How Nurses Can Promote Civic Engagement

Believe it or not, voting can improve your health — and not because you get in a few more steps walking to the polling place. In everyday practice, voting has a profound effect on public health. In their effort to promote healthier communities, nurses and healthcare professionals can incorporate civic engagement into their care tips for patients.

As Ben Ruxin, director of Civic Health Month, points out, “Civic health and physical health are intimately related: civically healthy patients can use their vote to shape the issues that affect their health.”

“Additionally, higher levels of civic engagement correlate with better health outcomes,” he adds.

Voting on issues like affordable housing and healthcare can ultimately lead to better living conditions, more supported communities, and better overall health.

While voting can help create healthier communities on a long-term, broad scale, nurses and other healthcare professionals might also consider taking part in civic engagement because of more direct, pressing issues. In the upcoming election, many factors affecting healthcare hang in the balance, including COVID-19 management, opioid use and regulation, and the comprehensive structure of the country’s healthcare system.

If you want to get involved in civic education measures, you can take advantage of a recent surge in initiatives to encourage voting as part of healthcare. This guide breaks down ways nurses can get involved with campaigns to promote voting, voter registration, healthcare advocacy, and other forms of civic engagement.

As anyone who works in the healthcare industry knows, the COVID-19 pandemic only exacerbates issues already affecting professionals working within the industry.

In many facilities, nurses and doctors lack the adequate resources they need to handle the pandemic. The healthcare industry has also suffered from the lack of a nationwide, cohesive strategy to battle the virus, says Jenneh Rishe, a registered nurse and founder of The Endometriosis Coalition.

Even without the pandemic, “the biggest thing impacting healthcare over all is cost,” Rishe explains. “Lack of insurance coverage or adequate insurance coverage for necessary healthcare related services hurt both healthcare providers and patients.”

Many healthcare providers cannot afford to operate with poor insurance reimbursement options, so they become out-of-network providers. This ultimately leads to large financial pressures on patients, Rishe points out, who need to pay “outrageous out-of-pocket costs” for appointments and medication.

In addition, Ruxin explains that healthcare professionals always work in the context of systemic pressures.

“No matter how hard our healthcare professionals work, persistent inequities across access to things like food, housing, clean air, educational opportunity and affordable healthcare mean that up to 80% of a patient’s health outcome will actually be determined outside of the healthcare setting,” he says.

According to a report from the Pew Research Center, healthcare is one of the most important issues to Americans in the upcoming election. The COVID-19 outbreak places added importance on an already critical issue.

Voters are paying close attention to the presidential candidates’ pandemic response plans. Democratic candidate Joe Biden plans to implement a nationwide tracking and testing program and provide resources to healthcare workers. Republican incumbent President Donald Trump has largely put pandemic response power in states’ hands while prioritizing “opening up America again.”

Finally, the future of the Affordable Care Act (ACA) is at stake this election. Biden served as President Barack Obama’s vice president when this legislation became law. He aims to protect the ACA while providing a public option to Americans. In contrast, Trump has advocated for overturning the law, and has challenged its constitutionality through the Supreme Court.

Other pressing public health issues in the U.S. include the opioid crisis and gun violence. As a healthcare professional, you can use this nurse’s guide to voting to find a full run-down of these issues.

When it comes to democratic processes like voting, experts refer to the concept of civic health. “Civic health describes how well you and your community are able to participate in activities that require you to come together, solve problems, and make decisions that affect everyone,” explains Ruxin.

When community members are civically healthy, through active voter participation for example, their actions can positively affect the health of their communities. Lekha Chilakamarri, medical student and co-chair of the Med out the Vote initiative, points out that “studies show communities with the highest rates of community civic engagement also have the healthiest populations due to implementation of public health policies.”

Civic participation is associated with a number of positive health benefits, including more community engagement, firmer networks and community ties, and even increased physical activity. One study of 44 countries, including the U.S., found that voter engagement correlated with better self-reported health. Results from another study support those voters’ self-reported results, concluding that people who didn’t vote reported worse overall health.

Voting impacts social issues with public health implications, including access to safe and reliable housing, healthy food, clean air, educational opportunity, substance abuse and addiction treatment, and of course affordable healthcare. All of these factors contribute to whether Americans, no matter their income, can lead healthy lives.

The large-scale civic education movement in healthcare spaces encourages healthcare professionals to recognize this link and to view civic health as part of their professional obligations, with the aim to improve long-term patient health.

Because they work closely with patients, nurses hold a unique perspective that allows them to understand the intricacies and complications of the healthcare system and its impact on patients.

“In the inpatient setting, we spend more time with the patients than anyone else does. In the outpatient setting, we establish a relationship of familiarity,” Rishe says. “We can see what’s working, and what’s not.”

From their insider stance, nurses understand the complex operations of medical insurance and healthcare costs. In addition to intel on the system, their extensive bedside care experience gives them a frame of reference on patients’ lives and the personal implications of healthcare costs. Often, Rishe points out, patients share important details about their lives, health, and financial situations with nurses instead of physicians.

With more than 3.8 million RNs, nurses make up the largest profession within the healthcare industry. Using these numbers to their advantage, nurses have the opportunity to harness their unique knowledge as a collective voice by voting for their own and their patients’ interests.

As Chilakamarri suggests, nurses working on election day might struggle to find time to vote.

“The need for civic engagement is clear in the larger policies that will ultimately lead to improved community health,” she says.

“Despite our best efforts, healthcare workers are often left without time or resources to participate in our democracy by voting,” she adds. Nurses working long hours on election day might vote early or try to vote by mail.

Joining professional organizations, such as the American Nurses Association (ANA), helps nurses stay up to date on pressing issues within the industry. Nurses can also volunteer their time by campaigning for their chosen candidate, helping out at polling stations, or participating in voter registration initiatives.

Nurses looking to integrate civic involvement as part of their approach to patient care can take advantage of the many organizations recently established to encourage nurses and other healthcare professionals to get involved with civic participation. Healthcare professionals can participate by voting, volunteering, participating in group activities, or providing access to community resources and facilitating community engagement.

The Power the Polls campaign, one of several initiatives from Med out the Vote, encourages healthcare workers to volunteer at polling places so that people at high risk of contracting COVID-19 can avoid doing so.

The organization is also turning to college campuses. “We are looking to empower medical students with institution-specific voter registration resources to help them get out the vote to their classmates and communities,” Chilakamarri says.

Civic Health Month, a collaborative effort between multiple voting advocacy organizations, including VotER, provides resources for healthcare workers to mobilize patient voters by helping them register to vote. Healthcare providers working with Civic Health Month can find resources to facilitate the sometimes challenging initial conversation with patients and on remaining nonpartisan in the process.

According to Ruxin, an emphasis on voter registration efforts at the point of patient care seems to be working.

“We observed a sharp uptick in orders of our voter registration kits in early June, and that earnest desire to engage civically has only continued to spread throughout the summer,” says Ruxin. “As of today (mid-September), over 21,000 healthcare professionals have signed up for our voter registration kits.”

Nurses perform important work that impacts daily lives; promoting civic engagement can help extend that impact to effectively promote long-term community health. “I do believe that voting can help these issues (in the healthcare industry),” Rishe claims. “Having people in power that understand and acknowledge what I believe to be a crisis in U.S. healthcare could help new programs and policies be shaped to address more options for access to quality, low-cost healthcare.”

The five major campaigns below provide nurses with information and the tools to encourage civic engagement.