Whanganui District Health Board covers a much larger area than the district council - covering around 65,000 people.
And while they operate entirely separately, it's a convenience and a confusion, that voting papers for both are combined.
But a new way of looking at health in the community is illustrating the link between the DHB elections and local body elections, making the connection between the two clearer than ever.
"One thing that we are thinking about a lot in the Whanganui DHB," head of communications Mark Dawson said, "is the impact of other factors outside health - the social determinants."
"Housing is an issue. Education, household income, access to services... there are a lot of things that go on outside the hospital, and are social factors in people's lives, that will affect their health, perhaps badly.
"Those things we are looking at and trying to think of ways we can address those."
The new approach is timely with DHB elections in full swing. But as with all local body elections, the challenge is getting people to vote.
There are 17 candidates standing for seven places on the board.
"The role of the board member on the District Health Board is one of governance to oversee the operation," said Dawson.
"The operation itself is huge. This is a very big organisation. It's the biggest employer in Whanganui - for over 1000 people. We have a budget of $260 million, we have a huge range of health services disability services to provide for out of that money."
As well as the hospital and emergency department, the DHB is involved in funding pharmacies and rest homes. Health providers in the community receive funding from the DHB. Iwi bodies such as Te Oranganui and medical bases in the Waimarino and at Marton in Rangītikei are included and the DHB funds the Whanganui Regional Health Network which looks after GPs and primary health issues.
But Dawson says there is a significant challenge for our DHB.
"We have a significant Māori population, probably around about 25 per cent of the population of our district. But I would estimate that of the people that come in who require our services, Māori would probably be 40 per cent. So there are discrepancies in Māori health and one of our key tasks and the key task for the incoming board in October, will be to address that inequity for Māori.
"There are certain things - diabetes, heart issues - that they are much more likely to get and life expectancy is one of the key ones. I think Māori are at least seven years less on life expectancy than non-Māori, certainly than European."
These challenges have led to some innovation in the way the region is looking at health with new candidates like Mary Bennett, Debra Smith and Sharon Duff campaigning on community wellbeing policies.
"In order for people to be healthy and thrive in our communities they need to be connected," Smith said.
"There is no point in talking to someone about their mental health when they are living in their car," Duff said earlier in the campaign.
While the increasing population means more pressure on Whanganui's health services, the region's rise in popularity has some positive benefits in attracting staff to the area.
"It was once a place rather looked down on with a bit of an inferiority complex," said Dawson, who is a former editor of the Whanganui Chronicle.
"I think that has changed quite a lot. I think you can look at people like the last two mayors, and the way the councillors tried to promote the city, and a lot of good things have happened in Whanganui over the last few years.
"It's become much more vibrant. The population has increased economically. There's a lot of positives happening and I think that is attracting people, and it's attracting professionals and it certainly helps us attract good medical staff which is fantastic."
Voting for Whanganui DHB and District Council ends this Saturday at noon.