Census undercount threatens federal food and health programs on reserves

(KHN) The 2020 census missed nearly 1 in 17 Native Americans living on reservations, an undercount that could very well lead to insufficient federal funding for essential health, nutrition and social programs in remote communities with high poverty rates and limited access to service delivery.

The census counted 9.7 million people who identified as Native American or Alaska Native in 2020 — alone or in combination with another race or ethnicity — up from 5.2 million in 2010. But the native population of some 325 reservations nationwide was underestimated by nearly 6%, according to a demographic analysis of census accuracy. Indigenous peoples on reservations are used to being underestimated – almost 5% were missed in 2010, according to the analysis.

At least 1 in 5 Native Americans live on reservations, according to previous census data. More detailed Native American population data from the 2020 census will be released over the next year.

Census figures help determine how much money is allocated to various programs on reservations such as health care, social services, education and infrastructure. For example, on the Blackfeet Reservation in northwestern Montana, the co-chair of a food pantry whose funding depends in part on census counts fears that undercounting will make it harder after this year for all families who need free meals to access them.

The pantry — run by an organization called FAST Blackfeet, which stands for Food Access and Sustainability Team — serves about 400 households a week, Danielle Antelope said. The 2020 census puts the population of the Blackfoot Reservation at 9,900, which Antelope says “does not reflect our numbers in reality.”

Thirty-seven percent of Blackfeet reservation residents lived below the poverty line from 2014 to 2018, compared to a statewide average of 13 percent, according to periodic estimates from the American Community Survey.

“I see the issue of census undercount as having to do with representing need,” Antelope said.

Antelope said he has seen firsthand what it means when people living on reservations fall through the cracks. His mother was a bus driver who earned too much money to qualify for income-tested federal food assistance programs, but not enough to adequately feed her children. The family depended on processed foods from the frozen aisle.

When produce is expensive or hard to find, inexpensive packaged meals are often the only option. “As we now know, these cheap foods are linked to health disparities,” Antelope said. “And those health disparities are high in communities of color and tribal communities.”

Census errors are not limited to Native Americans on reservations. Blacks (3%) and Hispanics (5%) living in the United States were also underestimated. Meanwhile, whites were overcounted (2%).

Among U.S. states, Montana has the fourth-largest share of Native residents, at 6%, and Native Americans are the second-largest racial or ethnic group in the state, after people who identify as white. The percentage rises to 9% when it includes people who identify as “American Indian and Alaska Natives alone or in combination” with another race or ethnicity. Most Native residents live on one of Montana’s seven reservations or in a nearby city or county.

The Indian Health Service, the federal agency required to provide medical care to most native residents of the country, receives funding partly based on the census. Nationally in 2019, the most recent year for which data is available, IHS spent $4,078 per person, according to agency data.

In comparison, Medicaid, the federal health insurance program for people with low income and certain disabilities, spent more than double that rate, $8,436. A note from the United States Government Accountability Office noted that the usefulness of per capita comparisons is limited because federal programs vary widely.

Health gaps were visible during the pandemic. In Montana, the leading cause of death among Indigenous people in 2020 was covid, largely due to other conditions people had, such as respiratory disease, obesity, and diabetes. Heart disease was the second leading cause of death.

More accurate censuses would lead to “increased financial support from the federal government and even the state government,” said Leonard Smith, CEO of the Billings-based Native American Development Corp., a nonprofit organization company that provides technical assistance and financial services to small businesses. . “I think it makes people realize that there is a much larger indigenous population than is reported, and so it becomes a higher priority. It’s all about the numbers,” Smith said.

A more accurate count could also help improve on-reserve infrastructure and housing.

Federal housing assistance remains inaccessible to many households on tribal reservations. Research indicates a strong relationship between housing and better health outcomes. A 2020 study published in the journal BMC Public Health found that nearly 70% of people who obtained safe and stable housing reported “significantly better” health outcomes nine to 12 months later, compared to then. where they experienced housing insecurity.

According to a 2017 report by the National Congress of American Indians, more than 15% of homes in areas on or near Indigenous reservations were considered overcrowded – meaning there was more than one person per room, including living rooms, kitchens, bedrooms, and enclosed porches — compared to 2% of homes among other populations.

Although about a quarter of households have incomes below 50% of the federal poverty level, according to the report, only about 12% received federal housing assistance. Census data is used to determine housing and community development grant funding.

“When a census undercounts an Indigenous community, it has a direct, long-term impact on the resources the community receives – things like schools and parks, health care facilities and roads,” said said Michael Campbell, deputy director of Native American. Rights Fund in Boulder, Colorado.

The impact of undercount on funding transcends budgets and social programs. This creates a feeling among indigenous peoples that their presence in this country matters less than that of others, leading to both political disenfranchisement and personal harm, tribal members said.

“Because for so many years we got used to not being counted, we don’t have this aspiration for our government to create space for us now,” Antelope said. “When we have accurate numbers that reflect our community, our voice is heard and we can get services and funding that better reflects our community. »

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