Voting is a mechanism for holding the state accountable. But accountability requires ground-truth data. This module steps slightly outside the voting booth to examine the literal data architecture required for a functioning democracy. We focus on the Pregnancy Risk Assessment Monitoring System (PRAMS) and Maternal Mortality Review Committees (MMRCs) as our core case study. In recent years, hostile state legislatures have realized that if their policies (such as abortion bans or hospital closures) result in high maternal mortality among marginalized populations, they will face electoral backlash. Their solution? Dissolve the committees that track the data. If the state refuses to count the bodies, the political problem ceases to legally exist.
In This Module
- Covers: Data suppression as a form of electoral defense, the PRAMS/MMRC infrastructure, and the concept of "Administrative Burden."
- Why it matters: Practitioners cannot file civil rights lawsuits against discriminatory maps or policies without data. The first line of defense for minoritarian rule is to systematically defund the civic instruments that measure their impact.
- After this module, the reader can: Audit their local public health data infrastructure and identify deliberate state opacity as a distinct anti-democratic tactic.
Reading List
Start Here
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An essential framework for understanding how power operates through numbers. Focus heavily on their analysis of "missing data." They argue decisively that failing to collect data (e.g., failing to count police violence or maternal mortality among Black women) is not a clerical oversight—it is a structural tool engineered by the state to systematically deny a problem exists.
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Review the investigative reporting surrounding states like Idaho and Texas in 2023. Facing spikes in maternal mortality following harsh healthcare restrictions, legislatures intentionally allowed their MMRCs to disband or severely curbed their funding. This is the clearest modern example of a government aggressively dismantling data infrastructure to preempt democratic accountability.
Going Deeper
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Connects the data argument back to the state's daily interactions with voters. The authors show how conservatives deliberately increase the "administrative burden" (complex forms, obscure data portals, lack of language support) to restrict access to the franchise and to welfare programs, weaponizing bureaucracy to achieve exclusionary policy goals they could not achieve via legislation.
For Legal and Policy Practitioners
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A look at the actual plumbing. Practitioners fighting for reproductive justice and healthcare equality must understand how the federal infrastructure connects to state systems. If your state tries to pull out of PRAMS data collection, you must be able to cite the exact federal definitions and funding streams they are intentionally sabotaging.
Core Concepts & Inquiries
How is missing data used as a tool of political power?
D'Ignazio and Klein argue in Data Feminism that failing to collect data on police violence, maternal mortality, or other harms to marginalized populations is not a clerical oversight but a structural tool engineered by the state to deny a problem exists. When the state refuses to count the bodies, the political problem ceases to legally exist.
Why have states dissolved Maternal Mortality Review Committees?
States like Idaho and Texas, facing spikes in maternal mortality following harsh healthcare restrictions, intentionally allowed their MMRCs to disband or severely curtailed their funding. This is the clearest modern example of a government dismantling data infrastructure to preempt democratic accountability for the consequences of its own policies.
What is administrative burden as a political weapon?
Herd and Moynihan show how governments deliberately increase administrative complexity—complex forms, obscure data portals, lack of language support—to restrict access to the franchise and to welfare programs. This weaponization of bureaucracy achieves exclusionary policy goals that could not be achieved through direct legislation.
What is the PRAMS system and why does it matter for democratic accountability?
The Pregnancy Risk Assessment Monitoring System (PRAMS) is a CDC-state collaborative surveillance system that tracks maternal and infant health outcomes. When a state pulls out of PRAMS data collection or defunds its Maternal Mortality Review Committee, it severs the connection between policy consequences and public accountability.
Goal: Measure your state's commitment to democratic data gathering within your Jurisdiction Electoral Analysis.
You cannot vote on what you cannot see. Let's test the opacity of your specific state government.
- The PRAMS Check: Does your state currently participate in the CDC’s Pregnancy Risk Assessment Monitoring System? (Hint: There are only a few states that do not.)
- The Review Committee: Does your state legally mandate a Maternal Mortality Review Committee? If so, when was the last time they published a public, unredacted report detailing the racial disparities of maternal deaths in your state?
- The Gap: If your state has not published a report in the last three years (or if the legislature recently defunded the mechanism), document this data blockade in your Electoral Analysis as an active defense against liability.