What the Funding? The Census is Coming: Here’s Why That Matters to Public Health!

This blog was originally posted by the Coalition for Health Funding on October 17.


By Mary Jo Hoeksema, Director of Government Affairs, Population Association of America and Co-Director, The Census Project

In less than a year, the nation’s largest peacetime mobilization, the 2020 Census, will be in full swing.  In January 2020, enumeration in remote Alaskan villages begins with the rest of the nation receiving their forms between March and April.  The public health research community has a major stake in ensuring a successful 2020 Census and should do its part to get everyone counted!

Census data are our nation’s statistical bedrock. These data, which capture essential information about changing U.S. socioeconomic and demographic characteristics, are used to inform consequential funding and planning decisions in the private, public, and academic sectors.  In the public health sector, census data – decennial data as well as the American Community Survey – are used in numerous ways, including:

  • Monitoring public health threats, such as the spread of communicable diseases;

  • Determining the location of clinics, hospitals, and other services;

  • Identifying the health care needs of vulnerable populations (i.e. the elderly, veterans, and young children); and

  • Understanding changes in mortality, disability, and fertility trends.

Population estimates and projections are used by the National Center for Health Statistics (NCHS), the nation’s principal health statistics agency, to determine health and longevity trends. Simply put, our most critical policy and programming decisions in the public health community hinge on the accuracy of census data.

An inaccurate census has lasting impacts for the next decade.  The equitable distribution of federal funds to the states relies on a complete and accurate count.  Census data are used in the formulas to fairly distribute funding each year for programs such as Medicaid, Medicare Part B, S-CHIP, SNAP, and other programs that build healthy communities.

Every decennial census faces its share of challenges, and the 2020 Census has been no exception. The proposed citizenship question to the 2020 Census, which the Supreme Court overruled recently, may have already done damage by discouraging individuals, especially those already identified as hard-to-count, to respond.  Important tests in rural and suburban regions of the country were canceled, jeopardizing our ability to understand the performance of the nation’s first online, digital census.  Innovative enumeration strategies to identify hard-to-count populations, such as American Indians, were not tested in the field. The Census Bureau plans to make promotional materials available in only 12 non-English languages, compared to 28 in the 2010 Census, leaving many communities without appropriate outreach materials. The Bureau’s Partnership Program, a proven mechanism for enlisting “trusted voices” in U.S communities to encourage participation in the decennial census, is falling short of its hiring goals.

Audience research has shown that residents uncertain if they would answer the census identified health professionals among those individuals they would most trust to encourage them to be counted. Thus, public health care professionals should feel empowered to encourage their colleagues, patients, friends, and families to participate in the 2020 Census.  The nation’s health is depending on it.