Abstract
By the time you read this editorial, it will be almost time to vote again in the United States. Voting affects health policy. Federal health policy in the United States is created by the three branches of government: Congress (the legislature-Senate and House), the president (executive branch), and the federal courts, including the Supreme Court. Congress passes legislation creating policy, which, if signed by the president, becomes law. The executive branch impacts policy by signing or vetoing legislation. Further, policy is created by members of the executive branch who write regulations to accompany laws. The courts create policy by declaring whether laws and regulations are legal or not. For example, in 1973, the U.S. Supreme Court found in Roe v. Wade that unduly restrictive state regulation of abortion was unconstitutional, legalizing abortion in the United States. In 2022, the Court, with different judges, overturned Roe v. Wade in Dobbs v. Jackston Women's Health Organization, the Court decision arguing that the U.S. Constitution does not guarantee the right to choose to have an abortion. (There are numerous articles and books that explain the details of these decisions and why people are for or against these decisions. See for example https://reproductiverights.org/resources/roe-v-wade/; https://www.brennancenter.org/our-work/research-reports/roe-v-wade-and-supreme-court-abortion-cases; https://history.princeton.edu/about/publications/roe-v-wade-fifty-years-after). Whom we vote for impacts all three branches of government and, therefore, health policy.
It is obvious that whom we vote for affects Congress and the presidency; however, it is less obvious how nurses' voting affects the courts. Under article III of the U.S. Constitution, all federal Judges (Supreme Court Justices, Court of Appeals judges, and District Court judges) are appointed by the president and confirmed by the Senate. Federal judges are appointed for life to promote the political independence of the federal courts. Whom Americans vote for president can have a years-long impact on the composition of courts. In the United States two-party system, Republican and Democratic presidents tend to appoint judges who share each president's approach to the interpretation of laws. Similarly, the Senate approves or doesn’t appointees consistent with the party having a majority in the Senate. Currently, the president and the majority of the Senate are from the same party, which almost assures that whomever the president selects as judges will likely be approved by the Senate. Therefore, not only does it matter what Senate candidate wins in a nurse's state but also who wins in other states. Sometimes it makes sense to support financially or with time Senate candidates in states other than our own.
There are no good recent estimates that I could find for the percentage or number of nurses who are registered to vote and who vote in the United States. Most data are from surveys that ask nurses if they voted or not and may not have valid findings. Nurses may not accurately report whether they voted, because they want to provide socially accepted data that they did vote or they may even have forgotten whether they voted or not. In Ludwick et al. (2025) “Analysis of Ohio Nurses’ Voting Behaviors 2020–2023,” the authors provide excellent data about the actual voting patterns and political affiliations of licensed nurses in Ohio. Using three years of data, the authors report that almost 74% of Ohio nurses were registered to vote; however, only 47.7% voted in all three years and 11% never voted at all. These numbers may be an underestimate because it is possible that some of the nurses lived outside of Ohio and may have voted in states other than Ohio. The authors report that in Ohio 1 in 51 registered voters is a registered nurse.
I tried to figure out about how many of the 5,000,000 U.S. registered nurses were 18 and over and U.S. citizens, making them eligible to vote and was unsuccessful in finding that number and even trying to calculate it. I could not find the number or percentage of registered nurses who are citizens. Most states do not require U.S. citizenship to obtain an RN license and therefore don’t collect such data. My best guestimate is about 1 in 50 eligible voters is a registered nurse.
We need to have a higher percentage of nurses voting so elected and appointed officials listen to our positions on healthcare and justice. Think of the impact we could have if 74% of registered nurses not only registered to vote but voted.
Please send me any information that you have about nurses voting.