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Greg Wright:
Welcome to Social Work Talks. I am Greg Wright. What does health have to do with voting? We will find out as I talk with a social worker, Kristina Whiton-O'Brien, director of partnerships at Vot-ER. Welcome to Social Work Talks, Kristina, how are you doing today?
Kristina M. Whiton-O'Brien:
Thank you so much, Greg. I am doing very well, a little warm here, but doing very well.
Greg Wright:
It's also warm here in the Maryland area. When I think about voting, I don't think about health. How are those two issues related to each other?
Kristina M. Whiton-O'Brien:
Well, there's actually research that shows that the healthier you are, the more likely you are to cast a ballot. It actually shows that voting can make people healthier. We at Vot-ER are really wanting to improve the health of our communities, improve the health of individuals in our communities, and see that healthcare professionals, healthcare providers, have a role in civic engagement, civic health engagement, and talking to patients about voting.
Greg Wright:
How long has Vot-ER been around and what is its purpose?
Kristina M. Whiton-O'Brien:
We actually launched at the start of the pandemic, which there's a lot of irony there, because if you think about how the health of our communities, our country, and the world was impacted by the COVID-19 pandemic, that was really a catalyst moment for us. Vot-ER was started by Dr. Alister Martin, who is an emergency room physician at Mass General Hospital in Boston. We are a nonpartisan, nonprofit organization with a goal of providing patients the opportunity to register to vote, because much of our healthcare system and our healthcare experiences are determined by the policies that our elected officials implement.
Greg Wright:
There's an idea called social determinants of health. I know a lot of social workers probably already know this, but could you explain that to our audience?
Kristina M. Whiton-O'Brien:
As social workers, we use the lens of person and environment. We understand how micro, mezzo and macro levels interact with one another. The social determinants of health are really the things that impact someone in their community and in their lives at those mezzo and macro levels. When talking with Dr. Martin, who started Vot-ER, he tells stories about patients who come into the emergency room who maybe are there not because of an urgent medical issue, but because they are inadequately housed or they're food insecure or they're having physical symptoms related to their diabetes because they're rationing their insulin because they can't afford the copays. Those are the types of things that happen as part of those social determinants of health that he was seeing in the emergency room.
Kristina M. Whiton-O'Brien:
He actually talks about being inspired to address voter registration with a patient because of advice from a social worker. He was working with a patient who was in the emergency room because she and her children didn't have anywhere to sleep in the winter. She admitted to him and he was working with a social worker around what to do to try and get her housing for the evening. The social worker said, "Well, one way that we can establish residency for her to get her into transitional housing is by registering her to vote."
Those are the kinds of things he was seeing in the emergency room and thinking, wow, there's more that we have to do than just write a prescription or treat somebody's health issue. We have to go upstream, we have to think about prevention. As social workers, we understand the need to do those types of things and to address the environmental factors, the societal factors, that are impacting the patients and the clients that we work with.
Greg Wright:
I know that folks are able to register to vote at a Department of Motor Vehicles, but are they also able to do that in healthcare settings too, Kristina?
Kristina M. Whiton-O'Brien:
Yes, yes. Actually, it's really interesting because in 1993, the National Voter Registration Act was passed and that really became what's known as the Motor Voter Bill, so that when you go to the DMV you are able to either get a new license, take your driver ed test, get new plates for your car, you get information about how to register to vote. Well, that law also made it legal and encourages healthcare institutions to register patients to vote.
Kristina M. Whiton-O'Brien:
Voter registration is a non-partisan activity. I think what's happened in our society, especially now, voting has become a political issue. It shouldn't, because it's a right that we all have. The National Voter Registration Act made it legal for nonprofit organizations, which with most hospitals and healthcare institutions are, to register patients to vote. More individuals show up at a doctor's office or at a hospital than they do at the Department of Motor Vehicles, and so that's why healthcare needs to be a gateway to civic engagement and voter registration.
Greg Wright:
I'm a social worker and I work at a hospital or I'm at a clinic. How do I approach a person about encouraging them to register to vote, Kristina?
Kristina M. Whiton-O'Brien:
Yeah. I also want to let you all know that Vot-ER has a wonderful partnership with Voting is Social Work. Voting is Social Work is a collaboration of schools of social work and other social work professionals out of the Nancy Humphrey School at UConn and other schools of social work across the country. There's a real partnership between Voting is Social Work and Vot-ER, where the tools that Voting is Social Work provides and Vot-ER has can really work in compliment to one another.
At Vot-ER, what we do is we have a healthy democracy kit that you can order off of our website that's free. It's a lanyard that has the Vot-ER logo and it says Ready to Vote, and attached to that lanyard is a badge backer. When working with a patient, and as I talked to my social work colleagues who are part of our social work strategy group, what you can do is wear the lanyard and that in and of itself can be almost a passive way that a patient or client that you're working with can say, "Hey, what's that lanyard all about? What does ready to vote mean?" You can say, "Oh, I'm glad that you asked. Here's a QR code that if you have your phone you can get out and scan that code and you can either check your voter registration or you can register to vote."
We're also, through Voting is Social Work, trying to embed the idea of voter registration and talking to patients or clients about voter registration as part of field education in schools of social work, or in their internship when they're working with clients and completing a bio-psycho-social so that maybe the last question you ask, or as part of that history, the demographic history you're getting, you can say, "Oh, and by the way, are you registered to vote? If not, we have a tool that can help you do it right now."
Greg Wright:
Yeah. Is that an online tool or are there forms there available for a patient, if that person in fact wants to register?
Kristina M. Whiton-O'Brien:
Right, right. For Vot-ER, we have tools that are all electronic and through QR codes. Those could be on a poster, it could be on a pamphlet, it could be on a button, it could be on that lanyard. I think that Voting is Social Work also has ways that you could get maybe paper ballots. The other thing we have to keep in mind is that every state has different voting laws, so there are certain ways that you need to bring up the conversation and be aware of in terms of talking to folks about voting. But right now we're using, at Vot-ER, the electronic method.
Greg Wright:
Well, what if a patient does not have access to a laptop or a smartphone or even the internet? I mean, is that a hurdle too that has to be overcome?
Kristina M. Whiton-O'Brien:
Yeah. It's interesting that you talk about that because I was having a conversation last week with a doctor at Harvard School of Public Health and she is very interested in working with incarcerated individuals and getting them registered to vote. We talked about how to do that in prison and jail systems, and thinking about nurses, social workers or doctors who are working within those systems. In there, individuals will not have access to a cell phone, so that would have to be a paper registration form that we would use in those types of systems. Right now, Vot-ER only has the electronic and so we would probably have to work towards getting something with a paper ballot or paper voter registration.
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Greg Wright:
I've been looking at your website. You offer advice to social workers and others, and one of the big things is be non-partisan. I was wondering, Kristina, if you could explain that just a little bit further for us?
Kristina M. Whiton-O'Brien:
I think it goes back to how polarized we've come as a country and that everybody thinks that voting is either a Democrat or Republican issue. It really isn't. We need to understand that voting is a right and that every person has the right to vote. In non-partisan, we are not telling patients who to vote for, we are telling them that they just should vote.
I was talking with a doctor last week in Georgia. She was saying that when she talks to her patients, she says to them, "What you do in the voting booth impacts what I can do with you here in the clinical treatment room, because it's not about whether you vote one way or another or for one candidate or another, it's that you're voting, that your voice is heard."
We really want to stay away from giving advice and being intrusive or interrupting a session or an intervention or interaction with a client or a patient. We really just want them to know that there is power that they can have in voting and that they should exercise their voice, because the more voices at the ballot box, the healthier our communities can become and the more power maybe they can feel if they're feeling disempowered in their lives.
Greg Wright:
Yes. Now, this is August and it's Civic Health Month.
Kristina M. Whiton-O'Brien:
Civic Health Month is actually a project of Vot-ER. We launched Civic Health Month in August of 2020. Civic Health Month is a nationwide celebration to highlight the strong connections between healthcare, healthy communities, and civic participation. As we were just talking about, it's a non-partisan advocacy and awareness month dedicated to making voting and civic participation accessible to all, particularly those underserved by healthcare systems.
We have three objectives for Civic Health Month. One is to drive voter registration by getting medical providers and hospitals to register as many patients to vote across the US as possible. The second is to increase awareness around upcoming elections and highlight the direct impact of local elections on health and encourage turnout in these typically low attendance and nonpartisan opportunities to shape local policy. Last year, 2020, was a big presidential year. This year, 2021, is an in-between year, but there is still local elections that are happening that are really important for people to be engaged in. The third objective is to amplify civic voice in healthcare and generate publicity and awareness to normalize the civic discussion in healthcare.
We bring together a diverse group of organizations and institutions to celebrate and partner with us. In 2020, we had about a hundred partner agencies. In 2021, we have now over 220 partner agencies. We had a launch event at the beginning of the month where we had over 175 participants, and we're having a closeout event at the end of August that's going to be co-sponsored by the American Public Health Association, the National Academy of Science, Engineering, and Medicine, and Healthy Democracy, Healthy People. These are webinars talking about bringing voting to health care and civic health engagement.
Last year we over 26,000 Healthy Democracy kits ordered by providers across the US, those are those lanyards and the badge backers that I talked about, and last year we helped over 9,500 patients use Vot-ER tools and the portal to either register to vote or request a mail-in ballot. September 28th is a National Voter Registration Day, and on that day alone, we helped over 1,000 people get ready to vote.
We really did a lot last year, we've done a lot this year already, and we're looking forward to next August and getting ready for the 2022 midterm elections and having an even bigger and better Civic Health Month in August of 2022, and certainly welcome any organizations to contact us about partnering to get ready for that next election.
Greg Wright:
When I'm at the doctor's office next time, I'm going to bring this up.
Kristina M. Whiton-O'Brien:
It's so funny because I actually brought a Healthy Democracy kit to one of my doctors and he was like, "I love this." He was like, "I'm going to use it, sign me up."
Greg Wright:
Is there any other thing that you would like to add, Kristina?
Kristina M. Whiton-O'Brien:
I would really like to add that every election matters. Voting is critical now, but it's always critical. For example, I'm going to be voting tomorrow in a local election for a selectman's race and the town is anticipating only a 7 percent voter turnout. I know it's the summer, it's a Saturday in August, but we really need to make sure that coming out in the local election for board of health, for selectman, for school committee, that we're doing that because those individuals, those elected officials, are voting right now on whether or not our kids should wear masks in school, on whether or not businesses should be requiring masks, and people are feeling concerned and worried about sending children back in school because of what's happening with the Delta variant and with COVID.
What happens is, is that campaigns look to who is a super voter, who gets out and votes all the time. I've done a lot of work on local and national campaigns, political campaigns, and we look and target those super voters because we know they're going to come to the polls. If underserved, vulnerable populations aren't getting to the polls and having their voices heard, those communities are not going to have the attention that they need and the elected officials aren't going to understand the needs of those communities.
Let me talk data for a minute. We have statistics from seven different urban areas across the country and we have some information from East Harlem. There's a section of East Harlem that in 2018, in the mayoral election, had about 35 percent lower voter turnout rates than the rest of the city. That same section of East Harlem has decades lower life expectancy rates, as well as increased rates of diabetes. We're seeing direct correlations.
We're living in a time right now of voter restriction bills being filed and passed across the country. We know at Vot-ER we're just trying to get people to register to vote, but it's very important to make sure that people get to the polls and that they do vote and that their vote is counted. That's additional work that needs to happen and that I think, as social workers, we have a role in that.
I know that NASW and other organizations are on the front lines of that type of advocacy work, but we're trying to do what we can from the front end and having healthcare organizations be the gateway and that entry point to voting and getting people registered to vote and beginning that conversation between a trusted healthcare provider and a patient who may not have ever been asked before if they're registered to vote. That's what we're trying to do with the front end, and we pass it along to NASW and other organizations to continue to do that work of advocacy, to make sure that every single person in every community has a voice with their elected official so that they can make changes in their local community for better health, better health outcomes, and that we can all have better, healthier communities.
One of the things I love about Vot-ER is that they elevate social workers. I think, after my 30 years in social work, we've always felt like in healthcare, especially social workers are at the bottom of the food chain. That's not what Vot-ER does. Vot-ER really promote social workers and sees social workers as key people in this process. I love that, because we need to do everything we can to elevate our profession.
Greg Wright:
Wow. It sounds like a wonderful program, thank you. I've learned a lot, I'm sure that our listeners have as well. Thank you for being our guest on Social Work Talks. Kristina Whiton-O'Brien at Vot-ER.
Kristina M. Whiton-O'Brien:
Thank you so much, Greg.
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