VOTER REGISTRATION AND EDUCATION AS A PUBLIC HEALTH PRACTICEAn Alameda County Case Study

May 20, 2016

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Project Purpose

The purpose of the Alameda County Votes Initiative (AC Votes) is to learn what ACPHD can do to increase Alameda County’s voter participation rates in the 2016 elections, especially among low income communities, communities of color, and historically disenfranchised

groups.

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Project Goals• Understand what role a local public health department

should play in voter engagement efforts;• Identify what ACPHD could feasibly do to address low

levels of voter participation given existing organizational capacity constraints;

• Design and implement the AC Votes pilot initiative in Alameda County for the 2016 general elections;

• Increase Alameda County’s voter participation rates, particularly among low-income communities, communities of color, and historically disenfranchised groups; and

• Distill and share lessons that can inform future public health efforts to ensure adequate levels of voter engagement in Alameda County.

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Methodology• Organizational Analysis

• Identifying ACPHD programs that were either directly or indirectly interacting with Alameda County residents.

• Learning about the characteristics of program beneficiaries.• Determining program staffs’ capacity to undertake AC Votes

activities.• Exploring the possibility of partnerships with other Alameda County

agencies and offices, and with community partners.• Data Sources:

• Interviews and conversations with over 70 county staff and community partners.

• Analysis of local voting and health data.• Secondary sources.à Clarify AC Votes’ objectives, identify staff needs, and inform

implementation strategies.

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PUBLIC HEALTH FRAMEWORK:Reducing Health Inequities

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Public Health Framework

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Community Health AssessmentInequitable Psycho-Social

Conditions

There are differences in social conditions, such as education and crime/violence, and psycho-logical factors, like stress and mental health, in high-poverty versus affluent neighborhoods.

2015 Social Determinants of Health Living Condition (SDOH-LC) Indicators

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Voter Participation as an Indicator of Health• Voting abstention is correlated with poor self-reported health.

• Health has both a direct and indirect effect on political participation and a person’s propensity to vote.

• Persons with poor health may weigh the benefits and costs of voting differently than individuals in good health.

Poor Heath

Low Social Capital

Voting Abstention

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Voting and Health in Alameda County: Life Expectancy

78.573.0

70.468.568.2

64.464.0

62.061.661.260.660.259.659.258.557.757.557.0

52.552.0

50.048.0

SunolPiedmont

AlbanyPleasanton

AlamedaCastro Valley

LivermoreBerkeleyFairview

Alameda CountyDublin

OaklandCalifornia

San LeandroSan Lorenzo

NewarkFremont

EmeryvilleUnion City

HaywardCherryland

Ashland

2010 Voter Turnout Rate by City/Pace

Source: The California Department of Public Health, Healthy Communities Data and Indicators Project (HCI)

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Source: Alameda County Vital Statistics Files

77.179.3

79.980.080.581.0

81.581.881.982.082.482.582.7

83.283.984.184.184.5

85.986.9

CherrylandAshlandOaklandHaywardFairview

EmeryvilleAlameda County

San LeandroSan LorenzoCastro Valley

LivermoreAlamedaNewark

Union CityFremont

PleasantonDublin

BerkeleyAlbany

Piedmont

Life Expectancy (Years) by City/Place, 2010-2012

Voting and Health in Alameda County: Life Expectancy

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Comparison with Other Bay Area Counties

76.7%

66.2%

64.5%

63.3%

62.9%

60.5%

60.2%

60.0%

58.2%

57.5%

56.1%

55.5%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

Marin

Santa Cruz

Sonoma

Napa

Contra Costa

San Francisco

San Mateo

Alameda

Santa Clara

United States

Solano

California

Total Turnout (voted/eligible)

2012 Total Turnout Rate by Bay Area Counties

While Alameda County’s total 2012 turnout rate (60 percent) was better than the national or statewide rates in 2012, it did not perform as well as its neighboring Bay Area counties. In fact, it came in 8th out of the 10 Bay Area counties. The average Bay Area total turnout rate was 62.9 percent.

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ALAMEDA COUNTY VOTES (AC VOTES) INITIATIVEAn Organizational Analysis: Assessing Organizational Capacity, Opportunities, and Needs

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Evaluative Criteria for AC Votes Strategies1. Equity: Maximize equity in voting participation rates

and access to voter information and resources, especially among low-income households, communities of color, or groups that have been historically disenfranchised.

2. Administrative Feasibility: The ease and speed with which an activity can be implemented by ACPHD staff, sister agencies, and community partners. The administrative feasibility of each activity varies by agency, department, program, initiative, or organization.

3. Cost-Effectiveness: The ability to maximize voter participation given the limited staff time available for implementation (approximately 926-1,454 hours).

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Agency, Department, and Program/Initiative PartnersALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT

Division of Community Health Services (CHS)Project New Start and Alcohol and Other Drug Prevention ProgramChronic Disease PreventionLegislative CouncilNutrition ServicesOffice of Dental HealthTobacco Control ProgramUrban Male Health InitiativeWomen, Infants & Children (WIC)

Division of Communicable Disease Control & Prevention (DCDCP)Acute Communicable Disease UnitImmunization Assistance ProgramOffice of AIDS Administration

Division of Family Health Services (FHS)California Children ServicesDevelopmental Disabilities CouncilMaternal, Paternal, Child, and Adolescent Health (MPCAH)

Division of Public Health Nursing (PHN)

Health Equity, Policy & PlanningBuilding Blocks for Health EquityCity-County Neighborhood Initiative

Office of the Director (OOD)Information SystemsPublic Information

ALAMEDA COUNTY HEALTH CARE SERVICES AGENCYBehavioral Health Care Services (BHCS)Community Assessment, Planning, & Evaluation (CAPE)Environmental Health Services (EHS)HealthPAC, Indigent Care / Health Care System Planning & ImprovementPolicy Office

ALAMEDA COUNTY REGISTRAR OF VOTERS

ALAMEDA COUNTY PROBATIONS DEPARTMENT

ALAMEDA COUTY SHERIFF’S OFFICEDeputy Sheriff’s Activities League (DSAL)

ALAMEDA COUNTY SOCIAL SERVICES AGENCYProgram Planning & SupportWorkforce and Benefits Administration

COUNTY ADMINISTRATOR OFFICEIntergovernmental Affairs and Civic Engagement

COMMUNITY PARTNERSAlameda Health ConsortiumCalifornia Foundation for Independent Living Centers (CFILC)Community Resources for Independent Living (CRIL)League of Women Voters of CaliforniaLeague of Women Voters—OaklandMapLightRegional Center of the East Bay

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Organizational Analysis Results

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What is AC Votes' objectives?•Increase voter participation rates among ACPHD staff and beneficiaries, particularly low-income residents and communities of color.• Increase access to voting information.• Increase understanding on the importance and benefits of voting.•Dispel misinformation on voting and who is eligible to vote.•Promote a culture of voting among staff, beneficiaries, and community members.•Empower program beneficiaries to exercise their right to vote and engage civically in their community.

What does AC Votes and ACPHD staff need to do to reach these objectives?•Become informed voters.•Connect beneficiaries to voter education resources and services.•Promote voter registration and assist with the registration process.•Disseminate information on key voting information like registration and election deadlines.•Host forums where program beneficiaries and community residents can learn more about voting, candidates, and ballot initiatives.•Promote voting, and provide program beneficiaries and community members access to voting resources and information.

What activities or experiences will help ACPHD staff learn the information needed to execute these activities?•Education and concise messages on the benefits of voting and its why it matters.•Short FAQ on voting and the AC Votes Initiative.•Staff trainings on voter registration, voter turnout, and public education activities.•Access to a centralized hub on the ACPHD Intranet with key voting information and resources for staff.

What will motivate ACPHD staff at all levels of the agency to contribute to AC Votes' work?•ACPHD leadership uplifting the importance of the AC Votes' goals and raising it as a priority.• Initiative coordinator and staff soliciting input and feedback from staff on how best to support their efforts and learnings.•Creating an internal culture of voting at ACPHD.•Ongoing communication and reminders on AC Votes priorities, activities, and key election deadlines.• Incentives like a prize or internal competition for the program or office with the most registration.

AC Votes Voter Engagement Model

Voter Education

Voter Registration

Voter Turnout

Informed Voters

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The overarching approach is to integrate voter engagement work into ACPHD’s day-to-day activities and to leverage the relationship that ACPHD staff has with the beneficiaries of its numerous programs and services to advance AC Votes’ goals and objectives.

Strategy Recommendations• Develop a clear communications strategy for AC Votes that

allows for the timely dissemination of critical voting information and increased access to voting resources among ACPHD beneficiaries, low-income adults, and communities of color.

• Host community forums on voting rights, the voting process, and candidates and ballot initiatives/measures that will appear on the November 2016 ballot.

• Promote voter registration and, when appropriate, provide opportunities for ACPHD beneficiaries to register to vote.

• Evaluate the 2016 election voter participation rates, specifically the registration rate, turnout rate, and total turnout rate, as well as monitor voter participation rates in the future as part of ACPHD’s community health assessments.

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Implementation PlanPHASE 1: Create an Infrastructure

• Onboard and orient AC Votes coordinator.

• Conduct staff trainings on voter registration, voter turnout, and public education activities.

• Build AC Votes’ online portal and communication channels.

• Create materials and resources.

• Follow-up with community partners and staff.

PHASE 2: Implementation & Refinement

• Implement recommended strategies and activities.

• Complete any needed activities beyond those recommended.

• Monitor progress and track emerging issues.

• Build evaluation tools, including a staff survey.

• Realize benefits.

PHASE 3: Evaluation & Next Steps

• Evaluation of impact on clients and on process from staff.

• Distill and share learnings with partners and other stakeholders.

• Identify opportunities and shared vision for future work.

• Explore possibility of adding voter participation section to community health assessment.

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QUESTIONS?Contact: Pam Willow at Pam.Willow@acgov.org.

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