Voting is a public health issue: Addressing voter participation and engagement among trainees

Document Type

Conference Proceeding

Publication Date


Publication Title

Academic Emergency Medicine


Background and Objectives: Practicing physicians vote less than the general public despite policy implications on patient care and physician practice. There is no published data on voting rates (VTR) of trainees or barriers they may face. Residency programs and teaching hospitals may have unique opportunities to promote trainee civic engagement. Our objectives were to measure voter registration rates (VRR) and VTR for trainees, identify barriers, and determine interventions to improve VRR and VTR.

Methods: Trainees (n∼895) at 3 Henry Ford Health System (HFHS) hospitals were surveyed in 2018 and 2020. They were asked about VRR status, voting habits and barriers to voting. Based on 2018 survey results, voter registration and absentee ballot request forms were provided to new trainees during 2020 orientation and 2 informational sessions were held in subsequent months. In 2020, VRR and VTR were compared to survey results from 2158 trainees at local hospitals who did not receive the intervention. Additional comparisons matched trainees to GP age/gender cohorts. Analysis used descriptive statistics, chi-square or Fisher's exact tests, and univariate analyses. Free-text responses were categorized into themes with iterative discussion.

Results: 37.6% and 34.5% of HFHS trainees responded in 2018 and 2020, respectively. VRR was higher among trainees than GP in 2018 (91% vs 67%). VTR among trainees in 2016 primary (53%), 2016 general (79%), 2018 primary (39%) and 2018 general (73%) were also higher than GP (26%, 61%, 20%, 53% respectively, p < 0.001 compared to general population and age/gender matched cohorts). Preliminary analyses of 2020 HFHS trainee data after intervention show VRR and VTR for primary and general elections increased over 2016 and 2018, with 98% of trainees registered and 91% voting in the 2020 general election. Forgetting to request absentee ballots and apathy were the most common barriers. Further 2020 analyses including non-HFHS trainees who did not receive the intervention and GP comparisons will be included in the final presentation.

Conclusion: Residents and fellows are more engaged in state and national elections compared to the GP. Programs may be able to further improve trainee civic participation by encouraging VRR and absentee balloting, and providing informational sessions. Limitations included a low response rate. Generalizability to other states may be limited due to unique voting regulations.




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