Vote … or Die? There’s a growing body of research examining the links between health and a fundamental aspect of American democracy. – By Susan Milligan (usnews.com) / March 28 2018
Beneath the quiet, postcard-pretty image of Massachusetts’ Cape Cod region is a thriving local activism scene. There are hundreds of community organizations and nonprofits in the geographically contained vacation spot. Locals show up regularly for town meetings, and if they don’t manage to buttonhole their selectman at an official event, they’ll make their opinions heard when dropping off their garbage at the local dump.
That civic passion translates to the polling place, as the Cape area’s Barnstable, Dukes and Nantucket counties are all among the country’s leaders when it comes to voter participation, a measure of community vitality included alongside factors like homeownership and nonprofits per capita in U.S. News’ ranking of America’s 500 Healthiest Communities.
“You don’t want to be the person not wearing an ‘I Voted’ sticker” on Election Day, says Liz Rabideau, chair of the Cape Women’s Coalition, which works to increase the amount of women in public office.
Travel 2,000 miles away to the rural, younger and poorer counties of south Texas, and that display of basic democracy appears to be happening in a different country or universe. There are just a handful of funded civic and nonprofit groups in places like Frio and Starr counties, and both counties fall within the bottom bracket of communities scored by U.S. News on ballot-box performance.
El Tejano, a weekly paper in Starr County, proudly hosted a recent debate so voters could assess candidates for three countywide offices, and it was only the second such event in 30 years, says the newspaper’s publisher, Dina Garcia-Peña. It’s hard to get candidates to respond, she says, and just as difficult to convince voters it’s worth it to care.
“It’s kind of like, ‘Why bother?’” Pena says.
Voting: It’s the most democratic and democratizing thing Americans can do, since it is an equal option for citizens over 18 of any race, religion, ethnicity or income group. Yet voter engagement varies wildly among communities, affecting not just residents’ influence on policy and politics, but their very health, experts say.
“We can look at voter engagement as kind of an outcome from some good things happening, and a cause of good things or bad things happening,” says Christopher Mann, an assistant professor of political science at Skidmore College in Saratoga Springs, New York, and an expert on voting patterns
People who turn out consistently for elections tend to get more attention – and more social services – than those who stay away from the polls, Mann says. And there’s a self-fulfilling effect in both cases, with residents of low-turnout areas continuing to stay disengaged because they feel ignored, while those in high-turnout areas see the ongoing value of their involvement.
“It’s kind of a symbiotic relationship,” says Barry Burden, a political science professor and director of the Elections Research Center at the University of Wisconsin-Madison. He points to two studies showing that higher voter turnout and registration occurred in areas that expanded Medicaid under the Affordable Care Act. “A person or a community could be in a virtuous cycle,” getting more attention from government, thus encouraging them to vote more, “or a harmful cycle, feeding off each other in a different way.”
There is evidence, too, that civic engagement is tied more directly to physical and mental health, with studies of both American and overseas individuals showing a link between a person’s health and voter participation.
Healthier people are more likely to vote, and that’s logical, Burden says, since people who have physical ailments or are distracted by pain or a doctor’s appointment likely have other priorities.
Flipping the relationship, a study of Israeli voters on Election Day tied the act of casting a ballot to increased levels of the stress hormone cortisol, while a study published online in January by the journal Child Development found that voting at the transition to adulthood was not associated with physical health later in life.
However, the Child Development study also found that casting a ballot was tied to better mental health and fewer risky health behaviors, as well as higher educational attainment and income in adulthood.
“Voting might be indicative of a general sense of connectedness with society, empowerment to be civically involved, or a belief in civic responsiveness,” the study’s authors wrote. “Each of these might serve promotive functions for mental health.”
Indeed, Burden says there’s a wellness-building sense of empowerment that comes with voting, and the social interaction that accompanies going to the polling place could be beneficial as well. The National Institute on Aging reports social interaction is connected to health, especially as people age.
“There’s a psychological [sense of] well-being a person might get for participating” in elections, Burden says. “Simply getting out of the house is a positive.”
Community health ratings appear to back up such assertions. In the U.S. News Healthiest Communities analysis, for example, communities were scored across 10 areas tied to health and well-being, with measurements of both mental and physical health included. Of the 25 counties that scored the highest for voter participation in the analysis, 22 fell within the 500 Healthiest Communities ranked by U.S. News, with outliers in Alabama, Idaho and east Texas.
The south Texas counties of Frio and Starr both landed in the bottom third of the nearly 3,000 counties and county equivalents scored.
Why the dichotomy between the Bay and Lone Star state communities? Some of it is sheer demographics, experts say. Barnstable, Dukes and Nantucket counties are all wealthy: Nantucket boasts a median household income of $89,428, according to Census Bureau estimates, while Barnstable’s is $65,382 and Dukes’ lands at $63,534. The average median household income in the U.S. is estimated to be $55,322.
Starr County, meanwhile, is among the poorest counties in the country, with a $26,682 median household income and nearly 40 percent poverty rate, Census Bureau estimates show. Frio County’s median household income is estimated at $37,163, and more than a quarter of its residents are thought to live in poverty.
Lower-income people in general are less inclined to go out and vote, notes Lydia Camarillo, vice president of the Southwest Voter Registration Education Project, based in San Antonio. “If there’s no investment, and no tradition of voting because there’s no investment, that leads to the participation being at a very low level,” Camarillo says.
Age, too, matters. The Cape counties skew older than the two in Texas, and older people are statistically more likely to get involved in politics regardless of where they live. In 2016, for example, citizens 65 and older had a 71 percent voter turnout rate, according to the Census Bureau.
There’s also a long tradition of voter and civic participation in New England that’s displayed on the Cape, current and former elected officials from the region agree.
“You have people who as a rule are well-educated, who have been active in their professional lives. And that continues with [political] activism. They want to continue to be engaged mentally and emotionally,” says former U.S. Rep. Bill Delahunt, a Democrat who represented the region, which is famous for being home to one of the most storied political families in politics, the Kennedys.
“What we know about voting is that it’s a habit,” and one that contributes to the overall sense of community on the Cape, says Julian Cyr, a Massachusetts state senator for the area. “The social bonds here are really strong.”
Despite its association with the Kennedys, the Cape is not universally liberal, either, notes Mark Forest, a selectman in the Barnstable County community of Yarmouth. It has an active tea party group as well as other associations, he says.
In south Texas, though, the task of spurring civic engagement is harder – even before organizers tackle the issue of voter disenchantment, says Rosalie Weisfeld, a Democratic Party activist in the region. Individuals in Texas must be deputized by the government to register others to vote, and in Starr County, Pena says some people are more than 40 miles away from the closest early voting site.
Groups like the Southwest Voter Registration Education Project are working to register Latinos, who Census estimates say account for more than 95 percent of the population in Starr County and nearly 80 percent in Frio County.
“We want to help them understand they have power through their votes. They can demand respect and dignity,” Camarillo says.
And, most likely, better health.
