IN THIS ISSUE

By Thomas E. Kottke, MD, MSPH Editor-in-Chief, MetroDoctors

It’s Your Voice, So Use It!

When I read the trilogy, Berlin Noire, in 2019, my first thought was that it was written as an allegory for 21st Century America. In the three books, Bernie Gunter, a police detective, experiences political crime, thuggery, and violence as autocracy crushes democracy in 1930s Germany. We know how it ends—very poorly for everyone. Written in the 1990s, it couldn’t be an allegory for the 2020s; maybe it was just prescient. It should come as no surprise to anyone who receives a newsfeed or reads a newspaper that democracy in America is under assault as it was in Germany in the 1930s. From the Supreme Court who made it harder to vote by dismantling the Voting Rights Act in 2013 to physical threats and intimidation of local election workers, the anti-democracy movement is strong, ubiquitous, and violent. What may surprise the reader is the strength of the association between democracy and health. The evidence can be found at Healthy Democracy, Healthy People, led by Jeanne Ayers. This nonpartisan initiative supports public health professionals and policymakers who are working to advance civic participation and public health. Visit their interactive website (healthydemocracyhealthypeople.org) where you’ll find that Minnesota does well with both voting and public health; but it is not at the top. This is particularly true for populations of color. Ayers has also contributed an article in this issue of MetroDoctors. Unfortunately, the violent, anti-democracy movement has carried with it a likewise violent anti-public health movement. In a July JAMA commentary (doi:10.1001/ jamanetworkopen.2022.23501), the University of Minnesota’s Sara Gollust wrote that, in a 2021 survey, one-third of Republicans and one-fifth of Democrats expressed belief that harassment of public health officials is justified. As Commissioner Jan Malcolm describes in her Colleague Interview, this belief has taken a toll. Many public health workers have received threats for simply doing their jobs, and Commissioner Malcolm warns that, “I don’t think we fully appreciate yet the consequences of the shift away from understanding or believing in science, and the absolute disdain that many have for expertise of all kinds, much less in government.” I urge you to carefully read her entire interview, reflect on it, and act on her advice to express an opinion: “Your voices can make a tremendous difference at the legislature and among private sector business and healthcare leaders.” In addition to using your voice with the legislature and other policymakers you, the reader, have many other pro-democracy opportunities this fall. Top of list? Vote. The voting rules in Minnesota make it easy. If you will be out of town or busy on election day, request an absentee ballot at the Secretary of State website (https://www.sos.state.mn.us/ elections-voting/other-ways-to-vote). Anyone, at home or not, is permitted to vote by mail. Ed Ehlinger writes that, in his pediatrics practice, he always made information on how to register to vote available to parents as part of the “anticipatory guidance” portion of the well child visit. Vot-ER (vot-er.org) makes this easy by offering healthcare workers a free badge with a QR code that takes the user to a non-partisan voter registration website. Maybe your patient or co-worker won’t vote the way you would vote, but that’s OK. It is the very act of voting that strengthens our democracy. I’m taking advantage of Minnesota election law and voting early this year. You may choose to do the same or you may choose to go to the polls in person on November 8. Either way know this, your vote is a vote for health. Lastly, visit the TCMS blog for an article: All Politics are Local: The Power of Engaging in Grassroots Advocacy, written by TCMS advocacy staff Lucy Faerber, MPH and Kate Feuling Porter, MPH.