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Make Children Count in 2020

Bottom Line: Don't let kids be down for the count.

In less than 12 months, the 2020 U.S. Census will begin. Children under age 5 are often the hardest to count accurately. Undercounting them can have a significant negative impact on their health and well-being. The U.S. Congress and state officials will use the results of the 2020 Census for the next 10 years to determine levels of funding for various programs, including Medicaid, the National School Lunch Program, the Supplemental Nutrition Assistance Program (SNAP), and the State Children’s Health Insurance Program (SCHIP).

Based on surveys and other programs, the U.S. Census Department itself estimates that about 2.2 million children were not counted in the 2010 Census. There are concerns about the risks of even more undercounting in the 2020 Census.

The American Academy of Pediatrics (AAP) is taking steps to try to ensure an accurate count in 2020, especially in “hard-to-count” geographic census areas. In a recent letter published in AAP News, Kyle Yasuda, MD, AAP President, describes the risks to children of census undercounting. As he explains, “Outreach will include federal advocacy, connecting with like-minded partners and helping pediatricians educate and motivate their communities and families to respond.”  As members of the Federation of Pediatric Organizations (FOPO), the AAP and the ABP will be working with other pediatric organizations to help pediatricians promote an accurate count of children.

We at the ABP are raising awareness of the issue through a Maintenance of Certification (MOC) Part 2 activity, Question of the Week(QOW).* The question released April 17 focuses on how the U.S. Census affects the health and well-being of children throughout the country, and consequently, how it may affect your ability to care for patients. If you are not signed up for QOW, we are sharing the context of the question because the issue is so critical for children over the next decade.

If you enjoy the QOW on the 2020 Census, we invite you to sign up to receive weekly QOWs as one way to earn MOC credit. If you are trying to access QOW for the first time and would like help, please reach out to

We know how much children count. Let’s make sure they are counted.

*You will need your ABP username and password to access the QOW site. If QOW still does not open, please right-click on the link, select "Copy," and paste the address directly into your browser.

About the Author

David G. Nichols, MD, MBA

David G. Nichols, MD, MBA is the President and CEO of the American Board of Pediatrics (ABP). As leader of the American Board of Pediatrics (ABP) staff and a member of the nonprofit organization's Board of Directors, Dr. Nichols actively promotes high-quality health care for children by upholding the standards of certification in pediatrics and by encouraging and facilitating initiatives in quality improvement. Although he assumed his new leadership role in late 2012, he has been associated with the ABP for more than 20 years. He is board certified in General Pediatrics and is board certified and maintaining certification in Pediatric Critical Care Medicine.