How medical providers are checking on patients’ civic health

According to Census data, fewer than three-quarters of eligible Americans are registered to vote. Since 2019, a nonprofit called Vot-ER has taken voter registration efforts into medical exam rooms across the country. Tionya Lawrence, a family nurse practitioner in Georgia, joins John Yang to discuss the initiative.

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  • John Yang:

    According to census data, fewer than three quarters of Americans who are old enough are registered to vote. Since 2019, a nonprofit called Vot-ER has taken voter registration efforts into medical exam rooms across the country. Health care providers checking on patients' civic health. One of them is Tionya Lawrence. She's a family nurse practitioner in Athens, Georgia.

    Tionya, thanks so much for joining us. We should state off the top that even though it's called Vot-ER, you don't do this in emergency rooms, right?

  • Tionya Lawrence, Family Nurse Practitioner:

    Not necessarily when they first come in. I'm actually in family practice, but a lot of our volunteers and health care providers are actually in the E.R.

  • John Yang:

    So how does this work? How do you bring this up in your conversation with patients?

  • Tionya Lawrence:

    I think it has to be a conversation that's done not just during an election year, but something that's done year-round all the time. I think it's important for health care workers and health care providers because we already have that rapport with our patients. When you come into our offices or clinics or hospitals, we're already asking you very invasive questions already — sexual history, smoking, do you drink? And so, I think it's important to implement that extra question in there. Do you drink? Do you smoke? Are you registered to vote?

  • John Yang:

    What's the reaction like?

  • Tionya Lawrence:

    We've had some great, awesome outcomes. I personally have had some awesome outcomes. I think initially it's a shocker to patients in general because you're there to talk about an illness or a chronic condition, and we're asking you about your voter registration status.

    It's been very well received, and any time I have any patient that seems a little bit puzzled, I always pause and give my little speech about how civic health is important to your physical and mental health and how some of the issues that are plaguing you as a patient are things that I can't fix with a speech on diet and exercise, or with surgery referral or with a prescription.

  • John Yang:

    Give us a little bit of that speech if you will. Draw the line between physical and mental health.

  • Tionya Lawrence:

    Absolutely. I'll paint a picture of a patient I had, a 67-year-old African-American female discussing diabetes, and it was an easy diagnosis. It's something that any provider could have done. And you pat yourself on the back because you've made the correct diagnosis and you've given them a speech about diet and exercise, and you've given them a wonderful prescription for a medication that they saw on tv that's going to work wonders for their condition. But then you realize that that patient can't afford any food changes or dietary changes because they're already living paycheck to paycheck.

    You realize they can't exercise because their neighborhood isn't safe, or they work two jobs and they don't have time when they get off work. You also realize that that wonderful prescription that you've written, that patient can't afford that either. And so that's when we talk about how the social determinants of health, which are things in the environment where people live, work, play, and interact, are directly correlated with their civic health. And so that's when we talk about voting and how I can't necessarily change those things from the inside of my office, but as a patient, you can with your vote.

  • John Yang:

    Do you ever get pushback or have you gotten pushback either from a patient, someone maybe accompanying a patient, or someone else outside the exam room?

  • Tionya Lawrence:

    I wouldn't necessarily say pushback. I've got a lot of, I will say, being ignored at some times. I think when you try to implement it here in certain areas, a lot of people presume partisanship. But the cornerstone of Vot-ER is that we are a non-partisan organization. Our job is to make sure that the democracy is reflected best when every voice is heard.

  • John Yang:

    And you do see this is an extension of caring for your patient.

  • Tionya Lawrence:

    Absolutely. This should be something that is implemented in everyone's practice. I believe in June of 2022, voting was implemented as a social determinant of health, as a health crisis. So, it is super important.

  • John Yang:

    Tionya Lawrence, family nurse practitioner from Athens, Georgia, who helps register her patients to vote. Thank you very much.

  • Tionya Lawrence:

    Thank you so much for having me.

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