Our patient Rosa is 62 and lives with five family members in a cramped two-bedroom apartment in East Los Angeles. She is a cashier at a large retail chain and, as an “essential worker,” is still paid less than a living wage, without guaranteed sick paid leave or the ability to work remotely. When Rosa, whose last name has been omitted to preserve her privacy, tested positive for COVID-19, the CDC guidance we gave her about social distancing and quarantine — which was difficult for many of us to adhere to — was tragically impossible for her in the face of oppressive financial and social circumstances.
We are physicians and leaders of the largest federally qualified community health center in the nation, located in East Los Angeles. We see patients like Rosa every day. The communities we serve are disproportionately experiencing the worst health outcomes of the COVID-19 pandemic. For months we have witnessed the public policy failures of the COVID-19 response: the systematic underfunding of community health systems and the resulting deaths.
These deaths are unacceptable. We believe it is our duty as health care leaders to educate and inform our patients on the importance of registering to vote, more so in this election than ever.
Studies show that civic engagement leads to better health. Communities with higher rates of voter participation have more social and political power and are often better positioned to successfully impact change.
Latinx residents make up 30.5 percent, or 7.9 million, of the eligible voters in California. Of the 3.9 million Latinx residents registered to vote in California, approximately 1.7 million of them reside in Los Angeles County. Many of these individuals are classified as “low propensity” voters. Low propensity voters are vulnerable, disenfranchised and not likely to participate in the democratic process. They believe that the political systems in place don’t support their needs or their communities. In other words, they are the least represented when their voice should be the loudest. Research shows that health care providers are among the most trusted messengers in low-income communities of color, giving them the opportunity to help these voters overcome barriers to voting, improve their own health, and engage in actions that address the social determinants of health.
Our organization, AltaMed Health Services, has spent the past several years increasing civic participation in underserved areas of Los Angeles through integrated voter engagement. Because the messenger is often more important than the message in getting people to vote, we have used our health centers as hubs to train community members to reach out to their peers, register voters, provide bilingual non-partisan electoral education, and offer ballot collection. AltaMed’s work in this area fills a critical gap in voter outreach that most political campaigns do not meet. By targeting this section of the community, AltaMed is increasing the size of the electorate and helping transform low propensity voters into voters that campaigns will target in future elections.
During the March 3, 2020 presidential primary election, in partnership with additional community health centers, we contacted 42,480 low-propensity voters in Southern California. We called and visited a total of 546,141 households across California, in San Diego County, Orange County, South East Los Angeles and Oakland.
And we saw results. Data validated by political scientist Matt Barretto of the UCLA Latino Policy and Politics Initiative shows there was a 12.75 percent increase in voter turnout among low propensity voters in this year’s presidential primary. These increases were across the four different regions that we contacted.
We developed the My Vote, My Health toolkit to help community health centers across the nation replicate the program. The toolkit demonstrates the 5-touch model designed to turn health centers into civic engagement hubs where every encounter during a patient’s medical visit is an opportunity to discuss civic participation. This work is critical to repairing the cycle of under-mobilization in minority and working-class communities who often face the greatest social and economic challenges.
As a global pandemic intensifies and civil unrest has unfolded, an already fractured health care system is unraveling before our eyes. Hospital ICUs are filling up, community health centers are in jeopardy of shutting down, and access to COVID-19 testing remains strained. The politicization of our current public health crisis has laid bare how civic engagement and better health care are fundamentally intertwined. There is no doubt that traditional in-person voter registration efforts will be curbed by the pandemic. As doctors, nurses and health professionals, we have an obligation to step in and educate patients that in this era of sickness, voting is medicine.
Our health depends on it.
Ravi Kavasery is a family medicine physician at AltaMed Health Services in South East Los Angeles and is the medical director of quality and population health at AltaMed Health Services in East Los Angeles, the nation’s largest federally qualified community health center.
Jennie Carreon is the associate vice president of civic engagement at AltaMed Health Services.