DEAN'S NOTE

Voting and Our Health

On the importance of voting for a healthier world this November.

On November 8, Americans will cast their votes in the midterm elections. In this divided, partisan era, voting is notable as one of the few actions we all still take together, regardless of socioeconomic class, partisan affiliation, or geographic location. We all go to the polls, or cast our mail-in ballot, and, in that moment, we are the same—we are citizens.

Often at election time, we hear about the value of the electoral process, how it is a democratic inheritance worth cherishing and protecting. This country has held elections during a civil war, an economic depression, and other political and cultural shocks. Over the last 30 years or so, the relative calm of the historical moment made it possible to take this inheritance for granted, to lose sight of its importance and its fragility. The tumult of recent years, however, has been a reminder of the necessity of voting. It has also been a reminder of the authoritarian impulses in our society and our body politic which can threaten the free exercise of our democratic inheritance. In this context, it strikes me as more crucial than ever to say what we always say at election time but do not always truly hear—that voting matters, and that the fact that we live in a country where we can access this fundamental right is a privilege not to be taken lightly.

Our school community, and public health more broadly, is deeply engaged with politics. We know that politics shapes access to the resources that support health, from clean air and water to housing and education, to income and wealth, to justice and equal treatment before the law. For this reason, we engage with politics as a core priority for the mission of public health. This means advising policymakers, working to advance social movements that support a vision of progressive change, and voting. It was with an eye towards fostering participation in the electoral process that we earlier this month hosted an event on encouraging voter turnout ahead of the national elections. It is a privilege to be part of an academic community that prioritizes civic engagement as core to its mission of creating a healthier world.  

We now look to an election where much is at stake for the issues that matter most for health. From climate change, to reproductive rights, to commonsense gun safety reform, to racial justice and the rights of LGBTQ+ populations, the outcome of the election will be deeply consequential. I have long felt that one of the single most important steps we can take for health is voting. Each day, we watch our political leaders make choices that shape health. On Election Day, we get to choose the choosers. In doing so, we are reminded of our collective power to create a better world, and of our responsibility to use this power to advance the policies that support health.

It is worth asking: what happens if we neglect this responsibility, and opt out of participation in the political process? What if we choose not to choose? In that case, others will choose for us. If we do not engage with the electoral process, we leave the work of politics to those who may not share our priorities for promoting health. There are many who have the resources to amplify their influence on the political process. If left unchecked, this can lead to outcomes that do not always support a healthy world. Voting is a necessary counterbalance to this. When we vote, we help ensure that the political process is shaped by our concern for health. When we hear politicians talk about addressing climate change, gun violence, income inequality, and other issues of consequence for health, it is not an accident. It is because we put them in a position to do so, because we communicated our values through political engagement, shaping our leaders’ priorities.

Politics is complex, and elections are no exception. It is not possible to predict with certainty what will happen in the midterms, but it is possible to say the outcome will reflect a range of intersecting factors, shaped by influences both national and local. For all this complexity, however, political races are often an exercise in the distillation of simple stories. Politicians do not just “sell” themselves to the voting public, they sell a narrative. We have seen many leaders and political movements rise to power by telling a story. Sometimes these stories empower positive change and sometimes they elevate bad ideas and people willing to implement them. In this period of intense partisanship, there are many ideas competing for primacy on election day. The power of these ideas has arguably been heightened by a pandemic that has deepened partisanship, seeded a distrust of expertise, and fed the fortunes of many in the electoral space who have shown few scruples about advancing false narratives for the purposes of political gain.

Public health, too, has a story to tell. In a time of division, it is a story with the power to unite. It is the story of something we all want for ourselves and for our children. It is the story of health. And it is the story of the social, economic, environmental, and political conditions that shape it. It is a story sustained not by what we think will sway public opinion during a given election cycle, but by a process of reason and analysis that generates the data that shape a healthier world. Hopefully, this election will support an outcome consistent with creating such a world, a world based on nuance and careful thought.

Thank you to all who continue to engage with the political process, who continue to keep faith with the American democratic experiment by voting, even when progress at the political level seems slow. We are in a moment when some voices argue that the system is too corrupt, too rigged, too compromised by our collective shortcomings to be worth our continued participation. Such voices call into question the principles of small-l liberalism that underlie our society and politics, making the case for a postliberal turn towards more authoritarian models. In such a moment, it is more important than ever to reaffirm our democratic inheritance by participating in the political process.

Regardless of what happens in the election, we will remain committed, as a school community, to shaping a healthier world. We will pursue this work guided by our core values. We aspire to create healthier populations, with particular concern for the marginalized and vulnerable. No matter what political reality emerges on Election Day, it will find us ready to meet challenges, seize opportunities, and work towards a healthier world. In the meantime, it is up to us to engage with the electoral process and vote for health.

Warm regards,

Sandro

Sandro Galea, MD, DrPH
Dean and Robert A. Knox Professor
Boston University School of Public Health
Twitter: @sandrogalea

Acknowledgement: I am grateful to Eric DelGizzo for his contributions to this Dean’s Note.

Previous Dean’s Notes are archived at: http://www.bu.edu/sph/tag/deans-note/