Issue link: https://tmcpulse.uberflip.com/i/1219671
t m c p u l s e | m a r c h 2 02 0 7 where you live and everyone who is living in your household on April 1. Starting in May, census workers, called enumerators, will visit those who do not respond. Data drives government funding Census data determines how $675 billion in federal funds (the figure in fiscal year 2015) are distributed annually. U.S. residents have been tallied every 10 years since 1790. Texas, which has more peo- ple than any other state besides California, added 4 million residents between 2000 and 2010 and gained four Congressional seats. Estimates since the last census show a state population increase of 3.5 million residents. That means Texas could gain two more seats in the 435- member U.S. House after 2020. Health economist Vivian Ho, Ph.D., who holds professorships at Rice University and Baylor College of Medicine, said the numbers influence every calculation and projection over the next decade for safety-net initiatives including Temporary Assistance for Needy Families (TANF), the Supplemental Nutrition Assistance Program (SNAP) and the Children's Health Insurance Program (CHIP). "The amount that each state receives for Medicaid from the federal government is dependent on something called the Federal Medical Assistance Percentage, which is based on the state's per capita income," Ho said. "If your per capita income is lower, you're going to get more money from the federal government. It's calcu- lated by total income divided by the number of people, so if you undercount the number of people, the income ends up looking higher, which means you're going to get less Medicaid money." An undercount holds grave consequences for public health. "For every 1 percent that we fail to count for the City of Houston, that is a loss of about $250 million," Houston Mayor Sylvester Turner said. "Ten years ago, Houston counted about 70 percent—and that was an improvement from 10 years before. So, 30 percent of Houstonians were not counted. You take that and multiply it by $250 million. Roughly speaking, it's about $1,500 per person, per year. All of those dollars are critically important to improving health and providing a much more accessible and affordable health care delivery system. The more federal dollars we are able to pull down, the better it is for everyone." In Houston, children under age 5 were significantly under- counted in 2010, the mayor added. Infants, toddlers and preschool- ers are among those the Census Bureau identifies as "hard to count" or populations at risk of being missed at disproportionately high rates. Other groups considered diffi- cult to count include highly mobile people (such as seasonal agricul- tural workers or campers), racial and ethnic minorities, non-English speakers, low-income people, those experiencing homelessness, undoc- umented immigrants, people who distrust government, LGBTQ per- sons, people with mental or physical disabilities and people who do not live in traditional housing. An inaccurate census count poses four major threats to public health by hindering planning efforts for standard population health needs, such as safety net health services; impeding work to monitor and reduce social disparities in health; challenging the identifica- tion and response to novel public health challenges, namely viruses; and compromising efforts to track and manage public health threats such as natural disasters, according to a Census 2020 editorial in the August 2019 issue of the American Journal of Public Health. ➟