Thread by @ChomiloMD

Committed to ending racial health inequities?

You need to be talking to your patients about their civic health.

Voting and health inequities are closely linked.

Thread.
#MedTwitter
#MedStudentTwitter
#MedEd

(1/)

Families separated at the border
Another school shooting
#COVID19’s racist impact
The ongoing fight for #Medicaid
#ClimateChange

All impact the health of our communities. Outcomes that are heavily influenced by participation in, or lack of, voting.
#VoteHealth #VoteKids (2/)

Although we know policies directly impact health we see gaps in opportunity not only for access to resources but to the ballot box where many of our communities’ decision makers are selected.
(3/)
#VoteHealth #VoteKids

tcf.org/content/report…

Voter registration among young people, particularly young people of color, is far lower than that of older individuals.

In 2016 white Americans over the age of 65 had a registration rate of 81%, compared to 61% of Black & <50% of Latinx & Asian Americans aged 18 to 29.

(4/)

Income & voting are also linked.

In every racial group having less income made you less likely to be registered to vote

**Note: unfortunately no data provided on American Indian/Alaskan Native/Indigenous populations in the above piece
(5/)

One’s health also impacts voting.

2016 turnout among individuals who self-report “Excellent” or “Very good” health was 64%

Among those reporting “Fair” or “Poor” health? 49%

Insured? 63%
Uninsured? 34%

#VoteHealth
(6/)

When fewer young voters, voters of color or voters w/low incomes or poor health are able to vote, elections are less likely to empower all communities.

Politicians become more responsive to the interests of fewer citizens.

Their policies reflect these inequities.
(7/)

This bias shows up in how #Medicaid programs are/aren’t supported.

States that have a disproportionate representation by healthy voters spend less on health & have less generous #Medicaid programs for both benefits offered & payment rates.

#VoteHealth #VoteKids
(8/)

“The negative relationship between the degree of health bias in state electorates and the level of Medicaid generosity remains after controlling for the degree of class bias in voter turnout.”

(9/)
#Medicaid
#VoteHealth

ssrn.com/abstract=24549…

Policies lead to community level racial health disparities.

On the left #Medicaid expansion as tracked by @KFF. Dark blue = states that have NOT accepted expansion

On the right Uninsurance rates as tracked by the @covid_atlas by county level data. Dark purple is >25%

(10/)

We know communities that have health insurance are generally healthier & have less incidence & complications from chronic disease

Diseases that impact susceptibility to #COVID19

We also know access to insurance helps ⬇️ racial health inequities

ncbi.nlm.nih.gov/books/NBK22063…

(11/)

So unsurprisingly our map of uninsured counties has a lot of overlap with #COVID19 infection rates (as of last month) via the same @covid_atlas county-level data

Left = Confirmed cases per 10k population: Red>>>Yellow

(12/)

Death rates follow a similar pattern.

Note the “Black Belt,” (circled in purple) counties in the Southern US where the population is at least 40% Black.

This is how structural racism manifests in health policy. To devastating effect.

#VoteHealth
#BlackLivesMatter
(13/)

It is clear that policies that impact health care access have had a direct tie to racial health equity.

This is true during #COVID19 & will likely have an even greater impact in the recovery phase of the pandemic.

#VoteHealth

(14/)

Inequity in voting access➡️disparities in voter participation➡️less responsive leaders➡️policies worsen health inequity➡️community level health disparities

The negative feedback loop on health created by voting inequity is clear.
(15/)
#VoteHealth

annfammed.org/content/annals…

Getting out the vote provides an opportunity to break the negative feedback loop!

Young adults who vote & are civically engaged have better mental health, achieve higher levels of education, & have higher incomes

#VoteHealth #VoteKids

(16/)
pubmed.ncbi.nlm.nih.gov/29359473/

Communities, especially those with high rates of poverty, that have high voter turnout have lower income inequality & higher wages.

States who have a higher voter turnout have better healthcare.

#VoteHealth
(17/)

scholars.org/contribution/h…

Enfranchisement of Black voters is associated with reductions in Black AND white education gaps.

Enfranchisement of women is linked with increased spending on children & lower child mortality.
#VoteHealth #VoteKids
(18/)

tcf.org/content/report…

So #MedTwitter & #MedEd this is the time to turn advocacy into action.

Voter enfranchisement is antiracism work. It is key to dismantling structural racism and the racial health inequities it creates.

(19/)

#BlackLivesMatter
#WC4BL #VoteHealth

There are lots of ways to start. I invite all to join @AmerAcadPeds, @md4healthequity, @Vot_ER_org & so many other organizations connecting clinicians to tools to help patients register to vote & get a mail-in ballot (so they can protect their health while they vote!)

(20/)

You can find out more about healthy democracy kits here: vot-er.org/watchkitvideo/

And more about key child health equity issues & their link to voting: services.aap.org/en/advocacy/el…

Let’s get our communities engaged & vote like our health depends on it.

Because it does.
#VoteHealth