Review PaperChallenges to the census: international trends and a need to consider public health benefits
Section snippets
Public health impact statement
Accurate census data are relied upon by epidemiologists and public health professionals to establish standardized incidence rates, mortality rates, and prevalence for the reliable identification and characterization of population groups for targeted public health intervention. The census is the chief source of information for denominators used for deriving and comparing rates of illness or conditions and contributing to the calculation of social deprivation scores and wider determinants of
Background and purpose
Over the past few years, trends to cut or severely hamper census and public health information have occurred internationally. In Canada, response rates to the long-form census dropped substantially (as low as 25% in a number of communities with some communities providing zero responses) after it was made voluntary in 2011. Canadian census estimates among the poor and under-served are now considered to be unreliable by experts.1
In the United Kingdom (UK), the Office for National Statistics (ONS)
What is a census?
A census is the official enumeration of a population defined according to administrative boundaries which includes enumeration by age, sex, race/ethnicity, and occupation, among other demographics. The term derives from the Latin word cēnsēre meaning ‘to assess’ as governments historically have used the census as a means of taxation. Debates about the census are not new. The census of Quirinius sparked a tax rebellion in Roman Syria and fueled the Zealot movement in the year 6 CE.3
As required
Cost and privacy
In general, threats to the census have come about through a number of concerns surrounding cost and privacy. Issues surrounding cost of the census are not without merit—the Committee on National Statistics of the National Academies of Sciences, Engineering, and Medicine has provided an extensive list of recommendations to substantially increase efficiency and reduce costs in the US.9 While the compulsory nature of the census heightens privacy concerns, census employees in several countries are
Cost-benefit analysis of the census
Cost-benefit analyses of the census are generally confined to the allocation of funding from the central to local governments in the USA and Canada. In the UK, the cost-benefit analysis for the 2011 census assumed six main uses: resource allocation, investment targeting, service planning, policy making and monitoring, research, and as a benchmark for other national statistics.21 In 2007, the benefit of the UK census was projected to be £945 million over a 10 year period (2012/13–2021/22),
Cancer control
The ability to measure disease rates and identify variation between areas as small as neighborhoods is a critical aspect of not only investigating suspected disease clusters, but also to efficiently and effectively address local resident concerns. Surveillance of cancer rates by geographic area are also useful for testing and generating hypotheses about disease occurrence, causes, and outcomes and may be used to target public health programs. Such an example of a current-day application started
Population threats, including threats to public health
Any analysis of vulnerable populations requires information on likely determinants such as incomes, education, ethnicity, labor market experience, and access to services. In Canada, this information could be found in the mandatory LFC, but is no longer reliable from the voluntary NHS.16 The inconsistencies in how the Canadian census has been carried out leads to other problems of linking the data for historical trends. Statistics Canada cautions that such linkages are not feasible because of
Conclusions
Census data are relied upon by epidemiologists and public health professionals to establish standardized incidence rates and prevalence within populations by age, sex, and race/ethnicity; to understand the role of individual and community-context influences (e.g., SES and education) in disease transmission, incidence, stage at diagnosis and prognosis; and to use demographic information in order to assess whether participants in clinical trials are representative of the general population.
Acknowledgments
The authors would like to thank the International Joint Policy Committee of the Societies of Epidemiology (www.ijpc-se.org) for their generous discussion and suggestions for the manuscript.
Ethical approval
None sought. This manuscript reviews publicly-available information.
Funding
None declared.
Competing interests
None declared.
Contributors
All authors have participated in the article preparation. All authors have approved the final article.
Authorship
All authors made substantial contributions to the following: (1) the conception of the manuscript idea; (2)
References (53)
- et al.
Strengthening cost-effectiveness analysis for public health policy
Am J Prev Med
(2016) - et al.
Factors affecting ambulance utilization for asthma attack treatment; understanding where to target interventions
Public Health
(2015) National household survey that replaced long-form census is unreliable: experts
(2013; 6 May)ONS responds to consultation on statistical output cuts
StatsLife
(2014; 13 February)A new history of early christianity
(2009)Department of Commerce v. US House of Representatives
(1999)Methodology and evaluation of population registers and similar systems, New York: United Nations
(1969)- et al.
The American community survey
Popul Bull
(2005) Measuring America: the decennial censuses from 1790 to 2000
(2002)- et al.
American community survey overview and the role of external evaluations
Popul Res Policy Rev
(2006)
Australia Census myths busted: how you can legally avoid filling out the form (but giving a fake name or going camping won't save you from a massive fine)
The census and future provision of population statistics in England and Wales: privacy impact assessment for the initial research stage
Minutes of Proceedings
National household survey: final response rates for Canada, provinces and territories
Good data and intelligent government
Republicans try to curtail the census
Atlantic monthly
The census and future provision of population statistics in England and Wales: recommendation from the National Statistician and Chief Executive of the UK Statistics Authority
The census and future provision of population statistics in England and Wales
Population health research wins “reprieve” in Europe
Epidemiology
The value of census statistics in England and Wales
Applying comparative effectiveness research to public and population health initiatives
Health Aff (Millwood)
Cost-benefit analysis for a quinquennial census: the 2016 population census of South Africa. Institute for Policy Research Working paper series WP-15–06
Cited by (6)
Counting the cost: Passchendaele 100
2017, Public HealthPotential impact of 2020 US decennial census data collection on disaster preparedness and population mental health
2019, American Journal of Public HealthCensus 2020—a preventable public health catastrophe
2019, American Journal of Public HealthInaccuracies in the 2020 census enumeration could create a misalignment between states' needs
2018, American Journal of Public Health