In a new analysis being released a year out from the 2020 election, the Center for Science and Democracy is recognizing and responding to the erosion of our democratic institutions. Our Unhealthy Democracy: How Voting Restrictions Harm Public Health—and What We Can Do about It, explores the link between electoral representation and constituent health outcomes and finds that disenfranchisement is associated with poor health outcomes.
Previous studies have shown that public health disparities have political consequences, and that some patterns have been emerging for decades. For example, one study found that “since 2000, overall death rates declined by less than half as much, and death rates from drugs, alcohol, and suicide increased 2.5 times as much in counties with Republican gains compared with counties with Democratic gains.”
Our report summarizes these and other findings and goes further to explore how democratic institutions have shaped current disparities in public health. For example, we show that the greatest declines in statewide determinants of health since 2010, measured using America’s Health Rankings composite index, are concentrated in states with the most gerrymandered legislatures and those with the most restrictive election laws. In these states, where representation is distorted and the public has greater difficulty holding representatives accountable, legislators are less likely to expand health care, provide services for the poor, adopt sustainable environmental policies or address issues around environmental injustice.
Increases in opioid deaths, measured as the ratio of deaths in 2017 over 2010, increased more in gerrymandered states with above average poverty, especially for African-Americans. Blue = white, non-Hispanic; orange = Hispanic; black = black, non-Hispanic. Source: UCS; United Health Foundation 2018.
When politicians distort the electorate through increased barriers to voting and partisan district maps, they’re not just changing the outcome of the next election. They’re changing the whole policy landscape—whose voice gets heard, whose needs and interests are valued, and who gets left out. That has real consequences. Consider the relationship between the increase in opioid deaths from 2010-2016 in high poverty states and partisan symmetry (bias). In states that are more heavily gerrymandered to advantage Republicans (negative scores indicate Republican advantage), the increase in opioid deaths has been higher, especially among African Americans.
This analysis confirms what civil rights organizations and community advocates have been saying for years—that the right to participate in the electoral process is an essential tool for communities to protect themselves. We can’t have healthy communities if we don’t have a healthy democracy. We need reforms that give power back to the voters, and make sure everyone can participate and be fairly represented.
Fortunately, there’s a path forward, and advocates for reform have been successful. Just this week, for example, voters in Virginia were able to elect their House of Delegates without the burden of a racial gerrymander for the first time this decade, and the results are consequential. New Yorkers also passed a major electoral reform, switching to ranked choice voting (RCV) for city races in order to increase turnout and competition. Other efforts over the last several years have led to positive expansions of voting rights, including automatic voter registration, extended early voting, and reform of the redistricting process.
As the nation gears up for the 2020 election, you can commit to taking action on voting rights and environmental justice in your community. Let us know today how you committed to helping create a healthier democracy.