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Voter Participation

Voter registration and participation rates


I. FACTORS ATTRIBUTABLE TO HEALTH

Political participation can be associated with the health of a community through two possible mechanisms: through the implementation of social policies or as an indirect measure of social capital. Political participation is directly related to the socioeconomic status and other demographic characteristics of individuals, with lower levels of participation observed in people with low income and low education levels. Disparities in political participation across socioeconomic groups matters for political outcomes; additionally, the resulting policies could have an impact on the opportunities available to the poor to live a healthy life. Lower representation of poorer voters could result in reductions of social programs aimed toward supporting disadvantaged groups.

Although there is no direct evidentiary connection between voter registration or participation and health, there is evidence that populations with higher levels of political participation also have greater social capital. Social capital refers to the existence of trust and mutual aid among the members of a society and high participation of its members in civic associations. There is evidence of a positive association between social capital and lower mortality rates and higher self-assessed health ratings. This linked knowledge allows inferring that there could be more favorable public health outcomes in populations with higher political participation.

There are multiple measures of social capital including participation, reciprocity, trust, and social support systems. Multiple studies have found that higher social capital, regardless of measure, consistently increases the odds of self-reported good health and other favorable health outcomes. In one study, the likelihood of mortality was more than double among people who lacked social and community ties (low social capital), after adjusting for age and self-reported health status and practices. Levels of political participation are negatively correlated with levels of mistrust, which is an indication of depletion in social capital. Certain social and health outcomes among African Americans/Blacks—like the graduation rates and suspension rates of students and infant mortality rates—were found negatively correlated with minority diversity by state in the United States, which could be related to lack of political support for policies that support minorities.


II. DATA SOURCE AND METHODOLOGY FOR HEALTH EQUITY ANALYSIS


California

Note to LHDs in California: The California Department of Public Health’s Healthy Communities Data and Indicator (HCI) project has already collected, cleaned, and compiled these data for this indicator for California, which can be found at http://www.cdph.ca.gov/programs/Pages/HealthyCommunityIndicators.aspx. For instructions on how to download and filter data from the HCI, see Appendix D. For jurisdictions outside of California, it is possible to obtain voter registration and participation data from the local registrar of voters or secretary of state.


Areas Outside California

To determine voter registration rates, these data can be geocoded and compared to Census 2010 data, which has the population 18 years and older by geographic area. One limitation of this method is that the data are not adjusted for non-citizens, felons in prison, and supervised felon parolees. For California, these categories make up 15.8% of the voting age population. One way to adjust for felons in prison would be to subtract out those persons in correctional institutions, available in Census 2010. These data are not available in the American Community Survey.

To calculate voter participation rates, the data are more straightforward. The data from the registrar of voters has the information on whether individuals voted in the last, and sometimes previous, election. Geocoded data, then, will include both the numerator and the denominator for the geographic area of interest.


How to Analyze Voter Registration and Participation

Estimates of the number of people who are eligible to vote were obtained from the California Secretary of State’s Reports of Registration (15 days prior to a general election) for counties and the state. The eligible population of voters is the number of individuals in the population that are 18 years and older, are citizens and not felons in prisons or supervised felon parolees. Eligible population is obtained by subtracting from population counts published by the California Department of Finance, the population that is 17 years or below, non-citizens, felons in prison, and supervised felon parolees. Complete enumeration data at the Census block level on the number of people 18 years and older who registered to vote and those who voted in the general elections was obtained from the statewide database. Data was aggregated into Census tracts, cities/towns, counties, regions, and the state. Regional estimates of the population eligible to vote were also obtained. Decile rankings of places and relative risk in relation to state average were calculated. Additionally, information on the population 18 years and older or voting age population (VAP) for the state and counties was obtained from the Department of Finance for all years available is included for those interested. Estimates of the VAP for cities/places and Census tracts were obtained from Census 2010.

Voter registration is determined using the number of individuals who are eligible to vote and registered to do so. Registered voters can be expressed as a proportion of the eligible population. Voter participation is calculated by assessing the number of individuals who voted in the most recent election among those registered to vote, and can be expressed as a percentage of all registered voters.


Example 1: Voter Participation for All Counties in BARHII Region

After downloading and filtering the data downloaded from the HCI project as explained in the note to health departments in California above, the chart below displays percentages of voter participation in BARHII member counties, which include all counties in the Bay Area and Santa Cruz.

Figure 33: Voter Participation, BARHII Counties, 2010

voter_participation_Figure-33

Example 2: Voter Participation for Places within Napa County in the 2008 Presidential Election

Figure 34 shows voter participation in places (i.e., towns and cities) in Napa County. These data were downloaded from the same dataset in example one but filtered to display places in Napa County.

Figure 34: Voter Participation, Napa County Cities and Places, 2008

voter_participation_Figure-34

III. BAY AREA LOCAL HEALTH DEPARTMENT EXAMPLES


The City–County Neighborhood Initiative
Alameda County Public Health Department

The City–County Neighborhood Initiative (CCNI) in the Sobrante Park neighborhood of Oakland is staffed by members of the Alameda County Public Health Department (ACPHD) and the City of Oakland. The CCNI is a community-building effort aimed at empowering the residents. The Sobrante Park Resident Action Council (RAC) made several efforts to encourage voter registration and promote education of issues on the ballot. The RAC went door to door in the neighborhood, handing out 837 voter registration forms. In addition, the RAC held voter education forums with the local League of Women Voters (LWV) chapter. The community also held debates on local issues and a candidate night.



REFERENCES

Baum FE, Bush RA, Modra CC, Murray CJ, Cox EM, Alexander KM, Potter RC. 2000. Epidemiology of Participation: An Australian Community Study. Journal of Epidemioly and Community Health 54(6):414-423.

Berkman LF, Syme SL. 1979. Social Networks, Host Resistance, and Mortality: A Nine-year Follow-up Study of Alameda County Residents. American Journal of Epidemioly 109(2):186-204.

Braveman PA, Egerter S, Woolf SH, Marks JS. 2011. When Do We Know Enough to Recommend Action on the Social Determinants of Health? American Journal of Preventive Medicine 40(1S1):S58-S66 .

Gilbert KL, Quinn SC, Goodman RM, Butler J, Wallace J. 2013. A Meta-analysis of Social Capital and Health: A Case for Needed Research. Journal of Health Psychologygy 18(11):1385-1399.

Hero RE, Tolbert CJ. 1996. A Racial/ethnic Diversity Interpretation of Politics and Policy in the States of the U.S. American Journal of Political Science 40(3):851-871.

Kawachi I. Social capital and community effects on population and individual health. Ann N Y Acad Sci. 1999; 896: 120-130.