Why the Census Matters for Health Care

In 2020 the federal government will count the roughly 330 million people in the United States (US) through the census, a tally that is mandated by the Constitution. The census occurs every ten years and requires every resident in the US to complete forms that detail household size, income, and other demographic details. The data from the census determines the number of seats each state has in the U.S. House of Representatives and representation in state legislatures, and is also used to distribute billions in federal funds to local communities.

Although the actual counting won’t begin until 2020, planning is underway to determine key components of the census that affect its accuracy and fairness. Historically, residents of southern states and people of color have been undercounted.

To ensure all Virginians are counted, and that our representation and funding matches our population and need, we as health advocates need to ensure our partners, patients, and community members understand the important role the census plays in funding and representation. With changes proposed to the 2020 census that could impact response rates, our Virginia health community must begin sharing the importance of the census today.

The census’ impact is far reaching

Because the census only takes place once every ten years, it is important that the process produces an accurate count of everyone in the US. This count is used to determine everything from the number of elected representatives in each state to state funding for public services. If every group isn’t properly accounted for in the census, it could mean constituents are underrepresented in Congress because the US government won’t have an accurate count of how many people are in their district, leaving important issues unaddressed. If we’ve learned anything in Virginia in the past year, it’s that votes matter! Without representation that reflects the total number of Virginians, critical oral health issues, like access to affordable services, will be overlooked and go unaddressed.

Not only does the census help determine representation in government, it funds over 130 public programs. Programs like Head Start, SNAP, school lunch programs, funding for water programs that ensure fluoridated water for communities, Maternal and Child Health Block grants, and more all have funding determined using census data. In the 2010 census an estimated 1.5 million minority people were missed and nearly 1 million children were not counted; if this trend persists, key programs will be impacted.

What’s new in the 2020 census?

The Trump administration proposed adding a citizenship question to the 2020 census that would ask if a person is a citizen, naturalized citizen, or noncitizen, without specifying that noncitizens are legally allowed in the country. This question has the potential to limit participation in the census, as it reinforces growing fears about immigration and deportation. Citizenship questions haven’t been asked of all households in the US census since 1950, but the administration argues that the question is key to enforcing the Voting Rights Act. We’ve already seen residents in immigrant communities forgo health care and other services because of threats to their own immigration status, like changes to public charge  and to the status of their families. This question will only reinforce the fear and will likely result in undercounting as individuals choose not to respond to census questions at all, ultimately affecting Virginia’s political representation and funding for important programs.

Ensure Virginia gets the funding and representation it needs

As community members and oral health advocates, we must take this opportunity to ensure everyone who needs public assistance programs has access to them and that we are all represented in our government bodies. Throughout the year and leading up to the census, we need to continue to communicate with community members and patients about the importance and safety of taking part in the census, and urge them to fill out the complete form when it arrives.

Every voice must be represented in the government, and health programs must get the funding they need, to improve access to comprehensive healthcare for all Virginians.  The Office of Management and Budget (OMB) will open a comment period this fall regarding the 2020 census. Stay up-to-date on the comment period and more policy news by signing up for our monthly update.

Sarah Bedard Holland