The Cost of Voting is Costing Our Health: How Can Kentucky Do Better?

Blog Post | 111 KY. L. J. ONLINE | May 1 , 2023

The Cost of Voting is Costing Our Health: How Can Kentucky Do Better?

By: Haley Campbell Garcia, Staff Editor, Vol. 111

Voting and democracy is one of the most revered parts of the American experiment. Our founders envisioned a government that was directed by the people and for the people. The most import facet of this government by the people, of course, is access to the polls and voting. Unfortunately, for many Americans it is not easy to vote, and there has been a wave of restrictive voting registration policy over the last several years.[1] In 2021 alone, nineteen states passed laws restricting access to voting, and this represents only a small fraction of the legislation that was introduced.[2] This restriction on who can vote, when they can vote, and what they must present when they arrive at the polls has far reaching impacts. Some of those impacts are well known. Public policy and lawmakers shape everything about our world and environment, including health, social, and economic policy.[3] Recent research has also indicated that that there is a strong correlation between access to voting and public health outcomes.[4] Overall, this research has indicated that states who have more inclusive voting policies combined with higher levels of civic participation have citizens who have better health outcomes.[5] Using the Cost of Voting Index[6] and health data gathered from the Behavioral Risk Factor Surveillance System and America’s Health Rankings[7], this correlation is easy to see.

The State of Washington has an overall cost of voting index score of two out of fifty.[8] This means that the overall time and effort associated with casting a vote in Washington is minimal, considering early or mail in voting, the number of polling locations, and other factors such as restrictive voter identification laws.[9] In fact, Washington has several policies that makes voting very easy for its citizens. Washington has inclusive registration policies[10], no restrictive voter identification laws, allows voting at home, and restores voting rights for those who have a felony conviction.[11] Washington also has high overall self-rated health score, with eighty-four percent of survey participants indicating that their health is good or better[12] when asked about their general health and an overall premature mortality ranking[13] of six out of fifty.[14] Contrast Washington with Mississippi. Mississippi has an overall cost of voting index score of forty-seven out of fifty, indicating that it has requires one of the highest amounts of time and effort to cast a vote.[15] Mississippi has several laws that make voting difficult for its citizens, such as no inclusive registration, restrictive voter identification, no voting at home, and no restoration of voting rights for those convicted of a felony.[16] In Mississippi, only seventy-eight percent of survey participants indicated that their health is good or better and the overall premature mortality ranking is forty-nine out of fifty[17] Comparing these two states, the correlation between access to voting and overall health is obvious and these provided metrics represent only a small fraction of what has been uncovered by research.[18]

Kentucky currently has a cost of voting index ranking of forty-three out of fifty, indicating that there is a high amount of time and effort required to vote in this state.[19] Kentucky does not have inclusive voter registration, does not currently have voter identification laws, does not allow voting at home, and does not restore voting rights to those who are convicted of a felony.[20] Only seventy-eight percent of survey participants in Kentucky report that their health is good or better when asked about their general health and the overall premature mortality ranking is forty-seven out of fifty.[21] If Washington is any indication, Kentucky could vastly improve their overall health outcomes by increasing access to voting. Lucky for Kentuckians, the legislature seems open to expanding voting access and has exemplified that openness by passing a law in 2021 that established three days of early voting, created voter services portals where people could track and request their absentee ballots, and creating voter centers so that people can vote without being tied to locations in their precinct.[22] If Kentucky is serious about increasing civic engagement, and perhaps then their overall health outcomes, there are a number of reforms that would be a step in the right direction. Chief among these reforms is automatic voter registration. Nearly a quarter of eligible voters in the United States are not registered to vote, and one in eight registration records are invalid or have serious flaws.[23] Kentucky could tackle this issue by making voter registration automatic when one has an interaction at a government agency such as when obtaining a driver’s license or accessing state benefits like Medicaid. Kentucky could also join other states in restoring voting rights to those who have been disenfranchised because of a felony conviction.

Kentucky should join the ranks of states that have a lower cost of voting and expand access to voting. Not only will these reforms improve access to democracy for all Kentuckians but may also improve overall health outcomes throughout the state.

[1] Brennan Center for Justice, Voting Laws Roundup: December 2021 (2022), https://www.brennancenter.org/our-work/research-reports/voting-laws-roundup-december-2021.

[2] Id.

[3] Nicholas Yagoda, Addressing Health Disparities Through Voter Engagement, 17(5) Annals of Fam. Med. 459 (2019).

[4] Healthy Democracy Healthy People, Health & Democracy Index (2021), https://democracyindex.hdhp.us/.

[5] Id.

[6] Scott Schraufnagel, Michael J. Pomante II, & Quan Li, Cost of Voting in the American States: 2020, 19 Election L. J. 503 (2020) (explaining that the Cost of Voting Index assigns each state a state rank which represents the relative costs associated with voting in that state as compared to the other fifty states, taking into consideration the registration deadline, voter registration restrictions, registration drive restrictions, pre-registration laws, automatic voter registration, voting inconvenience, voter identification laws, poll hours, and the availability of early voting).

[7] Healthy Democracy Healthy People, Health & Democracy Index, Methods (2021), https://democracyindex.hdhp.us/.

[8] Id.

[9] Schraufnagel, Pomante, & Li, supra note 6.

[10] Whether a state has inclusive registration policies requires the consideration of registration deadlines (later is better), the availability of same day registration, registration restrictions (such as the availability of online voter registration), any restriction on voter registration drives (such as required training by the state), the availability of pre-registration for sixteen- and seventeen-year-olds, and the availability of automatic voter registration.

[11] Healthy Democracy Healthy People, Health & Democracy Index, Washington (2021), https://democracyindex.hdhp.us/.

[12] Survey, 2019 Behavioral Risk Factor Analysis Surveillance System, Centers for Disease Control and Prevention (2019), https://www.cdc.gov/brfss/questionnaires/pdf-ques/2019-BRFSS-Questionnaire-508.pdf (good or better in this context refers to an answer of good, very good, or excellent when asked to self-report their general health status).

[13] The premature mortality ranking is a state ranking based on years of potential life lost before age seventy-five. In this context, a lower ranking is better, with one being the best ranking and fifty being the worst.

[14] Id.

[15] Healthy Democracy Healthy People, Health & Democracy Index, Mississippi (2021), https://democracyindex.hdhp.us/.

[16] Id.

[17] Id.

[18] Healthy Democracy Healthy People, Health & Democracy Index, Data Table (2021), https://democracyindex.hdhp.us/.

[19] Healthy Democracy Healthy People, Health & Democracy Index, Kentucky (2021), https://democracyindex.hdhp.us/.

[20] Id.

[21] Id.

[22] Jared Bennet, In Kentucky, rare bipartisan support for expanding voting access, The Ctr. for Public Integrity (Oct. 6, 2022), https://publicintegrity.org/politics/elections/who-counts/in-kentucky-rare-bipartisan-support-for-expanded-voting-access/.

[23] Brennan Ctr. for Justice, Automatic Voter Registration, https://www.brennancenter.org/issues/ensure-every-american-can-vote/voting-reform/automatic-voter-registration (last accessed Apr. 25, 2023).