Community Health Workers
VOTE Report - 2024/2025

 

I. Core Takeaways from the CHW VOTE 2024-25 Pilots

The CHW VOTE pilots in 2024-25 provided us with important evidence-based civic health
research on how CHWs' trusted relationships could be effective in increasing voter participation.
Although the number of people registered was just over 300 through both pilots, we were able
to successfully recruit health facilities and workers to participate in the effort and lay the
groundwork for expansion of the project in 2026 and beyond.

Other core takeaways from the CHW VOTE  24/25 pilot projects:

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1. Demonstrated that healthcare workers can successfully integrate voter registration into health-related encounters and service delivery, improving civic access to communities.

2. Established a new model that demonstrated how CHWs can be utilized to reduce informational and structural barriers to voting within underserved communities.

3. Added Cleveland to the short list of U.S. cities that has trained and utilized this CHW led model as emerging research recognizing voting as a social determinant of health.

4. Demonstrated that health systems and community health workers can effectively facilitate voter engagement with the proper training, guidance and technical support.

Finally, this pilot effectively positioned the CHW VOTE model to serve as an intersection
between behavioral science, social determinants of health, and the trusted messenger theory. The
framing becomes especially powerful when tied to the documented links between civic
participation and community health outcomes. National Center for Biotechnology Information

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 A. Trusted Messenger Theory

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Underserved communities have proven to be more likely to act on information delivered
by trusted, culturally aligned messengers, a well-established principle in social and health
psychology. CHWs already serve as credible, community-embedded figures who have proven to
be effective in reducing skepticism about voting and motivating their clients and residents to
participate in the electoral process.

 

The ever-changing election procedures related to voter registration, presenting the correct
identification to vote, updating their voter registration, or applying to Vote by Mail (VBM) can
seem cumbersome to many of the CHWs’ clients. Our pilot demonstrated the value of CHWs in
helping to navigate their clients through these barriers to civic participation.

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 B. Voting is a Social Determinant of Health

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Recent public health research identifies access to voting as a determinant of community health.
Policies shaped by voting outcomes influence healthcare access, access to affordable housing,
and access to a quality, accessible higher education. Issues of public safety, environmental
conditions, and government accountability also weigh heavily on every community.

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 C. Civic Engagement Improves Community Well-Being

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• Evidence shows that communities with higher civic participation experience: JAMA Network

• Better physical and mental health

• Lower crime rates

• Stronger social cohesion, and more responsive public institutions

The pilot also helped to clarify that registering clients and residents to vote on a non-partisan
basis in public health facilities is not political advocacy, but rather the promotion of voting and
civic participation as a tool for increasing the civic health of underserved communities.

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 D. Addressing Structural Barriers to Voting

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• Underserved communities face disproportionate barriers to voting due to:

• Ever-changing and confusing election and voting rules

• Frequent Changes to poll locations

• Limited public transportation

• Lower access to digital tools for online voting and VBM tracking

• Chronic disenfranchisement in low voter propensity communities

Nonprofits and community-based workers are uniquely trusted to help residents navigate these
systems. Independent Sector

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​E. The Urgency of Sustainability to Increase Program Impact

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Results from the most recent elections has shown the turnout of voters in the city of Cleveland
continues to decline precipitously. https://www.cleveland.com/news/2024/11/about-46-of-
cleveland-voters-turned-out-in-tuesdays-presidential-election-why-so-low.html The lack of
turnout in the city has also driven down the turnout of Cuyahoga County, once the driver of
statewide voter participation in Ohio.

While ballot issues and candidates can play a major role in effecting turnout of voters, OVF
believes that the non-partisan civic engagement groups have an important role to play in
strengthening civic health and voter participation of our communities.

Community health workers, non-profits, faith-based leaders, and advocates can help serve as
trusted messengers as communities grapple with ongoing issues of economic insecurity, access to
health care, and racial disparities in housing and employment. Increasing the voter education and
participation of African Americans, people of color and underserved communities through
innovative models like CHW VOTE can help to reverse the trend of decreasing civic
engagement.

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A. CHW VOTE 2026 Goals & Prospects

Goals for the planning process are to launch a Phase III of the pilot program in the fall of 2026.
Key components will include:

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1. Secure financial and in-kind support for the coordination of the program in 2026

2. Recruitment and training of 8-10 new Healthcare Workers to carry out the pilot project in CHCs and residential units.

3. Development and distribution of a program toolkit that includes enhanced graphic communications and digital components to increase the program’s impact, and visibility.

4. Securing a new Community Health Network anchor partner organization to adopt and carry out the model program within their community health centers and facilities that serve underserved communities.

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The long-term goals of the CHW VOTE 2026 Pilot program are to:​

 

1. Integrate voter registration into the hub of compensated services provided by CHWs and health care providers to their patients, clients and residents.

2. Urge CHW academic and training institutions to incorporate civic and electoral training into the core curriculum of CHW training and certification programs at Tri-C and CSU.

The Ohio Voter Fund and Promise of Democracy Foundation will be partnering again with the
Vote-ER national network, which has been working primarily with partnering health care
institutions and health professionals to undertake voter registration among their patients. By
utilizing marketing QR codes on individual badges and posters, our Vot-ER partnership
maximizes the use of online voter registration, verification and absentee ballot tracking tools.https://vot-er.org/badge/

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 B. Program Components

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• CHW Training: Nonpartisan voter registration, behavioral science-based communication, cultural responsiveness.

• Civic Health Toolkit: Simplified registration pathways and multilingual materials.

• Community Outreach Integration: CHWs can incorporate voter registration into home visits, health screenings, resource navigation, and community events.

• Data & Learning: Continuous improvement through tracking outreach touchpoints, registration assistance, and community feedback.

• Partnership Ecosystem: Collaboration with CHCs, local nonprofits, clinics, faith institutions, and civic organizations to ensure accuracy, compliance, and outreach.​

 

C. Expected Outcomes

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Short Term

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• Increased access to accurate, nonpartisan civic information among targeted communities

• Reduced logistical barriers to voter registration and voting

• Strengthened trust between CHWs and community members for ongoing engagement

 

Intermediate

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• Higher rates of voter registration among underserved populations

• Increased voter turnout, civic engagement and promote community empowerment

Long Term

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• Stronger civic participation as a pathway to improved community health

• More equitable representation in policy decisions that shape health, housing, education,and economic opportunity

• Institutional adoption of the CHW Vote Model into a participating Health and Wellness Care network that serve the underserved community.