For Juneteenth, Remember: Voting Rights = Healthy Communities – Free Press of Jacksonville

By Mary K. Canales

When you see something that is not right, you must say something. You must do something. Democracy is not a state. It is an act, and each generation must do its part.

 – John Lewis (2020)

We must heed John Lewis’ call to action if current and future generations’ right to vote are to be protected. As we approach Juneteenth, the federal holiday celebrating the end of slavery and the hope for a more racially just America, we need to recognize the intricate relationship between voting and health. Mounting evidence shows that communities with strong voting protections have better health outcomes

The historical legacy of Juneteenth, a federal holiday since 2021, shows the value of never giving up hope in uncertain times and provides guidance for future voting rights efforts.

We certainly need that guidance now. With the recent Supreme Court Louisiana v. Callais ruling, gutting Section 2 of the 1965 Voting Rights Act (VRA), and the subsequent rush to gerrymander Southern states to eliminate predominately Black voting districts, it can be difficult to remember that the year is 2026 and not 1956, when John Lewis was battling for the right to vote for Black Americans, or 1826, when the idea of the U.S. Black population voting was barely a dream. While 1826 saw major advances, including invention of the internal combustion engine, it was also a time of horror, as slavery hardened in the South and industrialization created harsh working conditions in the North.

Yet less than 40 years later, in 1863, President Lincoln issued the Emancipation Proclamation, ending slavery. Then in June 1865, the 13^th Amendment to the Constitution, enshrining emancipation as national policy, was ratified.

It was not, however, until June 19, 1865, referred to as Juneteenth, that the last enslaved people living in Galveston, Texas, were officially freed. Today, the accomplishments achieved in 1865 through the tireless efforts of those committed to a more equitable and just society are again in danger but also give us hope.

To start, we must strengthen voting rights for all. Because the U.S. Constitution did not originally enshrine the right to vote, mass struggle has been necessary to ensure the franchise, beginning with the 15th Amendment (1870), prohibiting denial of the right to vote based on race, color, or previous condition of servitude; the 19^th amendment (1921) prohibiting denial of the right to vote based on sex; and the 24^th Amendment (1964), prohibiting racist poll taxes. Both the 14^th and 15th Amendments empower Congress to enforce voting protections through legislation, including the Voting Rights Act of 1965. These legal gains have, in turn, improved community health, especially in former Jim Crow Southern states.

For example, a study published in the American Journal of Public Health found that “passage of the VRA led to pronounced reductions in Black infant deaths in Southern counties subject to government intervention.” Among Black Americans, the infant death rate in 1959 to 1965 was 51.9 per 1000 people in VRA-covered counties; by 2017 to 2021, these rates dropped to one fifth the 1959–1965 rates, a stunning improvement.

A great deal of data links voting rights to healthier communities. For example, a piece published by The Network for Public Health Law explains 25 years of evidence demonstrating the clear connection between voting and health, including fewer people without insurance and lower death rates for working-age adults. The Health & Democracy Index, created by the Institute for Responsive Government, has catalogued this relationship across the states for 12 public health indicators. This interactive tool visually demonstrates that some of the same barriers that negatively affect health also limit voting and when combined, reduce democratic participation. This vicious cycle, however, can be broken

For example, researchers writing in Health Affairs reported that of the 10 healthiest states, eight restore voting rights to those convicted of a felony. By contrast, of the 10 least healthy states, only one does so. Similarly, the 10 healthiest states all have programs that make it easy for eligible voters to register, such as same-day or automatic registration – compared to just two of the 10 least healthiest states.

Yet voting rights, and the health improvements they ushered in, are clearly threatened in the aftermath of Callais. As legal scholars, historians, and legislators examine the past, present, and future of voting rights, health professionals, especially those engaged in public health, must also join these efforts. Although national organizations, including the American Public Health Association and American Medical Association, support the importance of voting, and voter participation was included as a core Healthy People 2030 objective, designating it a high-priority public health issue, health professionals themselves are less likely to vote; physicians, nurses, physician assistants and dentists are 12-23 percent less likely to vote than the general population. Health professionals need to educate themselves – and do better.

Health and voting are intricately connected; we cannot have one without the other. Let’s heed the words of John Lewis: “Ordinary people with extraordinary vision can redeem the soul of America by getting in what I call good trouble, necessary trouble.”

Mary K. Canales, PhD, RN is professor emeriti from the University of Wisconsin-Eau Claire, where she concluded 30+ years of teaching community/public health nursing and health policy. She is a member of  Defend Public Health, which is publishing an extended version of this commentary at https://www.defendpublichealth.org/