Expand Voting Rights for Health: Yes or No?


The tidal wave of election denial and skepticism after the 2020 presidential election caused voting restriction and expansion laws to flood state legislatures. A mix of roughly 220 election skeptics or deniers were elected in the 2022 midterm elections, and the country can expect a persistent flow of election interference laws. The onslaught of voter suppression skews electoral outcomes and perpetuates health inequities among underserved and underrepresented communities.

Voting restrictions include strict voter ID requirements, prohibiting voter registration on election day, and reducing the number of polling stations in areas with large populations of Black and Hispanic voters. Restrictions also prevent voting among people with lower socioeconomic status who cannot afford to take time off during polling hours or whose employer does not allow time off for voting.

Roman Pabayo and colleagues measured COVID-19 case and mortality data with the burden of voting restrictions (COVI) across U.S. counties with different demographic makeups. The researchers analyzed the results against county income levels and the proportion of Black residents in a county.

The counties with a higher-than-average amount (greater than COVI score 0) of voting restrictions had higher rates of COVID-19 cases and mortality, specifically among people with moderate and low income. The results also showed an association between counties with a larger proportion of Black residents and higher mortality rates regardless of voter restriction levels. Voting restrictions in high-income counties barely affected mortality rates.

But there is hope. Several states with voting proposals on the 2022 ballot voted to expand voting access, improve voting fairness or block further voting restrictions. As voting access continues to fluctuate across the country, population health trends could become a key indicator in the harmful effects of denying a person’s right to vote.

Databyte via Roman Pabayo et. al. The relationship between voting restrictions and COVID-19 case and mortality rates between US counties. PLoS One, 2022.