement as integral to our mission of improving community health across the state. We’ve been championing civic engagement for 22 years through our nonpartisan CitizenBlue program, and we believe community health is shaped by the strength of the democratic process.
In 2020, Blue Cross declared systemic racism as a public health crisis. We know that many of the people facing the greatest health inequities today have been historically and continuously left out of the policy and decision-making processes. Through longstanding community partnerships, Blue Cross works to develop and strengthen civic engagement capacity within communities, with the goal of transforming policy and systems to address the social determinants of health. Advancing health equity requires changing power structures and public policies, and that starts with civic engagement on the community level.
About the author: Bridget Callaghan is a Public Affairs and Civic Engagement Specialist at Blue Cross and Blue Shield of Minnesota.