Health & Democracy Index

Policy Implications

There are several strategies the health sector can employ to promote a healthy inclusive democracy. A breakdown of some of the most impactful approaches to strengthen civic and voter participation are summarized below:

Update Voter Registration through Government Services

Assist people to update their voter registration when they sign up for other government services, just like when they renew their driver’s license.

For instance, the Centers for Medicare and Medicaid Services can empower states to let people update their registration when they enroll in Medicaid or sign up for health insurance on Currently, 87 million people are enrolled in Medicaid and 12.2 million people signed up for health insurance using in 2022. During Medicaid enrollment, health offices already verify information that is necessary for voter registration including current address and citizenship status. Including voter registration in these government services improves overall efficiency, makes our elections more secure, and helps keep voter registration information up to date. This simple reform can ensure voter rolls reach communities most likely to be unregistered.

Take Action on Civic Participation as a National Health Goal

The national Healthy People initiative is a roadmap for achieving national-level health goals over 10 year spans. Measuring and tracking these goals deeply informs local and state-level health plans, including through governments and health care systems. In June 2023, HDHP celebrated the the HHS approval of voting turnout as a Core Objective of Healthy People 2030.

We can do more to strengthen civic and voter participation. Healthy People can move to establish civic participation as a Leading Health Indicator. In fact, The National Academies of Sciences, Engineering, and Medicine — the Congressionally chartered experts who advise the government on critical science issues — recommended including voting as one of the Leading Health Indicators for Health Equity. An LHI on voting could include objectives like voter participation, Census participation, and volunteering. The Office for Disease Prevention and Health Promotion can further ensure state and local governments are promoting voter participation by providing health officers and departments with evidence based resources that illustrate strategies to promote voter participation in health settings and the broader community.

Additionally, state and local governments can use the Healthy People 2030 objective and resources to incorporate civic health into their health improvement planning processes, measurement strategies, and data dashboards to further investigate the relationship between health and democracy in the communities they serve.