The data showed that men who have sex with men—including gay and bisexual men—among the city’s Black population were disproportionately affected. That finding drove the health department’s response, which included working with community partners to surge thousands of free vaccines into neighborhoods across Chicago. Instead of a larger and far deadlier outbreak, the outbreak ended with 11 cases in Chicago and one death.
The public comment period on this proposal closes on Nov. 2. Health leaders must move quickly to oppose these deeply misguided changes. It is clear to us that these changes would amount not only to an assault on our public health system but also on the U.S. Constitution.
The repercussions would be vast. An inaccurate count would negatively affect congressional representation. The idea that some people do not deserve to be counted uncomfortably echoes the “3/5 compromise,” an insidious and later repealed clause in the original Constitution under which enslaved persons were counted as less than full people. Incomplete and unreliable demographic data could distort how trillions of federal dollars are distributed across hundreds of programs such as Medicaid, SNAP, WIC, and Head Start. Communities with the greatest needs, especially those with immigrant or mixed-status families, would likely be hardest hit.
During the H1N1 influenza pandemic in 2009, when one of us, Dr. Richard Besser, served as acting director of the Centers for Disease Control and Prevention (CDC), census data were instrumental in tracking the outbreak. CDC relied on this data to calculate infection rates by age, which showed that children and young adults were getting sick at far higher rates than older adults—a striking departure from typical patterns observed with seasonal flu. When a vaccine became available, these data directly informed recommendations that prioritized children and young adults.
These examples span different locations, diseases, and levels of government, but illustrate common themes: public health officials rely heavily on census data to save lives and protect communities, and protecting communities at greatest risk helps keep us all safer and healthier.
The next census count is still a few years away, but what our leaders decide now matters a great deal. A census that deliberately counts fewer people while telling us less about them will leave our nation ill-prepared for future outbreaks and pandemics, while making it harder to handle daily health challenges. It is essential for the public health community to speak out now.
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