年轻的声音,健康的未来:将投票年龄降至 16 岁的理由。

IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Medical Journal of Australia Pub Date : 2024-10-21 DOI:10.5694/mja2.52496
Kevin Kapeke, Planning Saw, Edward Krutsch, Claudia Burgner, Hannah Pitt, Ravin Desai, Khalid Muse, Jennifer Rowan, Charlize Nalupta, Judith Bessant, Susan M Sawyer, Sara Wardak
{"title":"年轻的声音,健康的未来:将投票年龄降至 16 岁的理由。","authors":"Kevin Kapeke,&nbsp;Planning Saw,&nbsp;Edward Krutsch,&nbsp;Claudia Burgner,&nbsp;Hannah Pitt,&nbsp;Ravin Desai,&nbsp;Khalid Muse,&nbsp;Jennifer Rowan,&nbsp;Charlize Nalupta,&nbsp;Judith Bessant,&nbsp;Susan M Sawyer,&nbsp;Sara Wardak","doi":"10.5694/mja2.52496","DOIUrl":null,"url":null,"abstract":"<p>The saying “If you don't vote, you don't count” highlights the importance of exercising our democratic right to vote in Australia.<span><sup>1</sup></span> Voting is a fundamental mechanism through which citizens can articulate their concerns and advocate for responsive governance.<span><sup>1</sup></span> Children and young people are currently paying a high price, especially in terms of their health, because individuals aged under 18 years are not allowed to vote. The disenfranchisement of young people perpetuates political disillusionment and exacerbates health disparities.<span><sup>2</sup></span> Historically, marginalised groups have experienced similar patterns of exclusion, leading to systemic neglect of their needs.<span><sup>3</sup></span></p><p>In this 2024 <i>MJA</i> supplement article for the Future Healthy Countdown 2030,<span><sup>4</sup></span> we argue that lowering the voting age to 16 years would empower young people and the political system to address inequities and build an inclusive society that promotes wellbeing. By examining the association between political participation and health outcomes, this article positions voting not merely as a democratic right but as a strategic intervention to improve public health (Box). This argument is grounded in the World Health Organization's conceptualisation of social determinants of health, which acknowledges that participation in political processes is essential for individual and community wellbeing.<span><sup>5</sup></span></p><p>Political participation is a critical social determinant of health, fostering social inclusion, empowerment and equity, which are essential for mental and physical wellbeing.<span><sup>6</sup></span> Voting, as a direct form of political participation, empowers individuals with a sense of agency over decisions that affect their lives.<span><sup>3</sup></span></p><p>Historically, expanding voting rights has led to improved health outcomes. In the United States, for example, the enfranchisement of women and racial minorities reduced inequities, resulting in significant public health gains, including better education and income, and increased longevity.<span><sup>7, 8</sup></span> These precedents suggest that extending voting rights to young people could similarly drive positive health outcomes by ensuring their representation in policy making.</p><p>Young people face barriers to equitable access to health services, such as primary health care, and issues of trust and confidentiality, compounded by complex health issues such as sexual health, mental health, family violence and homelessness.<span><sup>9</sup></span> Since the coronavirus disease 2019 (COVID-19) pandemic, young people have been disproportionately affected by challenges such as the cost-of-living crisis, high education costs, lack of affordable housing, generational wealth inequities, and a highly casualised youth workforce.<span><sup>10</sup></span></p><p>Currently, major social and policy issues in Australia — such as family violence, housing, education, climate change, social media, labour markets, income distribution, and criminal justice — affect all citizens, but are particularly relevant to young people given the developmental sensitivity of childhood and adolescence.<span><sup>11</sup></span> Yet, young people remain largely absent from formal deliberative decision making on these issues; those in power are not compelled to consider their interests.<span><sup>12</sup></span></p><p>The exclusion of young people's voices from meaningful political participation in adult-dominated decision-making processes is well documented across various policy areas, including climate change,<span><sup>13</sup></span> poverty, and wealth inequality.<span><sup>3</sup></span> Obesity is a prime example of the health consequences of excluding young people from policy decisions. Despite the staggering increase in obesity rates,<span><sup>5</sup></span> often beginning in childhood and adolescence,<span><sup>14</sup></span> and clear evidence of the negative impact of excessive sugar-sweetened beverages on obesity and type 2 diabetes,<span><sup>15, 16</sup></span> governments have failed to take meaningful actions.<span><sup>17</sup></span> Research shows that young people strongly support evidence-based government policies to restrict “junk food” marketing and improve food labelling.<span><sup>18, 19</sup></span> However, despite this support, no substantial policy changes have been implemented.<span><sup>17</sup></span> Instead, powerful lobbying by the beverage, food and sugar industries has led governments to adopt industry self-regulation, effectively prioritising industry profits over health.<span><sup>20</sup></span></p><p>The COVID-19 pandemic exemplified how children and young people's experiences were overlooked in key government decisions, some resulting in considerable harm.<span><sup>4</sup></span> The National Children's Commissioner acknowledged in 2023 that young people were rendered “invisible” during the pandemic.<span><sup>21</sup></span> This invisibility manifested in two significant ways. First, there was a lack of direct communication with children and young people, which might have amplified some of their fear and distress.<span><sup>22</sup></span> Instead, they were often left to receive critical information second-hand, even when it directly affected them.<span><sup>22</sup></span> Second, their views were not considered in decisions that deeply affected them, such as school closures and curfews.<span><sup>22</sup></span></p><p>The discussions around these measures focused primarily on adult concerns, such as the impacts on the economy and productivity, with inadequate consideration of the implications for children's education, healthy development and wellbeing.<span><sup>23</sup></span> The lack of representation of young people was further underscored by the absence of a Cabinet Minister for children or a Youth Parliament at the federal level.<span><sup>24</sup></span></p><p>Viewing policies solely from an adult-centric perspective during the COVID-19 pandemic contributed to a deterioration in the mental health of many children and young people, particularly those experiencing high levels of disadvantage.<span><sup>25</sup></span> Peer relationships, crucial to young people's social development, were severely disrupted by the absence of in-person interactions.<span><sup>26</sup></span> The repercussions of these policies continue to be felt, as evidenced by increases in delayed early childhood development, learning disabilities, and behavioural disorders in children and adolescents.<span><sup>26, 27</sup></span> Beyond recognising the invisibility of young people during the COVID-19 pandemic, little has been done to address this substantive problem. Despite well intentioned commitments,<span><sup>28</sup></span> budget announcements, policies<span><sup>29, 30</sup></span> and programs<span><sup>31, 32</sup></span> such as the National Action Plan for the Health of Children and Young People 2020–2030,<span><sup>29</sup></span> ostensibly designed to promote the health and wellbeing of young people, there remains no formal procedural mechanism for young people to participate in deliberative decision-making processes.</p><p>Although there has been an increase in youth involvement through platforms such as advisory committees, these often fall short of providing shared or equitable decision-making opportunities, treating participation as primarily educational rather than substantive.<span><sup>33</sup></span> Without a political imperative to ensure that policies serve the interests of young people, there is a risk that policy making will continue to favour short term election cycle approaches rather than the long term health and wellbeing of our younger, non-voting generations.</p><p>In 2024, the Australian Government released the report <i>Engage! A strategy to include young people in the decisions we make</i>. This report recognises that young people want their views valued and included in decisions that affect them, with 78.9% expressing a desire to be part of government decision making.<span><sup>28</sup></span> In fact, young people in Australia regard “having a say” as being linked to wellbeing.<span><sup>34</sup></span> In addition, the “Make It 16” campaign, a non-partisan initiative led by young people, calls for the federal government to amend the <i>Commonwealth Electoral Act 1918</i> to lower the voting age from 18 to 16 years.<span><sup>35</sup></span> This campaign highlights that 16-year-olds, already entrusted with responsibilities such as driving, consenting to medical procedures, joining the armed forces and being employed, deserve the right to vote. Movements such as the “Make It 16” campaign demonstrate that young people are eager to engage in formal political processes and influence the political and social issues shaping their lives.</p><p>Despite concerns about declining voter turnout among young people, this should not be mistaken for political disinterest.<span><sup>36</sup></span> Instead, extensive youth activism around critical issues such as climate change suggests that young people are politically and ethically engaged but are disillusioned with the traditional political systems. For instance, in 2021, a class action on behalf of all people aged under 18 years against the Environment Minister in the Federal Court underscored young people's lack of faith in achieving climate justice through traditional political channels.<span><sup>37</sup></span> Increasingly, young people are turning to alternative forms of political engagement, such as protests, social enterprises, and volunteering, which focus on values and issues rather than aligning with traditional political institutions.<span><sup>38</sup></span> This shift reflects their frustration with a system that fails to acknowledge or respond effectively to their needs.</p><p>Young people feel disillusioned when their concerns are not addressed through policies and practices advocated by politicians, which may partly be due to their disproportionate absence from the voting demographic. Under procedural justice theory, people respond to policies better when they feel that the policy was made through a fair process, even more than the distributive fairness or consequences of the policy.<span><sup>39</sup></span> Thus, by expanding the voting demographic to include 16-year-olds, young people would be fairly part of the policy creation process, and could more effectively influence political agendas, ensuring that issues pertinent to their health and future are prioritised.<span><sup>2</sup></span></p><p>Lowering the voting age would also encourage politicians to align their policies more closely with the interests of young people, promoting civic engagement and supporting balanced state investments across different ages and generations.<span><sup>40</sup></span> This approach could counterbalance the influence of powerful economic and commercial interests that often shape policies to the detriment of public health, ensuring that the long term wellbeing of all citizens is prioritised.<span><sup>41</sup></span></p><p>Young people have unique insights into their challenges and ideas about how governments should respond.<span><sup>19</sup></span> Ignoring their right to participate in the democratic process risks further disillusionment and may lead to implementing policies that could harm them. For example, as the federal government discusses the impact of social media on development, learning and mental health and considers potential bans for those aged under 16 years, the absence of young voices in these debates is glaring.<span><sup>42, 43</sup></span> Social media affects young people's mental health in both positive and negative ways. While it can contribute to anxiety, depression and cyberbullying, it also offers vital support networks, reduces isolation, and supports social and emotional development.<span><sup>44</sup></span> Many young people argue that banning social media platforms fails to recognise these nuanced effects and ignores the reality of growing up in a digital world. Instead of bans, they advocate for policies promoting digital literacy, transparency in algorithms, and responsible data practices to balance risks and benefits.<span><sup>45</sup></span></p><p>Adult perspectives in these debates often reflect parental fears that do not always align with the views of young people. This generational disconnect can lead to policies that prioritise control over understanding and support. The proposed Health Legislation Amendment (Parental Access to Information) Bill 2003, which aimed to prioritise parental access to health data over young people's right to confidentiality, highlights this mismatch.<span><sup>9</sup></span> Although the Bill was ultimately withdrawn due to opposition from the medical community, it underscores the need for young people to advocate for their rights and interests. Lowering the voting age to 16 years would empower young people to ensure their perspectives are considered in policy development, particularly on matters directly affecting their health and wellbeing. Including young people's voices in these discussions would not only enhance democratic participation but also lead to more informed and balanced policy making that better reflects the needs of all citizens and supports the mental and emotional health of the younger generation.</p><p>Lowering the voting age to 16 years is justified on developmental and participatory democracy grounds. By age 16, individuals have developed the cognitive capacity for logical reasoning and decision making, reaching similar levels of moral and scientific reasoning as adults.<span><sup>46-48</sup></span> The responsibilities currently entrusted to 16-year-olds — such as driving, consenting to medical procedures, and access to employment — demonstrate their ability to make informed decisions.</p><p>Specifically, cognitive ability has never been a criterion for voting eligibility; there is no upper age limit for voting, nor is there a requirement for cognitive testing. This underscores that voting is a fundamental democratic right, not contingent on cognitive assessments.</p><p>Many countries around the world have already lowered the voting age to 16 years.<span><sup>49</sup></span> Examining these international examples provides valuable insights for Australia. In Austria, where voting has been compulsory for all eligible citizens (including 16- and 17-year-olds) since 2007, this practice has led to high levels of youth engagement and increased attention to youth-specific issues.<span><sup>50</sup></span> Conversely, in Scotland, where the voting age was lowered to 16 years for Scottish Parliament and local government elections, voting is not compulsory for any age group. As demonstrated during the independence referendum, Scotland's approach showed that young voters could engage thoughtfully with complex political issues and influence significant outcomes, even without compulsory voting.<span><sup>51</sup></span></p><p>These international cases highlight the importance of aligning voting policies with the specific democratic and cultural context of each country. However, implementing such policies requires careful consideration of local conditions to ensure the successful integration of young voters into the democratic process. Given Australia's tradition of compulsory voting, extending this practice to younger voters would maintain consistency across the voting population and align with the national approach to civic duty<span><sup>52</sup></span> as opposed to introducing optional voting for this age group.</p><p>Concerns about criminalising young people for non-participation can be mitigated through thoughtful implementation. Adequate support, education, and outreach are necessary to maximise engagement and address potential challenges, ensuring that young voters are well prepared to participate in shaping their country's future. For example, to support first time voters and ensure a smooth transition, measures such as robust civic education programs, clear communication about voting responsibilities, and supportive initiatives including reminders and information campaigns targeted at young voters should be introduced. In addition, leniency or grace periods for non-participation in the early stages could help alleviate fears of criminalisation and foster positive voting habits.</p><p>Lowering the voting age to 16 years would acknowledge young people's right and ability to actively participate in shaping their present and future lives. Such a change would encourage politicians to consider the concerns of young people, foster civic engagement, and strengthen the democratic traditions of Australia's electoral system. Historical and international examples demonstrate that expanding voting rights improves health outcomes and societal benefits. Health and politics are deeply intertwined; an equitable society supports the best health dividends.<span><sup>53</sup></span> Although extending the right to vote to younger citizens is not a complete solution to political disillusionment, it is an essential step toward bridging the intergenerational divide and promoting health policies that are preventively and proactively oriented.<span><sup>40</sup></span> The critical question, therefore, is not why young people should be granted the right to vote, but why they should be denied it.</p><p>No relevant disclosures.</p><p>Not commissioned; externally peer reviewed.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"221 S10","pages":"S18-S22"},"PeriodicalIF":6.7000,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52496","citationCount":"0","resultStr":"{\"title\":\"Young voices, healthy futures: the rationale for lowering the voting age to 16\",\"authors\":\"Kevin Kapeke,&nbsp;Planning Saw,&nbsp;Edward Krutsch,&nbsp;Claudia Burgner,&nbsp;Hannah Pitt,&nbsp;Ravin Desai,&nbsp;Khalid Muse,&nbsp;Jennifer Rowan,&nbsp;Charlize Nalupta,&nbsp;Judith Bessant,&nbsp;Susan M Sawyer,&nbsp;Sara Wardak\",\"doi\":\"10.5694/mja2.52496\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>The saying “If you don't vote, you don't count” highlights the importance of exercising our democratic right to vote in Australia.<span><sup>1</sup></span> Voting is a fundamental mechanism through which citizens can articulate their concerns and advocate for responsive governance.<span><sup>1</sup></span> Children and young people are currently paying a high price, especially in terms of their health, because individuals aged under 18 years are not allowed to vote. The disenfranchisement of young people perpetuates political disillusionment and exacerbates health disparities.<span><sup>2</sup></span> Historically, marginalised groups have experienced similar patterns of exclusion, leading to systemic neglect of their needs.<span><sup>3</sup></span></p><p>In this 2024 <i>MJA</i> supplement article for the Future Healthy Countdown 2030,<span><sup>4</sup></span> we argue that lowering the voting age to 16 years would empower young people and the political system to address inequities and build an inclusive society that promotes wellbeing. By examining the association between political participation and health outcomes, this article positions voting not merely as a democratic right but as a strategic intervention to improve public health (Box). This argument is grounded in the World Health Organization's conceptualisation of social determinants of health, which acknowledges that participation in political processes is essential for individual and community wellbeing.<span><sup>5</sup></span></p><p>Political participation is a critical social determinant of health, fostering social inclusion, empowerment and equity, which are essential for mental and physical wellbeing.<span><sup>6</sup></span> Voting, as a direct form of political participation, empowers individuals with a sense of agency over decisions that affect their lives.<span><sup>3</sup></span></p><p>Historically, expanding voting rights has led to improved health outcomes. In the United States, for example, the enfranchisement of women and racial minorities reduced inequities, resulting in significant public health gains, including better education and income, and increased longevity.<span><sup>7, 8</sup></span> These precedents suggest that extending voting rights to young people could similarly drive positive health outcomes by ensuring their representation in policy making.</p><p>Young people face barriers to equitable access to health services, such as primary health care, and issues of trust and confidentiality, compounded by complex health issues such as sexual health, mental health, family violence and homelessness.<span><sup>9</sup></span> Since the coronavirus disease 2019 (COVID-19) pandemic, young people have been disproportionately affected by challenges such as the cost-of-living crisis, high education costs, lack of affordable housing, generational wealth inequities, and a highly casualised youth workforce.<span><sup>10</sup></span></p><p>Currently, major social and policy issues in Australia — such as family violence, housing, education, climate change, social media, labour markets, income distribution, and criminal justice — affect all citizens, but are particularly relevant to young people given the developmental sensitivity of childhood and adolescence.<span><sup>11</sup></span> Yet, young people remain largely absent from formal deliberative decision making on these issues; those in power are not compelled to consider their interests.<span><sup>12</sup></span></p><p>The exclusion of young people's voices from meaningful political participation in adult-dominated decision-making processes is well documented across various policy areas, including climate change,<span><sup>13</sup></span> poverty, and wealth inequality.<span><sup>3</sup></span> Obesity is a prime example of the health consequences of excluding young people from policy decisions. Despite the staggering increase in obesity rates,<span><sup>5</sup></span> often beginning in childhood and adolescence,<span><sup>14</sup></span> and clear evidence of the negative impact of excessive sugar-sweetened beverages on obesity and type 2 diabetes,<span><sup>15, 16</sup></span> governments have failed to take meaningful actions.<span><sup>17</sup></span> Research shows that young people strongly support evidence-based government policies to restrict “junk food” marketing and improve food labelling.<span><sup>18, 19</sup></span> However, despite this support, no substantial policy changes have been implemented.<span><sup>17</sup></span> Instead, powerful lobbying by the beverage, food and sugar industries has led governments to adopt industry self-regulation, effectively prioritising industry profits over health.<span><sup>20</sup></span></p><p>The COVID-19 pandemic exemplified how children and young people's experiences were overlooked in key government decisions, some resulting in considerable harm.<span><sup>4</sup></span> The National Children's Commissioner acknowledged in 2023 that young people were rendered “invisible” during the pandemic.<span><sup>21</sup></span> This invisibility manifested in two significant ways. First, there was a lack of direct communication with children and young people, which might have amplified some of their fear and distress.<span><sup>22</sup></span> Instead, they were often left to receive critical information second-hand, even when it directly affected them.<span><sup>22</sup></span> Second, their views were not considered in decisions that deeply affected them, such as school closures and curfews.<span><sup>22</sup></span></p><p>The discussions around these measures focused primarily on adult concerns, such as the impacts on the economy and productivity, with inadequate consideration of the implications for children's education, healthy development and wellbeing.<span><sup>23</sup></span> The lack of representation of young people was further underscored by the absence of a Cabinet Minister for children or a Youth Parliament at the federal level.<span><sup>24</sup></span></p><p>Viewing policies solely from an adult-centric perspective during the COVID-19 pandemic contributed to a deterioration in the mental health of many children and young people, particularly those experiencing high levels of disadvantage.<span><sup>25</sup></span> Peer relationships, crucial to young people's social development, were severely disrupted by the absence of in-person interactions.<span><sup>26</sup></span> The repercussions of these policies continue to be felt, as evidenced by increases in delayed early childhood development, learning disabilities, and behavioural disorders in children and adolescents.<span><sup>26, 27</sup></span> Beyond recognising the invisibility of young people during the COVID-19 pandemic, little has been done to address this substantive problem. Despite well intentioned commitments,<span><sup>28</sup></span> budget announcements, policies<span><sup>29, 30</sup></span> and programs<span><sup>31, 32</sup></span> such as the National Action Plan for the Health of Children and Young People 2020–2030,<span><sup>29</sup></span> ostensibly designed to promote the health and wellbeing of young people, there remains no formal procedural mechanism for young people to participate in deliberative decision-making processes.</p><p>Although there has been an increase in youth involvement through platforms such as advisory committees, these often fall short of providing shared or equitable decision-making opportunities, treating participation as primarily educational rather than substantive.<span><sup>33</sup></span> Without a political imperative to ensure that policies serve the interests of young people, there is a risk that policy making will continue to favour short term election cycle approaches rather than the long term health and wellbeing of our younger, non-voting generations.</p><p>In 2024, the Australian Government released the report <i>Engage! A strategy to include young people in the decisions we make</i>. This report recognises that young people want their views valued and included in decisions that affect them, with 78.9% expressing a desire to be part of government decision making.<span><sup>28</sup></span> In fact, young people in Australia regard “having a say” as being linked to wellbeing.<span><sup>34</sup></span> In addition, the “Make It 16” campaign, a non-partisan initiative led by young people, calls for the federal government to amend the <i>Commonwealth Electoral Act 1918</i> to lower the voting age from 18 to 16 years.<span><sup>35</sup></span> This campaign highlights that 16-year-olds, already entrusted with responsibilities such as driving, consenting to medical procedures, joining the armed forces and being employed, deserve the right to vote. Movements such as the “Make It 16” campaign demonstrate that young people are eager to engage in formal political processes and influence the political and social issues shaping their lives.</p><p>Despite concerns about declining voter turnout among young people, this should not be mistaken for political disinterest.<span><sup>36</sup></span> Instead, extensive youth activism around critical issues such as climate change suggests that young people are politically and ethically engaged but are disillusioned with the traditional political systems. For instance, in 2021, a class action on behalf of all people aged under 18 years against the Environment Minister in the Federal Court underscored young people's lack of faith in achieving climate justice through traditional political channels.<span><sup>37</sup></span> Increasingly, young people are turning to alternative forms of political engagement, such as protests, social enterprises, and volunteering, which focus on values and issues rather than aligning with traditional political institutions.<span><sup>38</sup></span> This shift reflects their frustration with a system that fails to acknowledge or respond effectively to their needs.</p><p>Young people feel disillusioned when their concerns are not addressed through policies and practices advocated by politicians, which may partly be due to their disproportionate absence from the voting demographic. Under procedural justice theory, people respond to policies better when they feel that the policy was made through a fair process, even more than the distributive fairness or consequences of the policy.<span><sup>39</sup></span> Thus, by expanding the voting demographic to include 16-year-olds, young people would be fairly part of the policy creation process, and could more effectively influence political agendas, ensuring that issues pertinent to their health and future are prioritised.<span><sup>2</sup></span></p><p>Lowering the voting age would also encourage politicians to align their policies more closely with the interests of young people, promoting civic engagement and supporting balanced state investments across different ages and generations.<span><sup>40</sup></span> This approach could counterbalance the influence of powerful economic and commercial interests that often shape policies to the detriment of public health, ensuring that the long term wellbeing of all citizens is prioritised.<span><sup>41</sup></span></p><p>Young people have unique insights into their challenges and ideas about how governments should respond.<span><sup>19</sup></span> Ignoring their right to participate in the democratic process risks further disillusionment and may lead to implementing policies that could harm them. For example, as the federal government discusses the impact of social media on development, learning and mental health and considers potential bans for those aged under 16 years, the absence of young voices in these debates is glaring.<span><sup>42, 43</sup></span> Social media affects young people's mental health in both positive and negative ways. While it can contribute to anxiety, depression and cyberbullying, it also offers vital support networks, reduces isolation, and supports social and emotional development.<span><sup>44</sup></span> Many young people argue that banning social media platforms fails to recognise these nuanced effects and ignores the reality of growing up in a digital world. Instead of bans, they advocate for policies promoting digital literacy, transparency in algorithms, and responsible data practices to balance risks and benefits.<span><sup>45</sup></span></p><p>Adult perspectives in these debates often reflect parental fears that do not always align with the views of young people. This generational disconnect can lead to policies that prioritise control over understanding and support. The proposed Health Legislation Amendment (Parental Access to Information) Bill 2003, which aimed to prioritise parental access to health data over young people's right to confidentiality, highlights this mismatch.<span><sup>9</sup></span> Although the Bill was ultimately withdrawn due to opposition from the medical community, it underscores the need for young people to advocate for their rights and interests. Lowering the voting age to 16 years would empower young people to ensure their perspectives are considered in policy development, particularly on matters directly affecting their health and wellbeing. Including young people's voices in these discussions would not only enhance democratic participation but also lead to more informed and balanced policy making that better reflects the needs of all citizens and supports the mental and emotional health of the younger generation.</p><p>Lowering the voting age to 16 years is justified on developmental and participatory democracy grounds. By age 16, individuals have developed the cognitive capacity for logical reasoning and decision making, reaching similar levels of moral and scientific reasoning as adults.<span><sup>46-48</sup></span> The responsibilities currently entrusted to 16-year-olds — such as driving, consenting to medical procedures, and access to employment — demonstrate their ability to make informed decisions.</p><p>Specifically, cognitive ability has never been a criterion for voting eligibility; there is no upper age limit for voting, nor is there a requirement for cognitive testing. This underscores that voting is a fundamental democratic right, not contingent on cognitive assessments.</p><p>Many countries around the world have already lowered the voting age to 16 years.<span><sup>49</sup></span> Examining these international examples provides valuable insights for Australia. In Austria, where voting has been compulsory for all eligible citizens (including 16- and 17-year-olds) since 2007, this practice has led to high levels of youth engagement and increased attention to youth-specific issues.<span><sup>50</sup></span> Conversely, in Scotland, where the voting age was lowered to 16 years for Scottish Parliament and local government elections, voting is not compulsory for any age group. As demonstrated during the independence referendum, Scotland's approach showed that young voters could engage thoughtfully with complex political issues and influence significant outcomes, even without compulsory voting.<span><sup>51</sup></span></p><p>These international cases highlight the importance of aligning voting policies with the specific democratic and cultural context of each country. However, implementing such policies requires careful consideration of local conditions to ensure the successful integration of young voters into the democratic process. Given Australia's tradition of compulsory voting, extending this practice to younger voters would maintain consistency across the voting population and align with the national approach to civic duty<span><sup>52</sup></span> as opposed to introducing optional voting for this age group.</p><p>Concerns about criminalising young people for non-participation can be mitigated through thoughtful implementation. Adequate support, education, and outreach are necessary to maximise engagement and address potential challenges, ensuring that young voters are well prepared to participate in shaping their country's future. For example, to support first time voters and ensure a smooth transition, measures such as robust civic education programs, clear communication about voting responsibilities, and supportive initiatives including reminders and information campaigns targeted at young voters should be introduced. In addition, leniency or grace periods for non-participation in the early stages could help alleviate fears of criminalisation and foster positive voting habits.</p><p>Lowering the voting age to 16 years would acknowledge young people's right and ability to actively participate in shaping their present and future lives. Such a change would encourage politicians to consider the concerns of young people, foster civic engagement, and strengthen the democratic traditions of Australia's electoral system. Historical and international examples demonstrate that expanding voting rights improves health outcomes and societal benefits. Health and politics are deeply intertwined; an equitable society supports the best health dividends.<span><sup>53</sup></span> Although extending the right to vote to younger citizens is not a complete solution to political disillusionment, it is an essential step toward bridging the intergenerational divide and promoting health policies that are preventively and proactively oriented.<span><sup>40</sup></span> The critical question, therefore, is not why young people should be granted the right to vote, but why they should be denied it.</p><p>No relevant disclosures.</p><p>Not commissioned; externally peer reviewed.</p>\",\"PeriodicalId\":18214,\"journal\":{\"name\":\"Medical Journal of Australia\",\"volume\":\"221 S10\",\"pages\":\"S18-S22\"},\"PeriodicalIF\":6.7000,\"publicationDate\":\"2024-10-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52496\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical Journal of Australia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.5694/mja2.52496\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Australia","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.5694/mja2.52496","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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摘要

例如,为支持首次投票的选民并确保平稳过渡,应采取有力的公民教育计划、关于投票责任的明确沟通以及针对年轻选民的提醒和宣传活动等支持性措施。此外,在早期阶段对不参加投票者给予宽限或宽限期,有助于减轻对刑事犯罪的恐惧,培养积极的投票习惯。将投票年龄降至 16 岁将承认年轻人有权利和能力积极参与塑造他们现在和未来的生活。这种改变将鼓励政治家考虑年轻人的关切,促进公民参与,并加强澳大利亚选举制度的民主传统。历史和国际范例都表明,扩大投票权能够改善健康状况和社会效益。53 虽然将投票权扩展至年轻公民并不能完全解决政治幻灭问题,但这是弥合代际鸿沟、促进以预防和主动为导向的健康政策的重要一步。40 因此,关键问题不是为什么要赋予年轻人投票权,而是为什么要剥夺他们的投票权。
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Young voices, healthy futures: the rationale for lowering the voting age to 16

The saying “If you don't vote, you don't count” highlights the importance of exercising our democratic right to vote in Australia.1 Voting is a fundamental mechanism through which citizens can articulate their concerns and advocate for responsive governance.1 Children and young people are currently paying a high price, especially in terms of their health, because individuals aged under 18 years are not allowed to vote. The disenfranchisement of young people perpetuates political disillusionment and exacerbates health disparities.2 Historically, marginalised groups have experienced similar patterns of exclusion, leading to systemic neglect of their needs.3

In this 2024 MJA supplement article for the Future Healthy Countdown 2030,4 we argue that lowering the voting age to 16 years would empower young people and the political system to address inequities and build an inclusive society that promotes wellbeing. By examining the association between political participation and health outcomes, this article positions voting not merely as a democratic right but as a strategic intervention to improve public health (Box). This argument is grounded in the World Health Organization's conceptualisation of social determinants of health, which acknowledges that participation in political processes is essential for individual and community wellbeing.5

Political participation is a critical social determinant of health, fostering social inclusion, empowerment and equity, which are essential for mental and physical wellbeing.6 Voting, as a direct form of political participation, empowers individuals with a sense of agency over decisions that affect their lives.3

Historically, expanding voting rights has led to improved health outcomes. In the United States, for example, the enfranchisement of women and racial minorities reduced inequities, resulting in significant public health gains, including better education and income, and increased longevity.7, 8 These precedents suggest that extending voting rights to young people could similarly drive positive health outcomes by ensuring their representation in policy making.

Young people face barriers to equitable access to health services, such as primary health care, and issues of trust and confidentiality, compounded by complex health issues such as sexual health, mental health, family violence and homelessness.9 Since the coronavirus disease 2019 (COVID-19) pandemic, young people have been disproportionately affected by challenges such as the cost-of-living crisis, high education costs, lack of affordable housing, generational wealth inequities, and a highly casualised youth workforce.10

Currently, major social and policy issues in Australia — such as family violence, housing, education, climate change, social media, labour markets, income distribution, and criminal justice — affect all citizens, but are particularly relevant to young people given the developmental sensitivity of childhood and adolescence.11 Yet, young people remain largely absent from formal deliberative decision making on these issues; those in power are not compelled to consider their interests.12

The exclusion of young people's voices from meaningful political participation in adult-dominated decision-making processes is well documented across various policy areas, including climate change,13 poverty, and wealth inequality.3 Obesity is a prime example of the health consequences of excluding young people from policy decisions. Despite the staggering increase in obesity rates,5 often beginning in childhood and adolescence,14 and clear evidence of the negative impact of excessive sugar-sweetened beverages on obesity and type 2 diabetes,15, 16 governments have failed to take meaningful actions.17 Research shows that young people strongly support evidence-based government policies to restrict “junk food” marketing and improve food labelling.18, 19 However, despite this support, no substantial policy changes have been implemented.17 Instead, powerful lobbying by the beverage, food and sugar industries has led governments to adopt industry self-regulation, effectively prioritising industry profits over health.20

The COVID-19 pandemic exemplified how children and young people's experiences were overlooked in key government decisions, some resulting in considerable harm.4 The National Children's Commissioner acknowledged in 2023 that young people were rendered “invisible” during the pandemic.21 This invisibility manifested in two significant ways. First, there was a lack of direct communication with children and young people, which might have amplified some of their fear and distress.22 Instead, they were often left to receive critical information second-hand, even when it directly affected them.22 Second, their views were not considered in decisions that deeply affected them, such as school closures and curfews.22

The discussions around these measures focused primarily on adult concerns, such as the impacts on the economy and productivity, with inadequate consideration of the implications for children's education, healthy development and wellbeing.23 The lack of representation of young people was further underscored by the absence of a Cabinet Minister for children or a Youth Parliament at the federal level.24

Viewing policies solely from an adult-centric perspective during the COVID-19 pandemic contributed to a deterioration in the mental health of many children and young people, particularly those experiencing high levels of disadvantage.25 Peer relationships, crucial to young people's social development, were severely disrupted by the absence of in-person interactions.26 The repercussions of these policies continue to be felt, as evidenced by increases in delayed early childhood development, learning disabilities, and behavioural disorders in children and adolescents.26, 27 Beyond recognising the invisibility of young people during the COVID-19 pandemic, little has been done to address this substantive problem. Despite well intentioned commitments,28 budget announcements, policies29, 30 and programs31, 32 such as the National Action Plan for the Health of Children and Young People 2020–2030,29 ostensibly designed to promote the health and wellbeing of young people, there remains no formal procedural mechanism for young people to participate in deliberative decision-making processes.

Although there has been an increase in youth involvement through platforms such as advisory committees, these often fall short of providing shared or equitable decision-making opportunities, treating participation as primarily educational rather than substantive.33 Without a political imperative to ensure that policies serve the interests of young people, there is a risk that policy making will continue to favour short term election cycle approaches rather than the long term health and wellbeing of our younger, non-voting generations.

In 2024, the Australian Government released the report Engage! A strategy to include young people in the decisions we make. This report recognises that young people want their views valued and included in decisions that affect them, with 78.9% expressing a desire to be part of government decision making.28 In fact, young people in Australia regard “having a say” as being linked to wellbeing.34 In addition, the “Make It 16” campaign, a non-partisan initiative led by young people, calls for the federal government to amend the Commonwealth Electoral Act 1918 to lower the voting age from 18 to 16 years.35 This campaign highlights that 16-year-olds, already entrusted with responsibilities such as driving, consenting to medical procedures, joining the armed forces and being employed, deserve the right to vote. Movements such as the “Make It 16” campaign demonstrate that young people are eager to engage in formal political processes and influence the political and social issues shaping their lives.

Despite concerns about declining voter turnout among young people, this should not be mistaken for political disinterest.36 Instead, extensive youth activism around critical issues such as climate change suggests that young people are politically and ethically engaged but are disillusioned with the traditional political systems. For instance, in 2021, a class action on behalf of all people aged under 18 years against the Environment Minister in the Federal Court underscored young people's lack of faith in achieving climate justice through traditional political channels.37 Increasingly, young people are turning to alternative forms of political engagement, such as protests, social enterprises, and volunteering, which focus on values and issues rather than aligning with traditional political institutions.38 This shift reflects their frustration with a system that fails to acknowledge or respond effectively to their needs.

Young people feel disillusioned when their concerns are not addressed through policies and practices advocated by politicians, which may partly be due to their disproportionate absence from the voting demographic. Under procedural justice theory, people respond to policies better when they feel that the policy was made through a fair process, even more than the distributive fairness or consequences of the policy.39 Thus, by expanding the voting demographic to include 16-year-olds, young people would be fairly part of the policy creation process, and could more effectively influence political agendas, ensuring that issues pertinent to their health and future are prioritised.2

Lowering the voting age would also encourage politicians to align their policies more closely with the interests of young people, promoting civic engagement and supporting balanced state investments across different ages and generations.40 This approach could counterbalance the influence of powerful economic and commercial interests that often shape policies to the detriment of public health, ensuring that the long term wellbeing of all citizens is prioritised.41

Young people have unique insights into their challenges and ideas about how governments should respond.19 Ignoring their right to participate in the democratic process risks further disillusionment and may lead to implementing policies that could harm them. For example, as the federal government discusses the impact of social media on development, learning and mental health and considers potential bans for those aged under 16 years, the absence of young voices in these debates is glaring.42, 43 Social media affects young people's mental health in both positive and negative ways. While it can contribute to anxiety, depression and cyberbullying, it also offers vital support networks, reduces isolation, and supports social and emotional development.44 Many young people argue that banning social media platforms fails to recognise these nuanced effects and ignores the reality of growing up in a digital world. Instead of bans, they advocate for policies promoting digital literacy, transparency in algorithms, and responsible data practices to balance risks and benefits.45

Adult perspectives in these debates often reflect parental fears that do not always align with the views of young people. This generational disconnect can lead to policies that prioritise control over understanding and support. The proposed Health Legislation Amendment (Parental Access to Information) Bill 2003, which aimed to prioritise parental access to health data over young people's right to confidentiality, highlights this mismatch.9 Although the Bill was ultimately withdrawn due to opposition from the medical community, it underscores the need for young people to advocate for their rights and interests. Lowering the voting age to 16 years would empower young people to ensure their perspectives are considered in policy development, particularly on matters directly affecting their health and wellbeing. Including young people's voices in these discussions would not only enhance democratic participation but also lead to more informed and balanced policy making that better reflects the needs of all citizens and supports the mental and emotional health of the younger generation.

Lowering the voting age to 16 years is justified on developmental and participatory democracy grounds. By age 16, individuals have developed the cognitive capacity for logical reasoning and decision making, reaching similar levels of moral and scientific reasoning as adults.46-48 The responsibilities currently entrusted to 16-year-olds — such as driving, consenting to medical procedures, and access to employment — demonstrate their ability to make informed decisions.

Specifically, cognitive ability has never been a criterion for voting eligibility; there is no upper age limit for voting, nor is there a requirement for cognitive testing. This underscores that voting is a fundamental democratic right, not contingent on cognitive assessments.

Many countries around the world have already lowered the voting age to 16 years.49 Examining these international examples provides valuable insights for Australia. In Austria, where voting has been compulsory for all eligible citizens (including 16- and 17-year-olds) since 2007, this practice has led to high levels of youth engagement and increased attention to youth-specific issues.50 Conversely, in Scotland, where the voting age was lowered to 16 years for Scottish Parliament and local government elections, voting is not compulsory for any age group. As demonstrated during the independence referendum, Scotland's approach showed that young voters could engage thoughtfully with complex political issues and influence significant outcomes, even without compulsory voting.51

These international cases highlight the importance of aligning voting policies with the specific democratic and cultural context of each country. However, implementing such policies requires careful consideration of local conditions to ensure the successful integration of young voters into the democratic process. Given Australia's tradition of compulsory voting, extending this practice to younger voters would maintain consistency across the voting population and align with the national approach to civic duty52 as opposed to introducing optional voting for this age group.

Concerns about criminalising young people for non-participation can be mitigated through thoughtful implementation. Adequate support, education, and outreach are necessary to maximise engagement and address potential challenges, ensuring that young voters are well prepared to participate in shaping their country's future. For example, to support first time voters and ensure a smooth transition, measures such as robust civic education programs, clear communication about voting responsibilities, and supportive initiatives including reminders and information campaigns targeted at young voters should be introduced. In addition, leniency or grace periods for non-participation in the early stages could help alleviate fears of criminalisation and foster positive voting habits.

Lowering the voting age to 16 years would acknowledge young people's right and ability to actively participate in shaping their present and future lives. Such a change would encourage politicians to consider the concerns of young people, foster civic engagement, and strengthen the democratic traditions of Australia's electoral system. Historical and international examples demonstrate that expanding voting rights improves health outcomes and societal benefits. Health and politics are deeply intertwined; an equitable society supports the best health dividends.53 Although extending the right to vote to younger citizens is not a complete solution to political disillusionment, it is an essential step toward bridging the intergenerational divide and promoting health policies that are preventively and proactively oriented.40 The critical question, therefore, is not why young people should be granted the right to vote, but why they should be denied it.

No relevant disclosures.

Not commissioned; externally peer reviewed.

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来源期刊
Medical Journal of Australia
Medical Journal of Australia 医学-医学:内科
CiteScore
9.40
自引率
5.30%
发文量
410
审稿时长
3-8 weeks
期刊介绍: The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.
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