Civic Health Matters to Health and Equity

Apr 6, 2023 | Health Equity, Uncategorized

Photo of two women outside of a community school. Copyright 2023 John Hosteen

Featured image: Copyright 2023 John Hosteen

 

By Carrie Carroll, MPA, Sustainability Strategy Leader, University of Wisconsin Population Health Institute

 

UW Population Health Institute’s 2023 County Health Rankings shows how public health and health care can nurture civic health.

The University of Wisconsin Population Health Institute’s (UW PHI) 2023 County Health Rankings has released a National Findings Report that connects communities’ civic health to health and well-being.

This year’s report shows that people and places thrive when everyone has the chance to participate in their community.

Two elements of civic health are highlighted:

  • Civic infrastructure – the places like schools, parks and libraries that keep us connected as well as the policies and practices that encourage belonging and fuel inclusive civic participation.
  • Civic participation – how people engage in community life, whether by voting or volunteering or mentoring, to improve conditions and build a better future.

Well-resourced civic infrastructure and active civic participation can improve health. Both allow communities to tap the collective knowledge, wisdom and action of residents.

County Health Rankings & Roadmaps: Building a Culture of Health, County by County Civic Infrastructure and Civic Participation Among Healthiest and Least Healthy Counties Horizontal bar chart: Access to Broadband (% of households) - Healthiest 10% of counties = about 90%; Least healthy 10% of counties = over 70% Horizontal bar chart: Access to Libraries (annual visits per capita) - Healthiest 10% of counties = about 2.5; Least healthy 10% of counties = about 1.5 Horizontal bar chart: Access to Parks & Recreation Facilities (% of population) - Healthiest 10% of counties = over 80%; Least healthy 10% of counties = about 50% Horizontal bar chart: Access to Adequately Funded Schools (% of counties) - Healthiest 10% of counties = about 90%; Least healthy 10% of counties = less than 20% Horizontal bar chart: Organizations for Social Association (# per 10K population) - Healthiest 10% of counties = over 11; Least healthy 10% of counties = about 10 Voter Turnout (% of citizen voting-age population) - Healthiest 10% of counties = 76%; Least healthy 10% of counties = 58% Census Participation (% of households) - Healthiest 10% of counties = 72%; Least healthy 10% of counties = 50% Data sources: American Community Survey; Public Libraries Survey; Environmental Public Health Tracking Network; School Financial Indicators Database; County Business Patterns; Census Operational Quality Metrics; MIT Election Data and Science Lab; 2023 CH&R Dataset

Geographic patterns emerged in both civic infrastructure and civic participation. Specific examples include:

  • In the most recent presidential election, 66% of the citizen voting-age population voted, with the highest turnout in the West, Northeast, and Midwest where civic infrastructure is more robust.
  • Similarly, 60% of households self-responded to the census, with higher participation in the Midwest and Northeast.
Redlining The Federal Housing Administration’s policies from the 1930s that entrenched racial residential segregation. Redlining denied Black people and some other ethnic groups access to government-insured mortgages and labeled homes in neighborhoods where Black people and some other ethnic groups lived as uninsurable, thereby guaranteeing that property values in those neighborhoods would be less than those in non-immigrant white neighborhoods (Mapping Inequality, n.d.) Voter turnout and census participation measures are important because counties with more available and well-resourced civic infrastructure have higher rates of high school completion and adults with health insurance, higher household incomes, and less income inequality. In these counties, people tend to live longer.
Are there new measures this year?

 

 

To dig deeper, website visitors can search for their state or county on countyhealthrankings.org. Snapshots include two new measures this year:  voter turnout and census participation.

 

 

 

Also new this year: county descriptions that include context such as Indigenous nations native to the land, characterization of the population density and connection to large cities, and neighborhoods that have experienced intentional disinvestment through redlining.

 

 

What role can public health and health care play in nurturing civic health?

There are lots of opportunities for public health and health care to continue to lead collaborative action to nurture civic health. Some examples include:

  • Partnering with community health workers and community organizers to ensure fair representation and a voice in community decisions by supporting transportation to city council and school board meetings.
  • Advocating for state and local elections infrastructure funding, such as automatic voter registration systems.
  • Following the federal government’s lead by incorporating the Healthy People 2030‘s research objective to increase the proportion of voting age people who vote into state and local Health Improvement Plans.
  • Sharing research on the connection between civic participation and health in advocacy efforts to eliminate laws that exclude people.
  • Partnering with communities on decisions that affect their lives.
  • Implementing programs such as Vot-ER which develops nonpartisan civic engagement tools and programs for health care practitioners, medical schools, and hospitals.

 

To learn more, check out these resources: