Health & Democracy Index

Missouri

Primary Metrics

• Cost of Voting Index

  150

  48

  The Cost of Voting Index (COVI) was developed by political science researchers at Northern Illinois University and was first published in 2016 as an analysis of the relative cost of voting in presidential election cycles from 1996-2016. The cost of voting refers to the time and effort associated with casting a vote and is intended to characterize the overall electoral climate in each state. Lower is better.

• Overall Health

  -1.0010.759

  -0.283

  This is a composite measure of weighted z-scores for each state calculated by America’s Health Rankings, and is a relative measure of population health in each state. Better health is associated with higher voter participation. Higher is better.

Policy

• Inclusive Registration

  No

  Includes automatic voter registration, same day, and election day registration

• Restrictive Voter ID

  Yes

  States that require additional documentation at the polls, such as photo ID, even after voters have already established their eligibility.

• Vote at Home

  No

  Includes all mail elections and states with no-excuse absentee voting

• Voting Rights Restoration

  No

  Includes states where rights are not lost after a felony conviction or rights are restored post-incarceration.

Civic Participation

• Voter Turnout

  5580

  66%

  This is one of the most common measures of civic engagement in the literature reviewed. It is the percent of eligible voters who cast a vote in a given election. This matters because participation in elections shapes policy.

• Voter Registration

  6284.6

  76%

  In order to vote, eligible people must register. Higher registration rates are associated with higher rates of turnout.

Health

• Self-Rated Health Good or Better

  7989

  84%

  This is the percentage of adults reporting that their health is good or better when asked “How is your general health?” People who report fair or poor health are less likely to vote, but people who have good or better health are more likely to vote. Higher is better.

• Poor Mental Health Days

  3.25.5

  4.6

  This is the average number of poor mental health days reported in the last 30 days. People with poor mental health are less likely to vote. Lower is better.

• Adults Receiving Disability Benefits

  2.47.9

  5.6%

  This is the percentage of adults 18-64 receiving Social Security Disability Insurance (SSDI) payments. This tells us about economic stability for workers with disabilities and also helps us understand labor force participation rates in each state. People with disabilities tend to vote at lower rates than people without disabilities. Lower is better.

• Uninsured

  318.4

  10%

  This is the percentage of people reporting not having health insurance coverage. Lack of coverage is associated with increased risk of chronic disease and mortality and delayed access to care. Lower is better.

• Active Physicians

  196.1466

  298.1

  This is the total number of active physicians of all types per 100,000 population. It tells us about access to health care in a population. People who are healthier are more likely to vote, and access to care is one way that people can obtain and maintain good health. Higher is better.

• Infant Mortality

  3.98.1

  5.9

  This is the rate of infants dying within the first year of life. It is a common measure of public health worldwide, and tells us about access to and quality of healthcare in a community. Lower is better.

• Premature Mortality

  150

  40

  This analysis uses a state ranking based on years of potential life lost (YPLL) before age 75. Many premature deaths are preventable. People of color are at higher risk for premature death, and there is some evidence linking this to lost votes over time resulting in significant voting disparities. Lower is better (1 is the best, 50 is the worst).

Community

• Poverty

  7.619.4

  13%

  This analysis uses the percent of households below the federal poverty line. This matters because people with lower incomes vote at lower rates than people with higher incomes, and experience worse health outcomes across a number of health indicators. Lower is better.

• Community & Family Safety

  150

  43%

  This analysis uses a state ranking that is a composite of several measures related to social and economic factors that influence community and family safety, including economic resources and violence. This matters because people who live in neighborhoods with greater safety are more engaged in their community and vote at higher rates. Lower is better (1 is the best, 50 is the worst).

• GINI Index / Income Inequality

  0.4350.514

  0.471

  This is a commonly used measure of income inequality. It tells us the extent to which the income distribution in a given area does not show perfect equality, and it matters because greater economic inclusion leads to greater economic growth and stability. Lower is better.