AAP Voices Blog

A 19-year-old in the ER with intractable nausea and vomiting. A mother in her twenties with a 12-month-old baby at a well-child visit. A grandfather who is the primary caregiver for a toddler admitted for refusal to walk. What do these clinical cases have in common? Each case involves a potential voter interacting with the health care system. While medical providers engage with these individuals in a variety of ways to promote physical and mental health, providers also have an opportunity to promote civic health  – which extends to all corners of the medical system. By implementing systems and strategies to provide non-partisan voting support, medical providers can enact meaningful change.

“Pediatricians have access to a unique sector of the voting population-- teenagers and young adults as well as the parents, grandparents, and other caregivers of all our patients.”

Despite the growing recognition of the importance of civic health among providers, voter engagement remains an area too often thought of as outpatient care rather than a priority in all health care settings, Pediatricians have access to a unique sector of the voting population—from teenagers to young adults, parents, grandparents, and other caregivers of all our patients. For young adults, specific barriers surrounding voter registration and lack of awareness of voting options impede this population's ability to vote successfully. Through targeted interventions that can easily integrate into normal medical care routines, we can help overcome these barriers to voting.  

Voting is one of the most fundamental and important aspects of civic engagement. Many health care-associated organizations, such as the American Academy of Pediatrics (AAP), Vot-ER, Nonprofit Vote, and Med Out The Vote recognize the importance of voting and promoting voter education in clinical settings. Many hospitals, healthcare associations, and civic engagement organizations have even come together to declare the month of August as Civic Health Month, specifically focusing on voter engagement. Beyond improving civic health, voting and other forms of civic engagement have been associated with improved health outcomes in young adults, specifically in decreased risky health behaviors and in decreased symptoms of depression.

In the 2020 election, 17.6 million young adults aged 18-29 years were not registered to vote (~37% of this population). Among the top three reasons reported for not registering to vote in 2020 across all age groups, including young adults, included missing registration deadlines. Similarly, a survey conducted by the Pew Charitable Trusts investigated unregistered adult citizens and found that although the largest response for why eligible citizens were unregistered was disinterest in voting (44% of respondents), 27% of respondents reported an intention - but failure- to actually register. Astonishingly, almost two-thirds of these unregistered, eligible voters reported never even being asked to register to vote. The data from these surveys underscore that there is a distinct opportunity to increase voter registration by providing resources to make the process easier and addressing the issue with patients, relatives, and caregivers.  

In addition to the barriers surrounding voter registration for young adults, the physical act of voting remains an obstacle.  A U.S. Census report analyzing American voters from 1980-2016, found voters aged 18-29 years comprised the smallest percentage of voters since 1988.  The same census report found a higher percentage of younger nonvoters cited being "too busy" or "having a conflicting schedule." Similarly, a study that offered voter registration to patients aged 18-22 years in a primary care clinic identified "work" and "transportation" as the two greatest barriers to voter turnout in this age group. With these findings in mind, we must work to improve young adults' understanding of non-traditional voting options that extend beyond simply voting in-person on election day.

At my institution, the Division of Adolescent Medicine and the Child Health Advocacy Institute created the Youth Voter Initiative Project to offer non-partisan voting support to young voters, developing voter resource guides geared towards youth voters and their unique voting barriers, and promoting the use of existing well vetted tools, such as those offered by Vot-ER. These guides – offered in both English and Spanish – explained voting requirements, registration procedures, different voting options, and additional resources.  These voter resource guides could be handed directly to patients and families or included as part of patient instructions distributed at the end of a visit. Of course, physicians should always check with their institutions on what kinds of voter engagement are acceptable – but even a poster on the wall can help educate voters.

The AAP is also mobilizing members to promote civic health. Through partnering with Vot-ER, the AAP is giving pediatricians across the country the tools they need to help register young voters, including conversation guides and QR code badges that direct patients to voter registration information. At aap.org/votekids, health professionals can also find graphics and videos to help get out the vote. If you attend this year’s AAP National Conference & Exhibition in Orlando, be sure to stop by the Advocacy booth for even more opportunities to engage on civic health.

These initiatives show there is ample opportunity for collaboration to provide voting support throughout the health care system. It is imperative that we continue to brainstorm creative ways to promote civic health, both during election years and beyond. It is easy to overlook civic health in the world of medicine. Patients are sick, parents are worried, and medicine moves at a fast pace. However, it is our responsibility as health care providers to promote this key component of our patients' overall health.