We recently celebrated America’s 243rd birthday. You probably have heard the United States (U.S.) described as a “melting pot” because it is made up of people of varying races, incomes, creeds, sexual orientation, gender identification, ages and gender. In 2020, those residing in the U.S. will be asked to participate in the decennial census — the 23rd since its inception in 1790. The goal of the U.S. Census 2020 is to count everyone once, only once, and in the right place
As public health practitioners, we at the Meigs County Health Department (MCHD) rely on the important work of the U.S. Census Bureau to provide us with accurate, wholly representative data of who is living in the U.S. When the accuracy of this data is at risk, we lose the basic ability to keep track of health and intervene on behalf of better health outcomes. As the U.S. Census Bureau has been forced to grapple with resource limitations, we have to pay more attention to how undercounting affects program funding and congressional representation in our government. (Source: Human Impact Partners)
Public health professionals have long played a vital — albeit underappreciated — role in shaping, not simply using, U.S. Census data to provide the factual evidence required for good governance and health equity (or a state where all persons, regardless of race, income, creed, sexual orientation, gender identification, age or gender are able to be as healthy as they can – to reach their full “health potential.”)
Since its advent, the U.S. Census has constituted a key political instrument, given the novel mandate of the U.S. Constitution to allocate political representation via a national decennial census. The data used to categorize and enumerate people and places have profound implications for every branch and level of government and the resources and representation accorded across and within states.
The MCHD is partnering with the U.S. Census. As part of its Health Equity Policy, the MCHD is committed to improving data collection, analysis and use of data to advance health equity by: expanding data collection to include information about smaller ethnic and cultural communities; using data that focuses on the conditions that create health; incorporating qualitative data to identify root causes of health inequities and to lead to solutions; engaging the community to understand what the data says.
Meanwhile, with the 2020 census quickly approaching, there are again concerns that this decade’s census could undercount the number of children in the U.S., especially in the birth to four-year-old population. Though the undercount of children isn’t a new issue, it could impact children’s health in the coming decade.
In 2010, the census missed nearly 1 million children ages zero to 4. Children can go uncounted for any number of reasons — for example, living in a household with multiple families or living at an unregistered address. Minority children or those who live in low-income families that rent are also more likely to be undercounted than their peers. The undercount of young children has increased over time, from 1.8 percent in 1980 to 4.6 percent in 2010.
So why should we be alarmed at the potential undercount of children in 2020?
Census data plays a vital role in determining funding levels for countless federal programs that create the foundation of public health in the United States. If children are undercounted in the census, then federal support for programs like Medicaid; Head Start; Women, Infants, and Children (WIC); foster care; and grants to local education agencies could fall short of on-the-ground need in states. These programs address essential social factors that shape children’s health; funding cuts mean they won’t be able to reach all of the children and families who rely on them.
In public health, accurate population data is the foundation of every informed decision we make. We use it to examine disease prevalence, how disease trends are changing over time, and whether public health interventions are working. Epidemiologists use census data for everything from monitoring asthma hospitalization disparities to understanding populations affected by natural disasters like Hurricane Sandy. If the 2020 census doesn’t capture accurate population counts for children, it will become much more difficult to monitor children’s health trends in the coming decade.
Furthermore, the data gathered by the US Census is important for advancing health equity. It reports on social determinants of health (or a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity). Contributing factors that describe social determinants of health include: income and social status; social support networks; education and literacy; social environments; physical environments; health services; personal health practices and coping skills; healthy child development; biology and genetic endowment; culture; gender.
Children uncounted by the census won’t get our help if we don’t know that they are there. And if they’re not counted, they’ll have a harder time accessing the very services that can help kids surmount early disadvantages. Health inequity (or a state where all persons, regardless of race, income, creed, sexual orientation, gender identification, age or gender are able to be as healthy as they can — to reach their full “health potential”) is at the heart of why we need to take seriously the consequences of a possible undercount of children. Representation in the census is a right of everyone living in the U.S.; if we’re to achieve equitable health outcomes for children in this country, that right must be fulfilled for every child in 2020. (Source: Children’s Health Matters blog/Center for Health Journalism at the University of Southern California).
The MCHD encourages you to complete the U.S. Census 2020 for yourself and any children residing in your household. All data gathered is de-identified to protect your privacy. The US Census Bureau is maximizing outreach by using both traditional and new media; offering and encouraging people to use the secure online response option for the first time; providing fieldworkers with handheld devices for collecting Census data. For more information about the U.S Census 2020, visit www.census.gov.
Courtney C. Midkiff, BSC, is the Administrator at the Meigs County Health Department.