Podcast Editor Jazlyn Gallego (MPM ’24) speaks with Aliya Bhatia, Georgetown School of Foreign Service graduate and Executive Director of Vot-ER, to discuss the link between public health and successful democracies. Vot-ER, a national nonprofit 501(C)3 organization, develops nonpartisan civic engagement tools and programs for every corner of the healthcare system—from private practitioners to medical schools to hospitals to help thousands of Americans register to vote.
Vot-ER’s founder is an E.R. doctor based in Boston and one evening, he was working an overnight shift and a family ended up in the E.R. that was homeless. He was trying to help them secure housing. It turned out that the most efficient way to get them to housing was to prove their residency and the easiest way to do that in … was … through voter registration.
Aliya Bhatia
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Jazlyn Gallego: Hi my name is Jazlyn Gallego with the Georgetown Public Policy Review Podcast. I am happy to bring you another episode on health policy. We are here today with Aliyah Bhatia from Vot-ER and I’m excited to talk to you a little bit about the intersection between democracy and health. Aliya, do you want to introduce yourself and tell us a little bit more about yourself?
Aliya Bhatia: Absolutely and Hoya Saxa, Jazlyn. It’s such a treat to be with you and be with the Georgetown community here. I’m Aliyah Bhatia. I’m the Executive Director of an organization called Vot-ER and I’m also an alum of the School of Foreign Service and back when I was there, I remembered distinctly in my comparative politics course, being taught about how to make sure that democracy can function effectively and make sure it serves the needs of the people and I’m grateful to be in a role that lets me work on that each and everyday through a touchpoint that were all very familiar with which is our health system and our relationship with our health professionals. That’s effectively what Vot-ER does. We create touch points for voter access all across the healthcare delivery system working with doctors, nurses, social workers, techs, you name it, we work with them across the entire ecosystem to help make sure that our patients are able to vote.
Gallego: That is amazing! Can you tell us about how Vot-ER got started?
Bhatia: Yes and I’ll share both how Vot-ER got started and how I got lucky enough to stumble into this work as well. Our founder is an E.R. doctor based in Boston and one evening, he was working an overnight shift and a family ended up in the E.R. that was homeless. He was trying to help them secure housing. And it turned out that the most efficient way to get them to housing was to prove their residency and the easiest way to do that in that context was to demonstrate that through voter registration.
Bhatia: At that time, the founder was like “Wait a second, we can leverage spaces like health spaces and the great relationships we have with our patients to support voter registration? From there, he developed the idea to make that a part of how we think about our health touchpoint with our patients. He got started on that, went on a journey in 2019 to get that up and running. Then, in December of 2019 is when my part of the story started.
Bhatia: I was in Atlanta Georgia my hometown. I was with the program that does leadership development and part of what we have to do as part of the program is do a ride-along with fire, police, and emergency medical services so I show up for my emergency medical services ride-along and I go on this ride-along through different parts of Atlanta. We’re seeing different ways in which the social determinants of health are manifesting in people’s lives. They’re responding to homelessness, food insecurity, changes in insurance that create emergency situations and I’m sitting here overwhelmed by all these things that this E.M.S. manager is navigating.
Bhatia: So at the end of the visit, I turn to him and I say “If you could only change one thing, what’s the one thing you would change?”And his response really surprised me. My background is in other areas of social policy including education and housing. I thought he was gonna name one of those.
Bhatia: Instead, he said, “Aliya, I wish all my patients voted. If all my patients voted then locally elected officials would invest at higher levels and things like housing affordability, jobs training, making sure they were grocery stores in every neighborhood, and when I needed to get somebody an ambulance, I would have the money to do so on time.”
Bhatia: A month later, I hear about this E.R. doctor in Boston and this organization Vot-E.R. and it was total serendipity that those two things happened in sequence and I hopped on board with Vot-E.R. and had the incredible opportunity to be part of it’s growth in 2020 and to now serve as Executive Director.
Gallego: Wow. That is incredible. Thank you so much for sharing that story. I find that Super Duper interesting! As you know, I previously worked for one of Vot-E.R.’s partners, VoteRiders. And I did see some of that intersectionality as you were talking about housing and the need to get folks involved, and when people turn out to vote, their elected officials pay attention, ensure that the community has what it needs in order to function at its fullest and a lot of that goes back into our public health system and it’s really important for us to know that it’s very very profound. And we think about the way that we can go ahead and respond to what’s going on isn’t just a one-fold solution. It includes the entire policy realm and voting is one of the greatest solutions that we can really throw out there.
Gallego: Do you have any interesting stories from healthcare professionals that you have partnered with through Vot-E.R.? I know that you do lots of work with healthcare professionals and empowering them to register patients to vote. It sounds like that was one really empowering story was you hearing firsthand someone saying, “One solution to our health crisis would be if people voted because we would have more resources at our disposal.” Have you seen anything else from a person-to-person story that has really kind of opened your eyes a little bit?
Bhatia: A couple stories I want to share. I wanna start with a nurse in Athens, Georgia who is a longtime member of the Vot-E.R. community. She builds this into what’s called the ‘social history.’ When she’s asking about “do you smoke?” “Do you drink?” “Do you wear your seatbelt?” “Are you registered to vote?” She puts it straight into that conversation with patients as a reminder to help emphasize for them that link between their vote and their health and their ability to take action and have agency over the things that they’re doing.
Bhatia: I think another really fun example is Dr. Peggy Stager who is a pediatrician in Ohio also similarly asks a lot of her patients in that social history and because she’s a pediatrician, there’s an evergreen opportunity to talk about voting. When somebody turns 18, there are things changing about their body, changing about their lives, and another thing that was changing was their ability to have access to the power to be able to shift the systems around them so that’s how a lot of our pediatricians treat that conversation.
Bhatia: You’re growing and evolving both in your body and your health as becoming an adult and you also have this new power which is voting. Please go ahead and register to vote. It becomes this year around thing that our pediatricians can ask as their patients get older and enter into the 16-17 pre-voter registration period or the 18 voter registration period. They can ask regardless of if an election is coming up or not. It’s just a rite of passage at age 18.
Bhatia: The third example I want to give is last year, the national medical association which is the association of Black physicians, along with the Latino Medical Association go together to put together a coalition of organizations to pass a resolution through the American Medical Association around voting as a determinant of health and that resolution has really opened the door for more and more organizations to get on board with this work and to advance it and push it forwards.
Bhatia: I think at Vot-E.R. what were really proud of is that while we are enablers of the work, the real people who are actually getting this done are health professionals from all different backgrounds who are seeing a need in their communities for patients to have more power and they’re the ones taking this forward whether it’s at the individual level with the individual patient or at the policy level with resolutions like the American Medical Association.
Gallego: Right. And also what I’ve heard from Vot-ER, from one of your presentations, is that this works! it has been proven to increase healthier communities – the communities where you’re present at – And you have noted that there is a high voter turnout, have seen improvements in their health. So I think that’s really interesting and it’s really powerful that these healthcare professionals that have this patient relationship are able to utilize that to then empower a voter to go ahead and change the system. As we know it’s a multifaceted approach to these solutions of both public health and democracy and I feel like that’s very important.
Gallego: In my work at VoteRiders, I saw that we were helping folks get their IDs to be able to get out and vote but ultimately, they were coming to us because they need that ID for either housing or to go to the doctor. So, these are all very intertwined things to be able to make sure that we’re empowering the community to later have a better outcome.
Bhatia: Jazlyn, I love how you point out the interconnectedness there because in our partnership with VoteRiders, one of the things that we would do is have a link to the VoteRiders chat support because sometimes the thing that a person needs when they’re registering to vote is coaching on how to navigate the voter ID issues. So, just in the same way that the ID component can help people get health, there’s also an element of our health professionals can point people to resources like VoteRiders to help them get an ID so they can then complete the process of voting and it’s really beautiful that mutual reinforcement.
Gallego: Absolutely! That coalition building, collaboration is so necessary, and I love seeing nonprofits be able to build that space in communities where it’s needed and be able to really bridge that gap in access. Is there a major obstacle that Vo-E.R. has identified as barrier to either voting access or healthier communities?
Bhatia: Jazlyn, when we talk about voter access in the U.S., the United States does require voter registration before you can vote and overtime through systems and policies like the National Voter Registration Act, the most common place to do that voter registration is the Department of Motor Vehicles.
Bhatia: Now, I want you to think for a second, I’d be curious if you drive. I do when I’m in Atlanta. I do drive. I only go to a D.M.V. once every 10 years, so I don’t go very often. I don’t know the name of the person I would see at the DMV and I’m usually trying to get out of the D.M.V. as soon as I get there.
Bhatia: When you think about that, what that means is the places we are registering people to vote are highly impersonal in a lot of ways and also that they’re probably not reaching people who don’t have drivers licenses or are not able to access driving and drivers licenses, so there’s a whole lot of the population that the D.M.V.s are missing out on. And also it’s not an effective way to keep our voter rolls up to date given how frequently people are moving these days.
Bhatia: And imagine, in the lens that Vot-E.R. comes from, imagine that we could help prepare people to vote in touchpoint that are more frequent, that are more personal to you and one of those is the work that Vot-E.R. directly does which is around hospitals and clinics. And also, hospitals and clinics have other things that they’re doing too. They’re providing people’s health and what not, so we want to make sure that we’re not overburdening any one single system in this work and how can we go upstream and make sure that voter access happens even sooner in the system beyond those individual touchpoints.
Bhatia: So what if we could get upstream of these spaces, like the D.M.V. right? Upstream even from your clinic or hospital? What if we could get to people earlier in the process? Imagine if when you go to enroll at healthcare.gov for insurance if you’re somebody who your employer insurance is not an option for you or there isn’t employer insurance. If you’re one of those folks – you may be one of those folks who’s not frequently at a D.M.V. or doesn’t have access to the D.M.V as a way to register to vote.
Bhatia: And what if a space like healthcare.gov could prompt you to register to vote as well? Just imagine how powerful that would be and who we could reach and encourage to vote by layering a very simple question into the federal health insurance exchange.
Bhatia: So at Vot-E.R., we try to think about our work as through the lens of the importance of the link between voting and health, but what we ultimately want to make sure to do is to make sure that the systems themselves are making this easier, that were making this simpler throughout the whole process and creating policies and systems that do that.
Gallego: Absolutely. I agree, it’s really important that you pointed out systems that are already exist like motor voter states where for example the state of Florida, you can go to the DMV and register to vote as you get your license or your I.D. and in those states you would think, Okay, that covers everyone, but it’s very important that you also pointed out where that gap lies and that not everyone is getting through those state agencies like the D.M.V. and those are likely the people that this system and this issue of health and democracy is really missing at this moment.
Gallego: And so, we need to be able to get to the people that are not getting through the typical ways that the state is already targeting people to vote such as at the D.M.V. and those are the people that already can’t afford their I.D. or license because of the cost of supporting documents like birth certificates, marriage certificates, or lack of transportation and those are the same demographics of people that are more at risk for health issues and that of course is more of the reason why we need to think about a more strategic targeting process. So I absolutely love that you pointed that out. Is there anything that Vot-E.R. is currently working on for 2023 that you would like to share?
Bhatia: We are working on a LOT of cool things for 2023. So, just right now, this Spring, we are in the process of our social work healthy democracy campaign so one of the things that we do is work very closely with health professional students including particularly social work students and medical students about really getting invested in voter access and health and really helping ensure that their classmates as well as those that they serve are also able to register to vote through that process.
Bhatia: And so, in March we do our social work health democracy campaign and then in August, we do a broader multidisciplinary healthy democracy campaign that emphasizes more of the medical school approach but also incorporates other health professional schools. We’re really, really excited for that. It’s a program that has grown over time and has helped us do a lot of really incredible work in health professional organizations and really deepen our relationship with a lot of those institutions.
Bhatia: Another big thing that’s going on is we, every year, run a Civic Health fellowship, which is an opportunity for health professionals to learn how to engage in community organizing techniques in order to advance voter access in their health professional spaces and in their communities. And that is led by a Nobel Peace Prize nominee faculty, Srdja Popovic, it’s a really incredible six month program.
Bhatia: And a third thing is we are gearing up for what is a number of state and local elections across the country and sort of our kickoff for any fall elections will be August which we celebrate by Civic Health Month. At a time when health professionals can really embrace this link between voting and health, that’s when we work particularly with our partners like VoteRiders and other voter access organizations to be able to bring these pieces together around voting and health, really demonstrating that impact and collaboration.
Gallego: Wow. That’s awesome. I love that there is so much going on at Vot-ER and that there are a lot of places where folks can really plug in. So, it sounds like there might be some room to get plugged in and get involved with Vot-er. Can you tell us a little bit more about how we can get involved?
Bhatia: For those of you listening who are health professionals or who know a health professional, vot-er.org/badge is a place where you can get a very simple lanyard and badge that supports with voter registration. What this will do is it will allow you to have conversations with patients about voter registration, or getting their mail in ballot, or just about upcoming elections and getting information about it in a really seamless and simple way. And in a way that helps get new people into the democratic process. We encourage you to get your friends that are in the health profession, whether they are a social worker, a nurse, a doctor – get them involved in that work. It’s a really simple way to get them involved in the organization.
Bhatia: We also have a number of summits as well as other events and opportunities for folks that might be adjacent to the health space to get involved. And then for organizations that work within the broader health ecosystem, Civic Health is an excellent way to get involved, where we provide supportive tools for employees to register to vote and get prepared for upcoming elections and where we work through best practices for how that organization can lift that link up between voting and health.
Gallego: One thing… that I’m just wondering about.. if you want to touch on a little bit more.. is that social determinant of health factor. I feel like we touched on it a little bit, but I wanted to know if we can go into a little bit more of a macro view of why filling the gaps matters in regards to public health and democracy?
Bhatia: Absolutely . I’m so glad that we get to dive into this question. You heard the story of the Emergency Medical Services manager I rode along with. You’ve heard also the stories of other health professionals who have seen this day in and day out in their work.
Bhatia: Let’s back up to the evidence. We see the evidence between voting and health at the global, national, state, and local level. We see at the global level is that the correlation between democratic involvement and health outcomes, but then we can also zoom in at some countries that have seen very specific transitions and measure that impact on health.
Bhatia: One example is in Brazil, they used to have an all-paper voting system. Now, I want you to think in your mind, all-paper voting system where there were hundreds of candidates to choose from and you had to vote by writing a person’s name legibly on a ballot. I want you to think about who that leaves out of the process. What would happen is that people would come and vote and then many of their ballots would get tossed out because they were not legible, and their voice would not be counted or be accounted for in the democratic process.
Bhatia: One fine day , Brazil figures out that it’s going to switch over to electronic voting which is going to completely change the way people can vote and cast their ballot. There’s just one problem. It is expensive to make this transition. And so, what do they do? They say alright, communities that are slightly bigger. You all are going to get this technology first. We’ll pilot it with you and then everybody else will get it in the next round of elections.
Bhatia: Well, for social scientists, that creates a really wonderful natural experiment. And what they did is they looked at the communities just above the cut off for the new technology and just below the cut off and looked at the impact of having voting technology on the number of ballots that were counted. What you find is that there’s this huge reduction of the number of ballots that get tossed out as illegible because literally, you’re picking a photo on a page and picking “enter.” Your ballot is cast in the moment of actually casting your vote.
Bhatia: In doing that, what we were also able to look at is as we see these cities and places where they’re using electronic voting- is there a shift in policy? And you see the investment in public health go up by a third and you actually see improvement in maternal and infant health in the differences in those that got this first and those that got it later. There’s that gap where you see this sudden change in the quality of health and the attention these politicians are paying to the very folks that are most marginalized by health systems. So that the global example.
Bhatia: When you zoom into the U.S., you can look at a bit of work that was done by our partners, Healthy Democracy Health People, and you can see their Health and Democracy Index which shows this correlation between voting and health which is based on the state. When you zoom down to the local level, there are researchers that have looked at the relationship between turnout and the amount that we’re investing in some of the social determinants of health including house, public health, education, and the like. As more people from more diverse segments of society turn out at these local elections, it turns out that that Emergency Medical Services person was right!!!
Bhatia: Your local politicians therefore invest in things that they otherwise would not invest in with money they otherwise would not put in as a part of making sure that they can get that voter back the next time around. So, we see it at all levels, and of course there is also the individual relationship that we see this correlation individually with voting and health. And, also, I want to name that there are systemic factors as well that we can track through that process.
Gallego: Awesome. It sounds like what I’m here is that there is a case that there is a global and domestic proof here that your voice actually does matter. And that when you use it and when you engage in the electoral process that one person could indeed spark a change and get their community involved. And once you get your community involved, that sparks a chain reaction. And that change really does happen. That’s awesome. Is there anything else that you want to share with us that you didn’t get the opportunity to share yet ?
Bhatia: Jazlyn. This is the moment. When we look back at the history of the world frankly, people are going to look back at this moment where everyone was wrestling with the question of the fragility of our democracy.And, what we have an opportunity to do is to demonstrate that when we connect democracy with real life outcomes for people, when we create that connection both in our minds and the narrative as well as in how we reach people around voting, that is the way that we get towards stronger healthier democracies, not just in the U.S. but across the globe.
Bhatia: We have over the last few years seen new dynamics and threats to democracy that we are struggling with how to handle. At the crux of a lot of those different pieces is the level of trust that we have in our democratic systems.
Bhatia: At Vot-ER, we can only do the part of the work that can be done through the healthcare system, but we also want to honor and acknowledge that healthcare professionals are amongst the most trusted professionals in America. Nurses have been the most trusted profession in the last two decades. Doctors and pharmacists are in the top 4.
Bhatia: We cannot realize a re-invisioned American democracy without including the health sector, one of the biggest sectors, without ensuring that the voices of those who are so trusted by their patients are incorporated in the process and I truly believe that if we can sustain the work of many organizations across many sectors, that we’ll look back at this moment and be able to see how people’s ability to connect their political power with their quality of life became a catalyst for a new vision and a new direction for democracy globally.
Gallego: Wow. That’s very profound how the current ability of those in the healthcare workforce can really be used as this duty to be able to carry on this civic duty that you have as an American and to hopefully be able to create a better world for yourself for the future. That’s amazing.
Gallego: Thank you so much for joining us for the Georgetown Public Policy Review Podcast. I definitely feel like my personal passions for health and democracy have deepened through this conversation and feel that we all have a sense of personal duty to ensure that we fulfill our part in making sure that our communities are healthier and that our democracies are stronger and are very much entwined as we learn more and more so I’m very glad that we had this conversation.
Gallego: How can we stay up to date with Vot-ER? Do you have social media handles? Can we follow your website? Tell us how we can stay up to date with you.
Bhatia: Absolutely. We are on Twitter, Instagram, LinkedIn, and then in addition, we also have a newsletter that you can sign up for at Vot-ER.org We look forward to folks being part of that incredible community and making magic happen as a result.
Gallego: Amazing. I will definitely be following the Vot-ER newsletter and will be looking up all the events and good things that are coming for the future. I hope to stay involved. Awesome. Thank you so much for being with us, Aliya.
More about Aliya Bhatia
Aliya Bhatia is the Executive Director at Vot-ER and Civic Health Month where she works to bring voter registration into health care settings, including emergency rooms, hospitals, and community health centers.
She completed her Masters in Public Policy from Harvard Kennedy School as a Sheila C. Johnson Leadership Fellow and is a graduate of the School of Foreign Service at Georgetown University.
Aliya was drawn to the connection between health and democracy through the combination of being raised by parents in the medical field and various defining experiences while studying, teaching, and working on housing and health initiatives.
Aliya started her career as a high school educator and then as a strategy consultant at the Boston Consulting Group (BCG). She prioritizes diversity and inclusion in all her endeavors.
Aliya resides in Washington, DC where she works to realize Vot-ER’s vision of healthy communities powered by an inclusive democracy. She is a Georgia native and has worked in Louisiana, Alabama, Mississippi, and Missouri.
Established in 1995, the Georgetown Public Policy Review is the McCourt School of Public Policy’s nonpartisan, graduate student-run publication. Our mission is to provide an outlet for innovative new thinkers and established policymakers to offer perspectives on the politics and policies that shape our nation and our world.