Count Your Cuties: How Hospitals and Medical Providers Are Helping Count Kids

David Elliot (CHN)

In the 2010 Census, more than 12 percent of Washington, D.C.’s young children — aged 0 to 4 – weren’t counted. That was almost triple the national average – and when it came time to distribute federal funds, D.C. missed out on resources that could have gone to key programs such as affordable housing, nutrition assistance and school programs.

Advocates are determined not to let it happen again. They’ve launched Count Your Cuties, a campaign to make sure every young person is counted in the 2020 Census.

Two groups behind the campaign are the DC Health Matters Collaborative and Children’s National Hospital. Overall, their efforts are two-pronged: provide education and awareness among healthcare providers and promote the importance of Census completion to patients and caregivers.

Gina Dwyer, Public Health Data Analyst and a force behind the effort, explains that the “Count Your Cuties” slogan grew out of an event that was organized last fall that attracted 3,000 young child educators. “We had a table and a presentation, but knew we needed something fun to draw people to our table (not that the census isn’t a hoot), but you probably get what I mean,” she explains. ‘Since we believe in healthy snacks we opted for clementines (or “cuties”) and drew silly faces on them. They were an absolute hit and really drew people in so we could tell them the importance of counting ‘cuties’ or young children ages 0-4. It was a fun, cheap, healthy way to spread the message.”

Dwyer adds that hospitals are a natural venue for spreading the word about the importance of filling out the Census form. “Healthcare providers are generally trusted in the community but particularly to promote the Census,” Dwyer says. “In D.C., we see many patients who rely on the critical services the Census funds and we know that much of what happens outside the clinic walls affects patient health — where they live, play, go to school — all affect health. The importance of adequate nutrition in prevention and management of disease, the quality of housing, the safety of our communities, access to healthcare facilities and providers all affect health; these things are all somehow impacted by the Census.”

Both because of the challenges of accurately counting kids in complex living situations, the high number of children in D.C. who live in hard-to-count areas, and the vital importance of funding for the District’s human needs programs, a concentrated effort to accurately count children is critical, Dwyer explains. She notes that in 2010, D.C.’s undercount was much higher than in surrounding Maryland and Virginia. One complicating factor: Overall, 13 percent of young children in D.C. are raised by grandparents, but in some neighborhoods, that figure is closer to 50 or even 80 percent.

“Over 80 percent of tracts in the city are at risk of either a high or very high young child undercount,” she says. “We are in the midst of a housing crisis and are the most rapidly gentrifying city in the country. We lack equitable distribution of pharmacies, grocery stores, healthcare providers and facilities. Two birthing hospitals have closed, leaving women on the eastern side of the city without access to prenatal or birthing services. We have a lot of work to do and an accurate Census is critical to closing these gaps and ultimately improving health.”

A lot of the effort to promote an accurate count of young children in D.C. involves marketing. Informational posters, flyers and tabletop signs will be placed within hospitals and community clinics. Health care providers will wear Census promotional items – shirts and buttons, etc. Patients will receive stickers, band aids, and other promotional materials at clinic visits. TVs in waiting rooms and patient hospital rooms will broadcast PSAs about the Census. Patients will receive information about the Census in their discharge packets. Even bibs with the slogan “I Count TOO!” will be distributed to newborns.

Caregivers are being recruited to serve as “Census Champions for Children;” also, “Census Ambassador Doctors” are being signed up and trained. These doctors are being taught how to address the root causes of not responding to the Census, and are learning skills to convert non-responders. “They are very knowledgeable about the Census and are familiar, trusted faces in the community,” Dwyer says.

What advice does Dwyer have for hospitals in other urban settings who might not have the comprehensive support that the DC Health Matters Collaborative and Children’s National Hospital are providing?

“It really only a takes a champion or two to start convincing others about how important this work truly is,” she says. “The first step is to contact your local Complete Count Committee. They may have resources to share and can provide the context of your particular city or state. If they do not have resources or there is not a local committee, visit the Census Bureau’s site for printable materials. Work with your PR and marketing offices to promote the Census. Signage and buttons go a long way in adding visibility to this work.”

And, Dwyer concludes, do not forget the importance of sharing stories, particularly healthcare stories, about the essentiality of an accurate Census. One story that Dwyer says has gained traction among her colleagues was published last year in www.talkpoverty.org.

The story discusses what happened when the city of Detroit – where many children are exposed to a lethally high level of lead poisoning – applied for a $1.34 million Centers for Disease Control and Prevention grant that would have allowed the city to hire more health department staff focusing on assisting the city’s ongoing efforts in preventing childhood lead poisoning.

The city was denied the grant. But the reason had nothing to do with public health. Rather, Detroit’s population, measured by the 2010 Census, was 713,777, shy of the grant’s 750,000 minimum population requirement.

Experts say Detroit experienced a serious undercount in 2010.

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