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WASHINGTON — Because the Census Bureau finalizes the questions for the 2020 census, key voices within the Trump administration are urgent for surveyors to ask one crucial query: Are you a United States citizen?

Advocates of the so-called citizenship query say it’s merely clerical, an effort to determine what number of noncitizens reside in the US. However the query would have broad ramifications, not just for the politics of redistricting that can emerge from the census however for a difficulty that goes past partisanship: public well being.

The concern is that immigrants — even ones within the nation legally — won’t take part in any government-sponsored questionnaire that might expose them, their relations or associates to deportation. However low response charges from any demographic group would undermine the validity of the following decade of well being statistics and applications, well being consultants warn. Scientists use census information to know the distribution of well being circumstances throughout the US inhabitants. In flip, officers use the information to focus on interventions and distribute federal funding.

“Knowledge is the lifeblood of public well being; it must be clear and goal,” mentioned Edward L. Hunter, the previous chief of the Facilities for Illness Management and Prevention’s Washington workplace and now the president of the de Beaumont Basis, which focuses on public well being. “The census could have cascading results upon each price, each share, each development we monitor over time. It’s very unsettling for individuals who want to make use of that information.”

The talk is heating up as a crucial deadline approaches: The Census Bureau says it should submit a closing record of the 2020 census inquiries to Congress by March 31.

In a December doc first reported by ProPublica, the Division of Justice argued that inquiring about citizenship standing within the decennial census was crucial to implementing Part 2 of the Voting Rights Act, which protects towards racial discrimination in voting. Measuring the full variety of residents of voting age in a area is important to understanding voting rights violations, the division argued.

On Monday, 19 Democratic and impartial state attorneys basic and one governor, John W. Hickenlooper of Colorado, despatched a 10-page letter to Commerce Secretary Wilbur Ross, who oversees the Census Bureau, arguing that the change to the census might “threat an unconstitutional undercount.” The decennial census has not had a citizenship question since 1950, they mentioned.

And, they argued, “including a citizenship query at this late date would fatally undermine the accuracy of the 2020 census, harming the states and our residents.”

The Justice Division is standing by its request.

“The Justice Division is dedicated to free and truthful elections for all Individuals and has sought reinstatement of the citizenship query on the census to satisfy that dedication,” a Justice Division spokesman, Devin M. O’Malley, mentioned in an announcement.

Even with out the citizenship query, minorities have been undercounted within the nationwide census, with undocumented immigrants and their authorized relations among the many least responsive. Amid a fiery immigration debate — together with Immigration and Customs Enforcement raids nationwide — the inclusion of a citizenship inquiry might make it worse.

“It’s all about belief,” mentioned Mr. Hunter, who earlier in his profession oversaw confidentiality coverage on the C.D.C.’s Nationwide Heart for Well being Statistics. “The federal government is legally certain to not reveal the identities of people who take part — and but at a time like this, you would wish the person to consider that.”

When census outcomes are launched, scientists typically measure the impression of a illness by evaluating its prevalence to the full inhabitants. With skewed census information, public well being officers might put money into fixing an issue that doesn’t exist — or worse, might overlook one which does.

“That is utterly foundational,” mentioned Michael Fraser, the manager director of the Affiliation of State and Territorial Well being Officers. “We take with no consideration that we’ve got a extremely correct understanding of who lives on this nation: their ages, ethnicities, the place they stay.”

Dr. Fraser added, “The underside line is, if we’re handed baseline numbers that aren’t correct, the whole lot we do for program planning and what we do for implementation might be insufficient.”

Public well being officers use demographic information to mannequin neighborhoods earlier than launching preventive applications, like monitoring outdated housing in low-income communities the place they anticipate finding lead-based paint. The identical is true for stopping bronchial asthma, a situation typically correlated with substandard housing. By focusing on the appropriate houses for remediation early, officers can stop illness and save hundreds of thousands of public in therapy down the road.

The outcomes of the census decide how greater than $600 billion is appropriated throughout state and native governments every year, together with federal block grants for youngsters’s well being and preventive care providers. An immigrant-heavy area that underreports its complete inhabitants might lose public well being — in addition to funding for meals applications, faculty applications and transportation providers.

“It’s not as if immigrants going into the woodwork would solely hurt providers for that group. It might throw the entire system off,” mentioned Dr. Georges C. Benjamin, the manager director of the American Public Well being Affiliation. “A consultant census is what’s finest for everybody.”

However Consultant Steve King, Republican of Iowa, argued that counting noncitizens prompted different issues.

“Solely U.S. residents ought to be represented in Congress,” he mentioned Tuesday. “If we counted solely residents for redistributing seats, California would surrender a number of congressional seats to states that truly honor our Structure and federal regulation.”

The highest two Census Bureau seats have interim occupants, and monetary constraints have led the bureau to skip two of its three trial runs of its overhauled course of for 2020. Specialists fear that the funding constraints will hinder the bureau’s skill to regulate the information for low participation charges or deploy satisfactory enumerators to low-response communities.

“Attorneys from the Division of Commerce are presently analyzing the justification for the information wanted by the Division of Justice,” Albert E. Fontenot Jr., the affiliate director for decennial census applications on the Census Bureau, mentioned in a briefing final month. “Technical consultants on the Census Bureau are additionally wanting on the points.”

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