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Redistricting and Public Health
August 14, 2021

Redistricting reforms will be considered by state legislators across the country in several states in the Fall of 2021, including Arizona, Florida, and North Carolina. Unfair redistricting practices such as gerrymandering exacerbate disparities in public health outcomes, while fair and equitable redistricting has the potential to help communities better address inequities in public health, including reproductive and maternal health and wellbeing. 

The Impact of Redistricting on Public Health 

Fair, transparent, and accountable redistricting led by independent commissions ensures more equitable representation in state legislatures and increases the likelihood that public health concerns (physical, environmental, and social) are addressed with policy solutions. 

This is particularly important for communities of color, who, due to systemic and structural racism, experience greater disparities in public health outcomes (including mental and physical health during and after pregnancy) than white communities.

Legislatures created with gerrymandered maps allow legislators to pass policy that the majority of their constituents do not support- including policies that can cause significant public health harm such as restrictions on abortion care and contraceptive access.

Gerrymandering keeps conservative politicians in power and hinders the ability of states to expand Medicaid. Communities of color are underrepresented in state legislatures (and Congress) due to gerrymandering and deliberate voter suppression. Medicaid expansion is associated with improvements in health outcomes, mortality rates, lower rates of housing evictions, lower rates of medical debt, and higher rates of financial wellbeing. 

Prison gerrymandering—the counting of incarcerated individuals in the county where they are imprisoned rather than their home communities—impacts representation, power building, and community funding, and disportionately affects communities of color who are incarcerated at higher rates due to the discriminatory judicial system. For example, the Wisconsin legislature’s refusal to switch to vote by mail in the midst of the 2020 COVID pandemic resulted in long, crowded, lines and increased risk of voter exposure to infection.

The Impact of Public Health on Redistricting

The COVID-19 pandemic has delayed the 2020 census…which has delayed the redistricting cycle. 

Delaying the map-drawing process could mean that new maps are not ready before legislative elections in some states, such as Virginia. Delayed maps may force other states, such as Texas, to address redistricting during special sessions. Special sessions have less oversight and increase the risk of unfair maps being drawn. 

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