The US Census and the People’s Health: Public Health Engagement From Enslavement and “Indians Not Taxed” to Census Tracts and Health Equity (1790–2018)

Public health professionals have long played a vital-albeit underappreciated-role in shaping, not simply using, US Census data, so as to provide the factual evidence required for good governance and health equity. Since its advent in 1790, the US Census has constituted a key political instrument, given the novel mandate of the US Constitution to allocate political representation via a national decennial census. US Census approaches to categorizing and enumerating people and places have profound implications for every branch and level of government and the resources and representation accorded across and within US states. Using a health equity lens to consider how public health has featured in each generation's political battles waged over and with census data, this essay considers three illustrations of public health's engagement with the enduring ramifications of three foundational elements of the US Census: its treatment of slavery, Indigenous populations, and the politics of place. This history underscores how public health has major stakes in the values and vision for governance that produces and uses census data.