Experts: Census undercounts could risk rural health funding

DUBOIS, Idaho – Bonnie Stoddard knows the history of Idaho’s sparsest county.

She’s chronicled the ranching families who settled Clark County more than a century ago. The notable statesmen after whom the county and the county seat are named. Buildings she’s hoping to keep intact.

In 1992, Stoddard and the local historical society published annals of the county’s early residents to help celebrate Idaho’s 100th anniversary of statehood, a few years earlier.

On Monday, she sat, perched on a stool in the doorway of her home. She lugged the tome onto her lap and slowly turned pages of the past.

“I’ve been collecting history,” she told the Post Register, pausing. “Good heavens, about 60 years.”

Her 90th birthday is in February. Stoddard has lived in Clark County since she was young.

She got her start in professional storytelling in high school, when she started contributing stories to the local newspaper.

A journalist and historian, Stoddard has learned to sift through records to find the truth, sometimes referring to historic census data. Counting heads and homes hasn’t been easy across Clark’s 1,700 square miles.

“It’s been hard to check out numbers in your area,” Stoddard said. “You don’t know how far they’re going to count people.”

“If you lose (local history) now,” she said, “it’s gonna be lost.”

But more than history is at stake in the decennial population count. The future is at risk. Federal funds tied to the census include money for a wide range of services residents rely on to bolster education, health care and more.

Each Clark County resident counted in the census equated to nearly $4,000 in federal funds in 2017, according to a February 2020 report from the George Washington University Institute of Public Policy. A miscount of even 25 people could leave critical programs here short of funding. The county is estimated to have lost 137 residents since 2010.

Stoddard has seen how Clark’s population changed over the years.

An area marked by family agricultural operations became home to larger ones. Seasonal jobs leave some homes unoccupied in the winter.

Last year’s census estimates say 45% of Clark’s residents are Hispanic or Latino, compared to 13% statewide. About 20% of all residents are 65 years old and older, compared to about 16% throughout the state.

Roughly 850 residents live throughout the sprawling county. That puts about 0.6 residents per square mile here, around half the population density of Butte County, another rural county of 2,600 residents about an hour’s drive away.

So much of Clark’s demographics make its population hard to count in the census, which worries Stoddard.

“To pin some of those things down would be a job I wouldn’t want to be responsible for,” she said. “And we’re just a small county.”

A flurry of factors makes this year’s census more difficult than the typical counting effort. The now-nixed citizenship question stoked concerns from people of color. And a pandemic recast social interactions.

Door-knocking, which experts say is crucial to counting people of color and rural residents, is stopping later this month, the Census Bureau announced in August. It’s a month earlier than the bureau had planned to stop. Experts worry undercounts could threaten federal funding for a host of programs that sustain rural areas.

“For communities like Clark County, nonresponse follow-up … efforts are crucial to counting every resident – but it will be much harder to do so with the census ending a month earlier,” Idaho Policy Institute researcher Gabe Osterhout said in an email. “… It’s likely that many of our rural communities won’t have accurate counts, and as a result, sufficient resources, for at least another decade until the next count happens.”

There are some promising signs, however, in statewide census counts. Roughly 96.7% of Idaho households have responded, according to a Monday report by Census Bureau. That’s the highest in the nation.

“This is good news for federal funding coming into the state,” Osterhout said, “but as funding is being allocated to local jurisdictions, I fear that rural areas won’t receive their fair share as a result of being undercounted compared to urban areas.”

More than a quarter of Idaho’s census responses came through follow-ups from census takers – a rate higher than in most other states – rather than households responding to census mailers, submitting answers online or via phone calls.

About 69% of Idaho households self-responded to the census. In rural counties, self-response rates are lower than the state average. Just 35% of households in Clark County self-responded to the census, which gives Clark the third-lowest self-response rate of all 44 counties in the state, according to Osterhout. (The census hasn’t provided total response rates for each county in 2020.)

Census Bureau spokeswoman Misty Slater said in rural communities, census takers organize events at places such as grocery stores, churches and libraries in hopes of getting more responses. A local census organizer here is working to set up four events in Clark County, she said.

Slater also said the census employs bilingual workers. More than 150 of the 1,110 census counters working in Idaho, at the height of door-knocking efforts, were bilingual, she said. Phone operators and forms are available in 13 languages.

“Our communication outreach approach is based on the most extensive research ever conducted to understand both what motivates people to respond to the census and what prevents them from responding,” Slater said in an email.

The “main reason” for Idaho’s high total response rate is, according to Washington State University sociologist Don Dillman, “in-person (counting) has been more successful here than in other places.”

Census counts determine how much representation states will have in the House of Representatives. They also guide funding formulas for public programs.

The Pew Research Center says 95% of all federal funding programs to local and state governments are tied to census figures, amounting to $580 billion. Even hospital planning uses census data.

Also funded through these figures are health care services such as the Children’s Health Insurance Program, Medicaid and school lunch programs.

In Clark County schools, “the majority of the students qualified for free and reduced lunches,” said Laurie Small, who serves on the school board.

Such programs are especially important in rural areas, said Yvonne Jonk, deputy director of the Maine Rural Health Research Center.

“Because federal dollars are tied to census counts, and if the state comes in low on numbers for these populations, then these programs will be relatively underfunded,” Jonk said.

In fiscal year 2016, Idaho received $3.6 billion in federal funds that were tied to the 2010 census count, according to George Washington University.

Eastern Idaho Public Health, which provides clinical services in the region’s eight counties, receives federal funding. Besides nurses and physicians from the health district visiting a few times each month in its clinic here, there are no medical providers in the county.

To access most health services, multiple residents the Post Register spoke with said they have to drive up to an hour or more. They said they regularly do the same to get groceries from bigger areas with more stores.

Stoddard said a few doctors have practiced here in the past. Mostly ones who served a wide area, switching between offices.

“There’s not enough” people here “to support it to give them a living,” she said. “We’re not large enough to support a doctor.”

At one house a Post Register reporter knocked on, a census mailer jutted out between the front door and the door frame. No one answered.

Danette Frederiksen, who lives at the edge of downtown Dubois, grew up in town. When she moved back a few years ago, she decided to live in her family’s old house.

Frederiksen said she hadn’t received a census mailer. She said she tried to fill it out online, but census workers showed up to her door two times and she was called by workers two times, who asked for more details.

The 2020 census marks the first time the census has allowed online responses, Slater said. Around one-third of households in Clark County have broadband subscriptions, census estimates say. Only 10% of Clark County residents have high-speed internet access, Microsoft estimates.

“There are lots of old people who don’t do online stuff,” Frederiksen said.