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Primary Submission Category: Reproductive health
Trust, Influence, and the Ballot Box: Healthcare Providers in State-Level Abortion Debates
Authors: Ri’enna Boyd, Caitlin McMurtry, Victoria Anders,
Presenting Author: Ri’enna Boyd*
The Supreme Court’s 2022 Dobbs v. Jackson Women’s Health Organization decision decentralized abortion policy, triggering a wave of state-level ballot initiatives. This decision placed reproductive health decisions in the hands of voters, allowing democracy to function as a social determinant of health. By the end of 2024, 16 states considered 18 measures, with outcomes carrying profound implications for health equity and access to care, particularly among marginalized communities already bearing disproportionate burdens of reproductive health disparities.
Navigating complex health policy at the ballot box, voters often rely on trusted messengers. A December 2024 Gallup poll found that 76% and 53% of Americans rate nurses and physicians, respectively, as highly honest and ethical – compared to just 8% for members of Congress. This trust differential uniquely positions healthcare providers as credible voices in abortion debates, yet little is known about how providers communicate about ballot measures or how political elites leverage that credibility to influence public opinion and, ultimately, health policy outcomes.
This project examines television and newspaper coverage of abortion ballot initiatives in four states (KS, KY, MI, MT) that voted on reproductive rights measures in 2022. We analyze how healthcare providers framed supportive and oppositional arguments in news media versus televised political advertisements to assess how professional expertise is deployed across contexts. Our analysis explores variation by state context, ballot measure content, and medium.
Our findings highlight how provider credibility shapes state-level health policy debates and how expertise functions within direct democracy. As institutional distrust grows, health disparities widen, and more states consider ballot initiatives in 2026, understanding how trusted health professionals influence democratic processes, and the health outcomes that follow, becomes increasingly necessary.