Every Child Counts: The Importance of the 2020 Census for Pediatric Health Equity.

Abstract

The decennial census, written as a mandate into the US Constitution over 200 years ago, remains critical to the health of children today. The census count determines the distribution of $1.5 trillion (in 2017 dollars) in federal funds,1 including funding for over 300 programs1 that are vital to child health. These include programs supporting health care (eg, Medicaid and Children’s Health Insurance Program), education (eg, Head Start and special education grants), food and nutrition (eg, Special Supplemental Nutrition Program for Women, Infants, and Children and Supplemental Nutrition Assistance Program), housing (eg, Section 8 housing choice voucher program), and foster care.1–3 Epidemiologists, health services researchers, and businesses also rely on census data to inform their research and investments.4 Furthermore, census data determine districting in Congress and state legislatures, ensuring fair representation in our democracy.2,3 Given the far-reaching impacts of census data on child health and health equity, pediatric health care providers have a strong interest in, and should work to ensure, an accurate count in the 2020 census. A major challenge with the census is the persistence of hard-to-count tracts. Hard-to-count tracts are districts or segments of the population with a census response rate of $2300 of federal funding for each person uncounted in the … Address correspondence to Amanda M. Stewart, MD, MPH, FAAP, Division of Emergency Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115. E-mail: amanda.stewart{at}childrens.harvard.edu