Accurate 2020 census count is critical for public health

In a year when public health is stretched thin because of a global pandemic, outrage over longstanding racial injustice is at a boiling point and mistrust of government is high, the 2020 U.S. Census might seem a trivial concern. But there might never have been a more important time to stand up and get counted.

“All the things that we talk about in terms of the social determinants are impacted by an accurate census count,” said APHA Executive Director Georges C. Benjamin, MD. That includes funding for schools and roads, how much federal money goes to states for such programs as the Children’s Health Insurance Program and Medicaid, and even how many representatives each state has in Congress.

Conducted every 10 years, the U.S. census is a huge undertaking that has historically resulted in undercounts of already under-resourced communities of color. The current census effort is no exception, with worries that the Trump administration’s attempt to add a citizenship question — an attempt the Supreme Court struck down last year — is still deterring people from participating in the 2020 census.

“There are people out there, for nefarious purposes, who are happy for you to be in the undercount. But they cannot use you being in the Census against you. You’re protected,” Benjamin said. “You are identifying yourself as a household, and you’re basically saying how many people are in your household.”

The actual census survey is short, just 12 questions, and takes 5-10 minutes to complete. People can get counted by a census taker in person, by mailing in a census survey or by completing the survey online at 2020Census.gov or via telephone by calling 844-330-2020. There is no question about immigration status on the 2020 census.

“There is a mistrust. I don’t blame people for fearing that question, especially with a lot of the back and forth that has happened this year, politically and socially,” said APHA Health Policy Coordinator Paulina Sosa, MPH, DrPH (c), founder and president of the Latinx Voces en Salud campaign and chair of the Latinx COVID-19 Task Force. “I understand why people are fearful, but none of this comes back to hurt them. This information is all fed up to an aggregate level.”

This year’s census count closes on Sept. 30, a shorter-than-usual timeframe in an already challenging year of trying to collect data during widespread quarantines and physical distancing due to COVID-19. But for public health, getting counted and encouraging everyone to get counted is urgent.

As APHA member Philip Huang, MD, MPH, director of Dallas County Health and Human Services told The Nation’s Health earlier this year, “For epidemiological purposes, the census is where we get our denominator data for all sorts of public health issues. It’s pretty key for assessing public health problems.”

This year, census outreach has run the gamut from the urgently serious to the humorous. Puerto Rican actor Carlos Ponce channels his inner vampire to encourage a reluctant food delivery guy to be counted in this hilarious video. The U.S. Census Bureau gives a great, 30-second call to participation in this one.

To help spread the word, the U.S. Census Bureau has online resources that include FAQs in multiple languages and a sample survey showing what questions are asked. Their “Spread the Word” page includes a social media challenge and shareables such as gifs and embeddable videos.

As of late August, Census Bureau officials estimated about 78% of households had been counted. Please help improve that number.

“We’re just telling you to get heard, because your voice does matter,” Sosa said.