Making it easier to vote hasn’t cut health-related inequality in turnout. Quite the opposite

Conscious that people with disabilities and health problems may find it difficult to vote, some countries have tried to make it easier for them by introducing mobile polling stations and proxy or advance ballots. But as Hanna Wass, Mikko Matila (both University of Helsinki), Lauri Rapeli and Peter Söderlund (both Åbo Akademi University) write, these measures have had a negligible effect on turnout. Indeed, health-related inequalities in turnout are largest in countries that have made the biggest effort to boost accessible voting. Why might this be so?

braille ballots

Braille ballots. Photo: Seika via a CC-BY 2.0 licence

Turnout in elections is unevenly distributed: the higher a person’s socioeconomic status, the higher her propensity to vote in elections. Lately, there has been a growing recognition that health is an important factor in thinking about inequalities in political participation. People suffering from ill health or disabilities are less likely to vote or to engage in other forms of political action.

Several explanations are in play. Weakened health may mean someone has fewer economic, cognitive and social resources to devote to politics. Their poor health may make them feel politically powerless. They may struggle to attend meetings and social activities organised by churches, voluntary associations, informal social networks and political organisations. And the costs of – or more precisely, the barriers to – participation are often higher for people who suffer from poor health or disabilities. Public buildings and transport may be inaccessible to them.

These observations are alarming, not only for groups suffering from health problems, but also the entire political system. In an inclusive democracy, political participation should be accessible to all citizens, regardless of their resources. In order to remedy the problem, many countries have tried to tried facilitate voting through various methods: they include postal voting, absentee voting, assisted voting and proxy ballots. Mobile polling stations are intended specifically to promote voting in hospitals and other institutions, and they are meant to increase not only participation but also the socioeconomic representativeness of the electorate, balancing out different sorts of bias in turnout.

However, because voter facilitation is often introduced in order to raise turnout among all potential voters, it typically does not lead to more equal participation. In fact, empiral evidence from the US suggests it has actually increased the socioeconomic bias in turnout by mobilising those groups that were more active to begin with. Nor has it shown more than a limited capability to narrow health-related differences in participation.

In our recent study, based on European Social Survey (ESS) data, we examine the extent to which voter facilitation policies, designed to boost turnout and to reduce various bias in participation, achieve the desired effect – particularly with regard to voters with limits on their activity or poor health. This question is particularly important given the substantial cross-country differences in such policies, as well as variations at a national level in health-related differences in turnout. Our analysis, which encompasses an 11-year period and 30 countries, reveals that not only are the main effects of voter facilitation insignificant, but that health-related inequalities in turnout are largest in those countries where the strongest efforts are made to ensure accessible voting.

How should we interpret these findings, which may seem surprising and even somewhat bewildering?

At a minimum, our results support the reverse causation or endogeneity argument. This means that countries where we can detect the sharpest differences in turnout rates between different health groups are more likely to have brought in voter facilitation instruments to remedy such skews. Where inequalities in turnout were less pronounced, there has been no urgency to make voting more convenient. Of course, such an explanation rests on the additional (and arguably optimistic) presumption that policy-makers are actively seeking ways to redress socioeconomic biases in voting. Analysing the motives for their efforts is, however, a subject for further research.

Our results highlight the fact that the ways in which health influences political participation are complex and cannot be affected by interventions that only focus on the political system, such as electoral engineering. Instead, any intervention to tackle health-related political inequality should take a more comprehensive approach: aspects of inclusive democracy should be embedded in the planning and implementation processes across different policy fields.

Having said that, many efforts to mobilise voters with health impairments have not yet been empirically analysed to a significant extent – such as online voting, and ballots in Braille. And new computer technologies may improve conditions for political participation among voters with disabilities, giving them better access to information, networking and recruitment.

This post represents the views of the authors and not those of Democratic Audit.

Hanna Wass is an Academy Research Fellow and university lecturer in the Department of Political and Economic Studies at the University of Helsinki. Her research project “Equality in Electoral Participation and Vote Choice”, funded by the Academy of Finland, examines political engagement and inclusive democratic representation from various perspectives. She is a member of the steering committee for the Finnish National Election Study, and the co-convenor of the ECPR standing group “Public Opinion and Voting Behaviour”.

Mikko Mattila is a Professor of Political Science at the University of Helsinki, Finland. He was the leader of an Academy of Finland funded project “Health and Political Engagement”. He has studied voting and other forms of political participation as well as political institutions in national and comparative settings.

Lauri Rapeli is the head of the research project “Problems in Present Patterns of Long-Term Decision-Making”, funded by the Academy of Finland, at Åbo Akademi University. His recent work has been published in European Journal of Political Research, Journal of Elections, Public Opinion and Parties and Government & Opposition. He is a co-author of the book “Health and Political Engagement”, forthcoming in Routledge in 2017.

Peter Söderlund is an Academy Research Fellow at Åbo Akademi University. He is the principal investigator of the research project “Personalisation of Electoral Competition: Long-Term Institutional Effects on Party-Voter Linkages and Party Systems”, financed by the Academy of Finland.