Census 2020: Why health reporters should care about an underfunded census

Insufficient funding for the 2020 Census and the potential implications for communities of color and immigrant groups is a critical topic for health journalists to monitor, census observers say.

This decennial count of the U.S. population is instrumental in determining everything from a state’s congressional seats to the amount of federal dollars directed toward health care. There are concerns that underfunding the census could result in low headcounts, especially in hard-to-count areas.

“The 2020 Census faces unprecedented challenges in collecting data, including fear of government authorities in immigrant communities, cybersecurity threats (real or perceived) and uneven access to reliable Internet service, which could disadvantage rural, low-income and older households,” wrote former U.S. Census Bureau directors Vincent P. Barabba and Kenneth Prewitt in a Washington Post op-ed.

Why health reporters should care

Terri Ann Lowenthal, a former staff director of the House Subcommittee on Census and Population, called the combination of factors “a perfect storm” that could “thwart a successful census,” in a New America Media op-ed. I caught up with Lowenthal this week to hear more about why health journalists should be closely monitoring the census story.

“There are a number of health-related programs that allocate funds directly or indirectly based on census data,” Lowenthal told the Center for Health Journalism. “An accurate census is vital to ensuring fair and equitable distribution of funds for many health-related programs.”

Census data impact federal funding on everything from Medicare and Medicaid to programs such as Healthy Start and Women, Infants, and Children (WIC).   

That’s not all, though. Ensuring the data’s accuracy is also key for researchers — and journalists — who use the census figures to study a number of health concerns, including care disparities. For example, if someone wants to look at care disparities, outcomes, or access to providers by race and ethnicity, they’ll often use the American Community Survey (ACS), a yearly survey by the U.S. Census Bureau.

The surveys are a gold mine of health stories. Want to study whether people with limited English proficiency have disparate outcomes because there are language and cultural barriers with their providers? Start with the survey’s data, Lowenthal said.  

The ACS also informs research published by organizations such as the Robert Wood Johnson Foundation, whose findings often guide policy makers — and fuel mainstream press articles.

Communities of color could be undercounted

The L.A.-based National Association of Latino Elected and Appointed Officials (NALEO) is also concerned about the health consequences of inaccurate census counts, said Ofelia Medina, the organization’s director of state civic engagement policy.

Undercounting young children — a longstanding problem with the census — would impact the number of federal dollars for programs such as Head Start and Early Head Start, which promote childhood development and support low-income families.

“If you’re not counting children, that impacts the amount of funds available for Latino working families,” Medina said.

There are numerous reasons why Latinos and other communities of color could be undercounted, from a reluctance to interact with the government to misconceptions that the forms are only for adults. Medina said she was also concerned that this census — with its anticipated reliance on more technology — could exclude people of color in rural areas that might not be as connected.

As 2020 approaches, her organization is working with other advocacy groups for people of color and children to promote outreach and awareness of why an accurate count matters. At a recent roundtable, they discussed the common fears these communities face, and the importance of targeting informational efforts in rural areas.

“I think there’s a good amount of organizations that already know what’s at stake for California,” Medina said.

Earlier this month, Commerce Secretary Wilbur Ross testified to lawmakers that the 2020 census will require $3.3 billion more than previous projections, according to media reports.

“There are still many challenges ahead, and these additional resources I have described are urgently needed,” Ross said in his testimony to the House Oversight Committee.

[Photo by Joe Raedle/Getty Images]