Gerrymandering does more than take our voices. It affects public health in NC | Opinion
North Carolina is no stranger to partisan gerrymandering and the ways it tarnishes our democracy by diluting voting power and disenfranchising communities.
But new research has found that gerrymandering doesn’t just affect election outcomes. It also may affect people’s health and lives.
A study published this month from researchers at the University of Massachusetts Amherst found that gerrymandering can limit access to essential health care services that offer primary and preventive care to people even if they cannot afford it. Gerrymandered legislative districts affected access to federally qualified health centers (FQHCs) in North Carolina, which provide comprehensive services to underserved populations, the study found.
When ZIP codes were carved into multiple districts, those communities ended up with fewer health centers, fewer patients served and significantly longer travel times to get care, the study found. In the most gerrymandered areas, the number of clinics was nearly 30% fewer than in less gerrymandered areas, and they had to travel about 30% farther to get there. The study examined gerrymandered districts between 2004 and 2022, so gerrymandering by both political parties was taken into account.
There are many aspects of society that are touched by politics, but health care should not be one of them. Arbitrary lines drawn by partisan actors should not determine how easily you can see a doctor, or whether you can even see one at all.
When you slice and dice communities across districts to guarantee victory for a certain political party, no single lawmaker is fully responsible for those voters. They’re under less pressure, and they don’t really have to be as accountable to their constituents. That doesn’t just affect voting power — it influences how funding and resources are distributed. It also makes it harder for voters to advocate for themselves and less likely that their representatives will advocate for them. When maps are redrawn often, as they are in North Carolina, voters may not even know who their representatives are.
This is especially serious in a state where health care deserts are already a significant issue. North Carolina’s rural counties have long suffered from physician shortages, particularly for primary care, largely due to population growth and workforce challenges. Add politics into the mix, and it becomes an even bigger public health crisis.
But the study also shows that it’s not just a rural problem. Even in suburban and exurban areas, political map manipulation can create barriers to health care access. A map published alongside the study shows some of the most affected areas aren’t just in rural northeastern and southeastern North Carolina; counties bordering Charlotte, the Triangle and the Triad are also affected.
It’s not the first time gerrymandering has been linked to health outcomes. Other studies have shown a link between gerrymandering and public health challenges, including lower life expectancy and higher uninsured rates. But it is the first time its effects have been so clearly articulated, and the authors of the study believe that the findings could offer a new way to challenge gerrymandering in the courts. Typically, gerrymandering lawsuits revolve around whether the maps are constitutional or compliant with existing federal law. That’s the case with North Carolina’s newest congressional maps, which have been challenged on the grounds that they dilute the power of Black voters.
The UMass study offers something different: the ability to actually quantify the harm caused by gerrymandering, particularly partisan gerrymandering, which courts at the state and federal level have said is permitted or out of their purview. It could allow people to argue that gerrymandering isn’t just a voting rights issue — it’s a health equity issue, too, and weakened representation may be responsible.
It’s true that gerrymandering is about politicians picking their voters instead of the other way around. But maybe it’s worse than that. Maybe gerrymandering also helps determine who gets to see a doctor, and who doesn’t. That shouldn’t happen, and this study might be a first step toward change.
Paige Masten is a deputy opinion editor for The Charlotte Observer and McClatchy’s North Carolina Opinion team.
