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Making Sure #EveryChildCounts in the 2020 Census


Eve Meltzer Krief MD, FAAP
February 14, 2020

The 2020 Census forms will start arriving in mailboxes around the country this March, launching the once-a-decade effort to count every person living in the United States. As pediatricians, we advocate for our young patients every single day. Most of us don’t realize that encouraging parents to fill out the census can play a very significant role in that advocacy.

Children are consistently the most undercounted demographic in the census. In fact, in the 2010 census an estimated 2.2 million children under 5 years old were not counted. Why does this matter? The federal government allocates over $1.5 trillion in funding to state and local governments based on census data. These funds help support programs our patients rely upon like Medicaid, the Children’s Health Insurance Program, the Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children (WIC) programs, Head Start, school lunch programs, special education funding, foster care and after school education programs for children of working parents.

Dr. Eve Meltzer Krief @eveamk calls on pediatricians to help ensure #EveryChildCounts in the #2020census so communities receive funding for key programs that help keep kids healthy. #AAPvoices http://ow.ly/Ab3Q50yptQi

Why kids often get missed by the census
Why do children get undercounted in the census?  There are several reasons, such as:
  • Young children often are missed because families completing the forms don’t realize that young children are considered “people,” and that even infants and toddlers should be included.
  • Some children’s primary caretakers are their grandparents or other relatives who may be unsure they have the authority or permission to list these children living in their households.
  • Many children divide their time between separated or divorced parents who don’t coordinate who will list the child in the census.
  • Young or single parents are less likely to complete the census, as are poor families, those who don’t speak English and immigrants who do not have permanent housing or share living spaces with multiple families in housing situations that may not be legal.
Getting an accurate count of children in immigrant families will pose a unique challenge this year because of the administration’s attempt to add a citizenship question to the census. Although this attempt ultimately failed in the courts, the suggestion of including the question has had a chilling affect among immigrants who either don’t know there is no citizenship question or who fear that the information they provide will be used against them. In reality, the census is meant to include both citizens and non-citizens. U.S. Code bars Census Bureau officials from publishing any information that could lead to personal identification of respondents. It also is meant to prevent government agencies such as Immigration and Customs Enforcement (ICE) from accessing census responses.

One tragic irony of this situation is that the very children who stand to gain the most from federally funded programs are the ones most likely to be undercounted and not get their fair share. Furthermore. the data collected will remain the basis for funding for the next 10 years until the next census is completed in 2030.


“Children are consistently the most undercounted demographic in the census. In fact, in the 2010 census an estimated 2.2 million children under 5 years old were not counted.”


What pediatricians can do to help
So, what can ordinary pediatricians do to ensure that more children get counted in the 2020 Census? As trusted healthcare providers, we can be great sources of information and encouragement.  We can commit to asking parents at every check up if they have filled out the census form for all their children, starting at the newborn visit. The U.S. Census bureau has many online resources including census coloring pages for patients and helpful information sheets for parents we can share. Those of us who work in historically undercounted poor, urban and minority communities can educate families about the importance of the census. Pediatricians who care for immigrant children can do the same, while being particularly sensitive to their fears and concerns.

Consider writing an op-ed or letter to the editor of your community media outlets, recording a video about the census to share on social media, or joining a census council in your state. AAP chapter 2 in New York has partnered with the Early Childhood and Immigration committees of our local census council, which has provided us with data and resources and allowed us to participate in coordinated actions on social media. Some of our chapter members created a podcast about the importance of the census that we were able to share widely with pediatric colleagues, patients and our local census partners.

Other AAP chapters across the country are also working to equip pediatricians with census information to share with families.  At the national level, the AAP Council on Community Pediatrics is hosting a webinar, “Pediatric Providers & Census 2020,” on Wednesday, Feb. 19, (register here).

As pediatricians, we understand the vital importance of the many federally funded programs that support the health and well being of our patients. Children deserve to be counted in the census so their communities can get the crucial funding they are entitled to. We must help spread the word that #EveryChildCounts and do all we can to make sure that all our patients get counted in the 2020 Census.

* The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.


About the Author


Eve Meltzer Krief MD, FAAP, serves as Legislative Chair of New York American Academy of Pediatrics Chapter 2. She is a general pediatrician at Huntington Village Pediatrics. Follow her on Twitter at @eveamk.