A Perilous 2020 U.S. Census: Why the Count Counts

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By Lucy A. Savitz, PhD, MBA, Vice President of Research for Kaiser Permanente and Director of Kaiser Permanente’s Center for Health Research

In our fast-paced world, time flies — whether you’re having fun or not! While 2020 sounds like it’s in the distant future, it will be here before we know it and preparations for the 2020 U.S. Census are already well underway. 

After all, obtaining an accurate count of 330 million U.S. residents is a daunting task.

Threats to Obtaining an Accurate Count

For the first time in 2020, the Census Bureau will offer an e-Census in addition to mail and telephone options, and without adequate testing and promotion, there is good reason to be concerned about undercounting, particularly among groups with lower income levels, limited comfort using technology, and lower educational attainment.

Respondents may also face a citizenship question for the first time since 1950, pending Congressional approval. The addition of this question could prevent some immigrants from responding to the census out of fear that the information will be used against them or their families.

What’s at Stake: Why the Count Counts

Census numbers are used for a variety of purposes beyond the determination of district representation at all levels of government; including to distribute public health and social services funding; to plan infrastructure and location decisions based on population settlement patterns; to monitor vital statistics; and by researchers who work in health services and social sciences. 

Health services researchers know that social determinants (the conditions in which people are born, grow, live, work and age) may lead to different health outcomes. In my work, I use an important social determinant measure that relies on Census data: the area deprivation index (or ADI), which reflects a geographic area’s level of socioeconomic deprivation. We use the ADI to design interventions, target limited resources, predict needs, prevent disease, and improve the quality and safety of care. In other words, this measure helps us address the health needs of even our most vulnerable community members by ensuring we get the right care to the right patients at the right time.

When all Americans aren’t accounted for in the Census, we risk skewing measures such as the ADI and reducing public health funding for areas where it is sorely needed.

Learn More about Ensuring an Accurate Count in 2020

It’s so important that we address these threats to the 2020 Census now to ensure the accuracy of the count. We have a chance to avoid the perils of undercounting all of those living in the U.S. I will continue to monitor and work toward a fair 2020 Census — my mission depends on the result.

If you’re interested in learning more,  the Georgetown Center on Poverty and Inequality has developed reports, webinars, and fact sheets on this topic.