In states and cities across the nation last week, Americans voted “yes” for public health – passing ballot initiatives that have the potential to improve community health through housing, education, financial security, and other areas.

As I was leaving my local polling place, a reporter from the Wall Street Journal stopped me to ask why I had voted in the mid-term election. When I told him I was interested in a number of the local ballot measures, his eyes glazed over. He clearly wanted to focus on my state’s gubernatorial election, and my answer wasn’t what he was looking for.

This interaction reminded me that many people (and the media) often overlook how important our local choices are. This year’s ballot initiatives show the power that local residents have in shaping the environments where they live, work, and play. Here’s a look at how some ballot initiatives fared.

At the state level, three conservative states voted to expand Medicaid. Voters in Idaho, Nebraska, and Utah approved ballot referendums to expand coverage to about 300,000 people. While insurance coverage doesn’t guarantee improved health, the resounding support for healthcare access in these states was notable.

Financial security has a clear tie to health and well-being, and citizens in Arkansas and Missouri voted to raise the minimum wage. In an advisory referendum, voters in Chicago showed their support for an increase in the minimum wage and voiced their approval for paid sick leave.

Californians approved two statewide measures that will fund affordable housing efforts. These will complement Measure C in San Francisco, which will tax local businesses to pay for housing for the city’s homeless. Affordable housing measures also passed in Austin, Baltimore, and Charlotte.

Baltimore voters passed a creative measure that aims at eliminating structural and institutional racism. The so-called “Equity Assistance Fund” will provide assistance to city residents who have experienced discrimination based on their race, gender, or economic status. Given the link between health and discrimination, it will be interesting to see how this policy is implemented and evaluated.

Dallas, Indianapolis, San Diego, and Seattle all passed initiatives to support education. Seattle’s measure provides funding for pre-K through community college, and will provide a certain number of local high school graduates free tuition to community college. Dallas’s successful education tax will, among other things, increase funding for early childhood education and expand the number of pre-K classrooms in the city.

In Denver another initiative focused on children received broad support. Voters in the Mile High City passed a ballot measure designed to provide fresh, healthy food to low-income children.

A number of cities passed measures that will fund improvement to their infrastructure. Austin, Tucson, and Charlotte all passed transportation bonds that will increase access to bike lanes and improve walkability in their municipalities. These policies are very similar to Complete Streets, which helps ensure safe streets for motorists, pedestrians, mass transit, and cyclists.

If you’re interested in learning more about some of these local measures, see Ballotpedia’s “Local Ballot Measure Elections in 2018,” and CityLab’s “On Ballot Measures, A Progressive Sweep.”

Catherine Patterson is Managing Director of Urban Health and Policy at the de Beaumont Foundation.

Recent Posts

View More