Results of a Voter Registration Project at 2 Family Medicine Residency Clinics in the Bronx, New York

Abstract

PURPOSE Federally qualified health centers provide care to medically underserved populations, the same individuals often underrepresented in the electoral process. These centers are unique venues to access patients for voter registration services. METHODSWe undertook a clinician-led, nonpartisan voter registration drive within 2 university-affiliated federally qualified health centers in the Bronx, New York. Patients were approached by voter registration volunteers in clinic waiting areas during a 12-week period.RESULTS Volunteers directly engaged with 304 patients. Of the 128 patients who were eligible and not currently registered, 114 (89%) registered to vote through this project. This number corresponded to 38% of all patients engaged. Sixtyfive percent of new registrants were aged younger than 40 years.CONCLUSIONS This project was successful in registering clinic patients to vote. Clinics are not only health centers, but also powerful vehicles for bringing a voice to civically disenfranchised communities. INTRODUCTIONI n the United States, voting is a fundamental right of citizenship and represents the power to influence societal conditions that affect health conditions. Despite this opportunity, only 42.5% (93 million) of the American electorate voted in the 2012 presidential election.1 Low voter turnout is even more of a challenge in local elections. In 2009, just 18.4% of voters cast a ballot in the New York City mayoral election, the lowest turnout since 1969.2 This phenomenon may lead to skewed health policy outcomes that favor more civically active citizens. 2,3The demographic composition of a community can predict low voter turnout. Whites vote at a rate 10% higher than blacks and 50% higher than Latinos and Asians nationally.3 Low household income, young age, and residential mobility are also major predictors.2,4-6 The Bronx community is particularly vulnerable. It is the poorest urban county in the United States, with 29% of its residents living at or below the poverty level. Additionally, Bronx residents experience high rates of residential mobility. 8 Twelve percent of residents change addresses within 1 year of moving to a new address.9 In many ways, social disparities mirror health disparities in that inequitable distribution of health resources and disproportionate adverse health outcomes affect these same groups. 10The magnitude of voter disparity is especially great among individuals who are likely to receive care at federally qualified health centers (FQHCs). These patients are most often Medicaid eligible, uninsured, and low income. Offering voter services in this setting allows increased access to potential voters, facilitates civic participation, and enables patients to get involved to improve community health. Additionally, the National Voter Registration Act of 1993 empowers FQHCs to provide voter ser- vices. Under the law, offices that provide public assistance, including Medicaid services, are considered voter registration agencies. 11The National Association of Community Hea...

Voting, health and interventions in healthcare settings: a scoping review

“…Many articles included calls to action for healthcare practitioners to engage in and advocate for democratic engagement in their patient communities through policy change, accessibility, support, and even intervention to help increase voter participation. Healthcare organizations are well suited to engage directly with marginalized populations and can be involved in improving democratic engagement through education and interventions similar to Liggett et al, who undertook a clinician-led voter registration [45]. Other possible interventions could include reducing barriers to voting (proxy voting at hospitals), organizing nonpartisan townhalls, or compiling and sharing information for communities on the voting process [50,51].…”

“…Hassell and Settle ran an interventional study that induced life stressors on patients and found that increasing stress decreased likelihood to vote for typical nonvoters [44]. Liggett et al conducted an evaluation of clinician-led, nonpartisan voter registration drives over 12 weeks within two university-affiliated health centers in the Bronx, New York [45]. The project was successful in registering 89% of eligible voters, demonstrating the importance of health centers as, "powerful vehicles for bringing a voice to civically disenfranchised communities".…”

US doctors and hospitals offer a new treatment: voter registration

“…Her first project succeeded in registering 114 of 128 eligible unregistered patients as part of regularly scheduled clinic visits in the Bronx 6. “It was not that people didn’t want to engage,” she says, noting the many roadblocks these patients face with regard to voter registration, including frequent house moves.…”

Addressing Health Disparities Through Voter Engagement

“…18 Community health centers and hospitals, ven-ues regularly engaged with marginalized groups, have hosted and promoted nonpartisan voter registration drives. 19,20 Community Health Vote (CHV), a program of the National Association of Community Health Centers, has developed a Health Center Tool Kit to guide implementation of voter engagement initiatives. 21 In 2012, over 200 community health centers across the United States registered more than 25,000 voters.…”