Reductions have resulted in the termination of over a dozen surveillance initiatives by US health agencies
U.S. Health Secretary Robert F. Kennedy's rallying cry is "Make America Healthy Again," but the Trump administration's budget cuts could hinder our ability to measure this success.
The Associated Press scrutinized draft and final budget proposals, as well as discussing the matter with more than a dozen current and former government employees, to examine the extent of budget cuts to programs tracking Americans' health.
Among the programs discontinued at the Centers for Disease Control and Prevention were experts tracking a variety of issues, including abortions, pregnancies, job-related injuries, lead poisonings, sexual violence, and youth smoking. The AP found that these cuts could leave us blind to critical health issues.
"If you don't have staff, the program is gone," said Patrick Breysse, former head of CDC's environmental health programs.
The administration has remained tight-lipped about the specific surveillance programs being axed. Instead, a U.S. Department of Health and Human Services spokeswoman pointed to a Trump administration budget proposal released Friday. It lacked specifics, but proposes to cut the CDC's core budget by more than half and vows to focus CDC surveillance solely on emerging and infectious diseases.
Kennedy has suggested some of the CDC's other work will be moved to a future agency, the Administration for a Healthy America. He also stated that the cuts aim to eliminate waste at a department that has seen its budget rise in recent years.
However, some health experts argue that the eliminated programs are not duplicative, and erasing them will leave Americans in the dark.
"If the U.S. is interested in making itself healthier again, how is it going to know, if it cancels the programs that help us understand these diseases?" posed Graham Mooney, a public health historian at Johns Hopkins University.
The core of the nation's health surveillance is compiled by the CDC's National Center for Health Statistics, which generates information based on birth and death certificates, as well as operating longstanding health surveys that provide data on obesity, asthma, and other health issues. Thankfully, this center has been barely touched by the layoffs and remains intact under current budget plans.
On the flip side, many other efforts have been targeted by the cuts. Some examples include:
Pregnancies and Abortions
The Pregnancy Risk Assessment Monitoring System, which surveys women across the country, lost its entire staff - about 20 people. This program provides the most comprehensive data on the health behaviors and outcomes before, during, and after childbirth and has been used to investigate the nation's maternal mortality problem.
Lead Poisoning
The CDC eliminated its program on lead poisoning in children, which helped local health departments investigate lead poisoning clusters, identify areas of greatest risk, and collaborate on solving contamination issues. This program is crucial for identifying and addressing sources of lead exposure in kids, such as old paint, contaminated dust, and lead pipes.
City officials are worried about losing this expertise to track the long-term effects of lead poisoning. As Mike Totoraitis, the city's health commissioner, put it, "We don't know what we don't know."
Environmental Investigations
Also gone is the staff for the 23-year-old Environmental Public Health Tracking Program, which provided information on concerns including possible cancer clusters and weather-related illnesses. This loss will greatly decrease the capacity to make linkages between environmental factors and health impacts.
Transgender Data
Transgender status is no longer being recorded in health-tracking systems, including ones focused on violent deaths and on risky behaviors by kids. This change will make it more challenging to quantify the extent to which transgender people face higher risks of violence.
Violence
The small amount of information released suggests that some CDC violence-prevention programs have been halted, and work on a system that collects hospital data on nonfatal injuries from causes such as shootings, crashes, and drownings has also ceased. Furthermore, the National Intimate Partner and Sexual Violence Survey seems to have been discontinued, depriving us of valuable data that's not found in law enforcement statistics.
Work Injuries
The National Institute for Occupational Safety and Health, which tracks work-related illnesses and deaths and makes recommendations on how to prevent them, has been gutted by the cuts. 20% of the employees laid off might be reinstated, but little progress has been made in restoring many other programs, such as the ones focused on workplace deaths in the oil and gas industries or research projects into common hearing loss in that industry.
Smoking and Drugs
The HHS cuts eliminated the team responsible for the National Survey on Drug Use and Health, one of the main ways the government measures drug use. Additionally, the CDC staff working on the National Youth Tobacco Survey also lost their positions. Together, these cuts mean fewer insights into the correlation between drug use and both adults and adolescents.
Regrettably, the trend of reducing public health funding sets a precedent for broader impacts on health surveillance and data collection over time. The obscurity surrounding specific programs curtailed within the first 100 days makes it challenging to assess the immediate impact. However, the Trump administration's push for budget cuts and the elimination of data-gathering programs over time are cause for concern. As Mooney points out, "If you keep people from knowing, they're less likely to be concerned."
The U.S. Health Secretary Robert F. Kennedy's call to action for a healthier America faces potential challenges due to budget cuts, which might hinder our ability to measure progress.
The Associated Press inspected draft and final budget proposals, along with discussions with government employees, to understand the extent of the cuts to health programs.
Among the programs discontinued at the Centers for Disease Control and Prevention were experts tracking various issues, such as abortions, pregnancies, and job-related injuries. These cuts could leave us in the dark regarding critical health issues.
Patrick Breysse, former head of CDC's environmental health programs, stated that without staff, the program would disappear.
The administration has been tight-lipped about the specific surveillance programs being axed. Instead, a U.S. Department of Health and Human Services spokeswoman referred to a Trump administration budget proposal that lacked specifics but proposed to cut the CDC's core budget by more than half, focusing CDC surveillance solely on emerging and infectious diseases.
Kennedy suggested that other CDC work would be moved to a future agency, the Administration for a Healthy America. He also stated that the cuts aim to eliminate waste at a department that has seen its budget rise in recent years.
Health experts argue that eliminated programs are not duplicative, and erasing them will leave Americans in the dark.
Graham Mooney, a public health historian at Johns Hopkins University, questioned how the nation would understand diseases without the programs that help us monitor them.
The core of the nation's health surveillance is compiled by the CDC's National Center for Health Statistics, which generates information based on birth and death certificates, as well as operating longstanding health surveys that provide data on obesity, asthma, and other health issues. Fortunately, this center has been barely touched by the layoffs and remains intact under current budget plans.
On the flip side, many other efforts have been targeted by the cuts. For instance, the Pregnancy Risk Assessment Monitoring System, which surveys women across the country, lost its entire staff - about 20 people.
The CDC eliminated its program on lead poisoning in children, which helped local health departments investigate lead poisoning clusters, identify areas of greatest risk, and collaborate on solving contamination issues.
City officials are worried about losing this expertise to track the long-term effects of lead poisoning. As Mike Totoraitis, the city's health commissioner, put it, "We don't know what we don't know."
Also gone is the staff for the 23-year-old Environmental Public Health Tracking Program, which provided information on concerns including possible cancer clusters and weather-related illnesses.
Transgender status is no longer being recorded in health-tracking systems, making it more challenging to quantify the extent to which transgender people face higher risks of violence.
Some CDC violence-prevention programs have been halted, and work on a system that collects hospital data on nonfatal injuries from causes such as shootings, crashes, and drownings has also ceased.
The National Intimate Partner and Sexual Violence Survey seems to have been discontinued, depriving us of valuable data that's not found in law enforcement statistics.
The National Institute for Occupational Safety and Health, which tracks work-related illnesses and deaths and makes recommendations on how to prevent them, has been gutted by the cuts.
The HHS cuts eliminated the team responsible for the National Survey on Drug Use and Health, one of the main ways the government measures drug use.
Additionally, the CDC staff working on the National Youth Tobacco Survey also lost their positions, leading to fewer insights into the correlation between drug use and both adults and adolescents.
The trend of reducing public health funding sets a precedent for broader impacts on health surveillance and data collection over time.
The obscurity surrounding specific programs curtailed within the first 100 days makes it challenging to assess the immediate impact.
The administration's push for budget cuts and the elimination of data-gathering programs over time are causing concern.
As Mooney points out, "If you keep people from knowing, they're less likely to be concerned."
Furthermore, other government bodies face budget cuts. For example, the Environmental Protection Agency proposes to cut funding for climate change research.
The Federal Communications Commission is considering rolling back net neutrality, which could affect technology and smart home devices, such as wearables, in the realm of cybersecurity and internet accessibility.
In the manufacturing industry, employment figures have risen due to corporate tax cuts, leading to the question of how the layoffs in health programs will impact overall health and wellness in this sector.
The Census Bureau's proposed budget cuts could impact health data collection for chronic diseases, such as chronic kidney disease, cancer, respiratory conditions, digestive health, eye health, hearing, skin conditions, and neurological disorders.
The budget cuts could also impede the government's ability to gather data on environmental science, art, finance, energy, science, and medical-conditions, including autoimmune disorders, cardiovascular health, and psoriasis.
The cuts may negatively affect education by minimizing programs that offer solutions for children with learning disabilities or addressing the impact of health issues on educational outcomes.
Additionally, the education sector might face difficulties in implementing programs that promote science, technology, engineering, and math (STEM) education, which goes hand-in-hand with a healthy understanding of the environment and personal health.
The federal budget cuts also affect transportation, with $10 billion diverted from the Federal Transit Administration, potentially jeopardizing проеcks related to electric buses and advanced transportation technology.
Furthermore, the cuts could impact healthcare services for the elderly, veterans, and low-income families, leading to worry about the long-term health implications for these groups.
Lack of funding for the bodies responsible for researching climate change and environmental issues could result in an inability to tackle issues like pollutants and greenhouse gases, thus jeopardizing our health and the environment.
The budget cuts could also have unforeseen consequences for industries such as retail, interior design, cooking, food and drink, dining, fashion, and beauty, as well as home and garden, home improvement, baking, business, personal finance, and real estate.
In addition, cuts to the banking and insurance sectors could impact investing and wealth management, further affecting personal finances and the economy as a whole.
The trend of cutting programs and resources that focus on health and wellness is concerning, as these areas are vital for society's overall prosperity and quality of life.
Increased transparency, communication, and responsible budgeting are necessary to ensure that the health and wellbeing of our nation are not jeopardized.
