The Healthy Democracy Campaign:
Medical Students Taking Action to Address Social Determinants of Health
By: Dr. Jennifer Caputo-Seidler
Given the reality of health disparities in the United States, it is not enough for medical students to learn evidence-based medicine. Most of an individual’s health is determined by nonmedical factors such as job opportunities, education, and the safety of their physical environment. Medical students must develop the skills to understand and address social determinants of health to optimize the care of their patients.
Civic Health Month
Civic Health Month takes place every August and promotes voting as a tool to empower patients to challenge social determinants of health. Government policy and spending shape the social, economic, and physical conditions contributing to poor health. Who votes determines what policies are created and how government funds are spent. However, 51 million eligible people in the United States are not registered to vote. This group of unregistered eligible voters disproportionately includes younger Americans, those of lower socioeconomic status, and those identifying as a member of a minoritized race or ethnic group. Importantly, these same groups have shown the most significant increase in voter turnout when encouraged to vote by their healthcare provider. Expanding voter turnout to include those who the electoral process has historically marginalized has the power to alter policy and funding allocation to address the social determinants impacting the health of these communities, including affordable housing, food security, and employment opportunities.
Actionable Tools to Get Started
Recognizing this relationship between health and voting, in 2022, the American Medical Association (AMA) passed a resolution declaring voting as a social determinant of health. Multiple professional organizations, including the American Academy of Pediatrics, have come out with statements encouraging physicians to engage patients and their families in conversations around voting. Several organizations have emerged that promote voter engagement in healthcare settings, including Civic Health Alliance, Vot-ER, and Doctors for America.
Vot-ER, a nonpartisan, nonprofit healthcare-based voter registration project, makes it easy to incorporate voter registration into existing clinical workflows with their Healthy Democracy Kits. Free to all healthcare providers, including medical students, the kits come with a “Ready to Vote?” lanyard to promote conversation and a badge card with QR and text codes that patients can use to register to vote on their phones. The landing page also includes a helpline for those who have questions about eligibility or any part of the registration process and a link to nonpartisan information about what will be on upcoming ballots. The Vot-ER website provides sample scripts for badge users to learn how to incorporate asking about voter registration into the social history. Individuals are also able to track their impact through the site’s dashboard.
Engaging Medical Students
The Association of American Medical Colleges (AAMC) encourages nonpartisan voter registration as an effective way for medical students to foster civic engagement and promote their school’s commitment to health equity. They provide the guidance of asking patients if they would like to register to vote, and providing services to help them register to vote, but not endorsing any political party, candidate, or specific policy.
In 2020, Vot-ER launched the Healthy Democracy Campaign, a national competition among medical students during Civic Health Month to encourage people to register to vote or request a mail-in ballot. That year, 80 medical schools participated, and over 15,000 adults started the voter registration process using the Healthy Democracy kits. This year’s campaign kicked off on August 1, 2023, and its vision has expanded to encourage participation from all health professions students, not only medical students. The Healthy Democracy Campaign runs through October 13, 2023. During the campaign, students can participate in activities such as social media outreach, organizing a voter registration drive, and encouraging classmates to ask about voter registration during patient encounters. There is still time to start or join a team and take action to improve the civic health of your community!
Dr. Caputo-Seidler is an Assistant Professor of Medicine in the Division of Hospital Medicine at the University of South Florida. Her interests include medical education, narrative medicine, and civic engagement. She completed a Certification in Professional Achievement in Narrative Medicine from Columbia University. Her writings have appeared on KevinMD, STATNews, and SheMD. Dr. Caputo is a former Vot-ER Civic Health Fellow and continues to work closely with the organization, including as the faculty advisor for the Healthy Democracy Campaign at the University of South Florida. You can follow her on Twitter @jennifermcaputo.
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