Civic Engagement

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What is civic engagement?

Civic engagement, the actions that we and our communities take to identify and address problems, shapes our opportunities to be healthy. By taking actions to get more civically engaged, like voting, we exercise our right to make decisions about our communities, like whether our neighborhoods have walkable sidewalks, how much funding goes to reproductive health clinics in our states and how prepared the nation’s infrastructure is for future pandemics and disasters.

A recent analysis of civic engagement and state health outcomes from 1996 to 2020 showed that in states where people are more civically engaged and vote more, public health outcomes are better.

Another analysis, the Health & Democracy Index, showed that states with more inclusive voting policies and fewer barriers to voting have better health outcomes. States with restrictive voting policies have worse outcomes. These barriers to voting also worsen existing health disparities, like disparities in infant mortality. 

Who can take action to help our communities become more civically engaged?


Vote, and encourage your friends, colleagues and neighbors to vote. Let your community members know how voting, as well as participation in town halls, public meetings and volunteer activities, will help shape local policy and strengthen community cohesion.

Encourage your workplace and organizations to be voter-friendly. Thirty states and the District of Columbia require employers to give their employees time off to vote. Find out if your state is one of them! If you’re not in one of those states, let your employer know that offering flexibility to vote is a good way to provide employee benefits and represent the company’s culture and values.

Learn about voting policies in your state. Inclusive voting policies, like policies that allow election day voter registration and online voter registration, help make communities healthier and more equitable. Barriers to voting, like felon disenfranchisement (a practice in most states where people convicted of felonies are permanently banned from voting), do irreparable harm to communities’ health and equity.


Organize Pledge to Vote campaigns. Pledge to Vote Campaigns increase the likelihood that a voter will vote by asking them to make a pledge and list a reason why they are going to vote in the upcoming election. These campaigns are often paired with voter contact efforts to also remind those who took the pledge to vote on or before election day.


Pass inclusive voting policies and remove barriers to the ballot box. In addition to impacting the health and well-being of communities, evidence has shown that areas with enhanced access to voting also have improved economic status. For our communities to thrive, both in health and economically, states should prioritize policies that improve access to the ballot box.


Include voting metrics in Healthy People 2030. The Healthy People program is an important nationwide framework for advancing the health of all Americans and already has a history of recognizing the importance of voting in its framework, including the relationship between voting and health in its Healthy People 2020 program. Going further and including voting as a key metric in Healthy People 2030 would create more actionable opportunities to advance voting access and spread awareness about the impact of voting on health.

Make voter registration easier through existing processes. This year, Oregon became the first state to implement a change that would allow Medicaid participants to be automatically registered to vote. Experts estimate that if the Centers for Medicare and Medicaid Services approved the policy, that over 170,000 Medicaid recipients could be added to state voter rolls. Allowing other states to implement this change would drastically help reduce barriers to voting and target communities that face many of the highest barriers.

Furthermore, offering the opportunity to register to vote during the application process would ensure that the more than eight million annual users of the federal exchange would gain access to participation in our democracy. Many of these users have moderate to low incomes and live in states that erect barriers to voter registration. This change was previously mentioned in President Biden’s 2020 Executive Order on Improving Access to Voting – the Department of Health and Human Services should take swift action to finalize and implement the integration of voter registration in the application process before the next open enrollment period.

Pass the John Lewis Voting Rights Advancement Act. Over the past decade, U.S. Supreme Court decisions such as Shelby County v. Holder and Brnovich v. Democratic National Committee have unfortunately eroded key protections provided by the Voting Rights Act that protect against racial discrimination in the voting process, giving many states the ability to suppress and discriminate against voters. Since then, state lawmakers in at least 19 states have introduced and enacted legislation to restrict voting access. The John R. Lewis Voting Rights Advancement Act would restore VRA protections by establishing a federal review process of changes to state voting laws. Potentially discriminatory changes would be paused until federal review is completed, and changes found to be discriminatory would be blocked entirely. Furthermore, strict oversight would be applied to states with histories of voter discrimination and policy changes known to be used to discriminate against voters of color. The bill also incorporates the Native American Voting Rights Act to increase representation of Tribal communities in the voting process.

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American Public Health Association