“My hope is that people will stay loud. That mothers will still fight for their children. That fathers and families will not stop sacrificing and pushing until the next generation has access. I realize this. I have an 11-year-old son. I may not see [us] reverse what is happening now. But I’m going to do everything I can while I have breath to fight on the frontlines, particularly for healthcare.”
How Civic Participation Shapes Democracy and Health
Civic participation can shape policies that support the health and wellbeing of our communities.
A strong democracy where all people have the power to vote and organize drives health equity. Collective action that is grounded in humanity, courage, and perseverance can build systems that work fairly for all.
Yet today, the administration is intentionally silencing dissent and perpetuating structural barriers to health and equity. We are witnessing deliberate attempts to remove decision-making authority from the many and concentrate it in the hands of the few. And political ideology is replacing knowledge rooted in science and lived experience.
Still, I have hope because individuals and communities are refusing to accept the status quo by working together to protect democracy. At RWJF, we believe these efforts can be a turning point, leading to a more just world.
To explore how civic participation can serve the nation’s health, Reverend Shavon Arline-Bradley, president and CEO of the National Council of Negro Women (NCNW), joined me for a compelling discussion. We explored how communities, philanthropy, and civic leaders can work together to defend shared values. These key takeaways from our discussion can help inform the groundwork for a just and equitable future.
Politics, policy, and health are deeply connected.
Most of us agree that we are “one nation... indivisible, with liberty and justice for all.” Even if we disagree about the root causes of inequity and how to address them, we share the core belief that every zip code should be a place where all of us can lead our healthiest lives regardless of race, ethnicity, class or politics.
Yet these ideals, which were once almost universally accepted, have become subjects of debate. Policies that have improved people’s health are under attack through threats and cuts to Medicaid, food assistance programs like SNAP, maternal and child health, mental healthcare, and other critical services.
These harms especially affect Black families. Layoffs within the public sector have disproportionately affected Black women, contributing to a tremendous loss of jobs along with the healthcare coverage that often accompanies them. Reverend Arline-Bradley shared that NCNW has lost federal government funding for its programs that promote vaccinations against influenza, COVID, and RSV among people of color.
That’s why it is crucial to protect democracy. And while that can feel risky right now, history teaches us that becoming disillusioned and disconnecting from democracy is even more dangerous.
People have the power to shape policy.
As healthcare has become a political target, it’s been alarming to watch the federal government abandon obligations to its own people. But in these challenging times, we should also remember that public policy can change for the better. And people have the power to influence that change.
Reverend Arline-Bradley shared her personal experience with asthma, a pre-existing condition that once meant insurers could deny her coverage. The Affordable Care Act (ACA) made it illegal for providers to deny coverage to people with pre-existing conditions. The ACA also lowered costs and broadened access to healthcare for millions of Americans. The result: Fewer people need to face impossible decisions like whether to spend their money on prescriptions or food and housing for their children.
The ACA is just one example of the government’s impact. Many unhappy patients tend to blame hospitals, insurers, or drug companies for negative experiences, but that’s only part of the equation. Public policies determine how easy it is to get healthcare and who pays for it. Policies can perpetuate barriers to equity or remove them.
As Reverend Arline-Bradley reminded us, the health of our community and our democracy are the result of intentional choices. Our elected leaders can do tremendous good for our communities, or they can do great harm. When people speak out, organize and vote, they can influence decisions that help families flourish, no matter how much money they have or where they live, work, play, learn, or worship.
Our stories and our votes matter.
Sharing lived experiences has the power to shape how policymakers understand problems and the solutions they pursue. When advocates come to Capitol Hill to describe what is happening in their rural, suburban, or urban hometowns, policymakers listen. When families describe what it is like to survive in unsafe neighborhoods or struggle with finding affordable, healthy food, policymakers are more likely to fight for policies that address those conditions.
Speaking your truth matters because elected officials depend on your vote to stay in office. Voting is the most fundamental way to influence the political determinants of health which can advance or hinder health equity.
That’s why NCNW launched the POWER UP initiative to ensure voters are fully prepared to participate in elections, especially Black women and new voters. NCNW is intentional about protecting voters so they aren’t intimidated at the polls and disabled people with mobility challenges or other health needs can readily cast their ballots. In a democracy, “people power” depends on the vote so NCNW shares the responsibility of making it easy to do.
The work of defending democracy and protecting health belongs to all of us.
The urgency of now demands “staying loud” as Reverend Arline-Bradley puts it. If we accept the status quo and tolerate attacks on health equity, we are complicit. Remaining quiet means allowing children to lose access to healthcare, accepting the destruction of institutions that conduct medical research, and undermining a public health infrastructure that has been the envy of the world.
We’ve faced profound challenges before. The law once permitted segregation and denied women and Black people the right to vote. But we dismantled legal segregation, won universal suffrage, and enacted the Civil Rights Act only because people of all backgrounds came together, took risks, demanded to be heard, and forced change. Today’s challenges demand equal determination. We need to protect access to the ballot, demand liberty and human rights for all, and stay engaged to meet this moment and build systems rooted in dignity.
Reverend Arline-Bradley said this is deeply personal for her:
Even as we face division and heartbreak, let’s hold onto hope. Reversing the damage that has occurred is going to take time and commitment. Not all of us may be here to see things change. But continuing the fight for voting rights, civic participation, and equitable representation is crucial because a healthy democracy is essential for building a future together where health is no longer a privilege for some, but a right for all.
Join a movement that harnesses the collective strength of advocates working to lower healthcare costs. Sign up for the Cost and Coverage Collaborative!
About the Author
Avenel Joseph is vice president, Policy, at the Robert Wood Johnson Foundation. She brings a wealth of government, management, and political expertise to leading the Foundation’s programming.