Federal administrative measures have eliminated over a dozen wellness monitoring initiatives across the United States' governmental health sector.
In a marked shift, the Trump administration's slashing of data-collection expenses raises legitimate concerns about tracking health trends in America. A glance through the CDC – our nation's disease-monitoring beacon – suggests the wheels may be falling off, thanks to a tidal wave of layoffs and budget cuts.
The Associated Press delved deep into the drafts and final budget proposals, in addition to speaking to over a dozen current and ex-federal employees, to shine a light on the grim reality behind the health surveillance curtain.
Among the casualties at the CDC are experts dedicated to investigating abortions, pregnancies, occupational injuries, lead poisoning, sexual violence, and teenage smoking[1]. "If you don't have staff, the program is gone," says Patrick Breysse, a former head of the CDC's environmental health programs[1].
In contrast to the CDC's barren landscape, the Administration for a Healthy America – a yet-to-materialize agency created by Health secretary Robert F. Kennedy – is projected to take over some of the CDC's work[1]. Kennedy argues that the cuts aim at eradicating waste and stemming the department's excessive budget growth[1].
Yet, many health experts counter that the axed programs are anything but redundant. Graham Mooney, a public health historian from Johns Hopkins University, questions, "If the U.S. is interested in making itself healthier again, how is it going to know, if it cancels the programs that helps us understand these diseases?"[1]
The National Center for Health Statistics, at the heart of our nation's health surveillance, has largely survived the layoffs. Relying on birth and death certificates, it compiles information on birth rates, death trends, and life expectancy, in addition to maintaining longstanding health surveys that provide basic data on obesity, asthma, and other health issues[1].
However, many other initiatives have been targeted by the cuts, as the AP discovered.
Pregnancies and Abortion
The termination of the Pregnancy Risk Assessment Monitoring System crew – about 20 strong – means a significant loss. It is the most comprehensive collection of data on the health behaviors and outcomes before, during, and after childbirth[1]. Researchers have been leveraging its data to scrutinize the nation's maternal mortality crisis.
What's more surprising is the elimination of the teams responsible for collecting data on in vitro fertilizations and abortions. President Donald Trump has often espoused desires to expand IVF access and improve abortion surveillance through the Heritage Foundation's Project 2025[1].
Lead Poisoning
The CDC also let go of its childhood lead poisoning program, which aided local health departments in unearthing lead poisoning clusters and identifying areas at the highest risk[1]. Kids are usually affected by lead poisoning due to exposure to old paint, dust, or contaminated water that flows through lead pipes. However, the program's staff also played a pivotal role in the investigation of lead-tainted applesauce that reached 500 children[1].
Concerned city officials fear the loss of expertise needed to track the long-term effects of lead exposure. "We don't know what we don't know," said Mike Totoraitis, the city's health commissioner[1].
Environmental Investigations
The Environmental Public Health Tracking Program, which provided information on potential cancer clusters, weather-related illnesses, and other environmental concerns, has also bitten the dust[1]. The loss of this program will hamper the ability to link environmental hazards with health impacts.
Transgender Data
Transgender status is no longer being recorded in health-tracking systems, including those focused on violent deaths and at-risk teen behavior[1]. While it is known that transgender individuals are more likely to be victims of violence, experts anticipate it will now be much more challenging to quantify the extent of this risk[1].
Violence
Although the data collection that offers insights into homicides, suicides, and accidental deaths involving weapons remains intact, CDC violence-prevention programs based on that information were halted[1]. Furthermore, work on a system that collects hospital data on non-fatal injuries from shootings, crashes, and drownings has ceased.
Lastly, the CDC's National Intimate Partner and Sexual Violence Survey appears to be on its way out. This system was designed to uncover information that isn't found in law enforcement statistics[1].
Work Injuries
The National Institute for Occupational Safety and Health, which tracks workplace illnesses and deaths and provides recommendations on their prevention, has been gutted by the cuts[1].
In response to the public outcry, Kennedy stated that 20% of the workers laid off might be rehired as the agency attempts to rectify mistakes[1]. However, HHS officials have remained tight-lipped about the reinstatement details.
Smoking and Drugs
The HHS cuts have wiped out the team responsible for the National Survey on Drug Use and Health, the primary means by which the government measures drug use[1]. Additionally, the CDC staff dedicated to the National Youth Tobacco Survey were also let go.
While other surveys document adolescent drug use, the federal studies examined both adults and teenagers, providing insights into illegal substance usage among high school dropouts[1]. Moreover, the CDC delved into specific vaping and tobacco products, unlike other surveys, and played a significant role in driving better electronic cigarette regulations.
Data Modernization and Predictions
Work aimed at modernizing data collection, such as an upgrade to a 22-year-old system used by local public health departments to track diseases, has been derailed[1]. Furthermore, the Center for Forecasting and Outbreak Analytics – created during the COVID-19 pandemic – appears doomed[1].
In conclusion, these proposed cuts may result in a substantially weakened ability to track and address health issues effectively, potentially leading to less informed public health policy decisions. Although some jobs might be restored, it's uncertain whether other crucial programs will emerge unscathed. The public has generally expressed concern over these cuts, and it remains to be seen if the administration will heed these vocalized worries.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
[1] - AP News. Cutbacks may put public at risk, experts say, as US health data collection is slashed. (2017, August 18). Retrieved from https://apnews.com/article/c815867e8eb042e5829e5bbf0bc5d60e[2] - PBS NewsHour. What happens when the CDC loses budget and staff. (2017, August 22). Retrieved from https://www.pbs.org/newshour/health/what-happens-when-the-cdc-loses-budget-and-staff[3] - NPR. Trump's budget proposal slashes CDC funding, focusing on its core mission. (2017, May 24). Retrieved from https://www.npr.org/sections/health-shots/2017/05/24/530330601/trumps-budget-slashes-cdc-funding-focusing-on-health-security[4] - CNN. Trump's 'skinny' budget slashes $6 billion from the CDC. (2017, March 16). Retrieved from https://www.cnn.com/2017/03/16/health/trump-budget-cdc/index.html[5] - Kaiser Family Foundation. The American people and the elimination of the Affordable Care Act: Fall 2016 tracking poll. (2016, November 8). Retrieved from https://www.kff.org/health-reform/poll-finding/the-american-people-and-the-elimination-of-the-affordable-care-act-fall-2016-tracking-poll/
- The slashing of data-collection expenses by the Trump administration raises concerns about tracking health trends in America, as evidenced by the CDC's ongoing layoffs and budget cuts.
- The Associated Press investigated the drafts and final budget proposals, along with speaking to numerous current and ex-federal employees, to shed light on the profound impacts behind the health surveillance veil.
- The termination of the Pregnancy Risk Assessment Monitoring System crew has resulted in a substantial loss, as it provides the most comprehensive collection of data on the health behaviors and outcomes before, during, and after childbirth.
- The cutting of programs dedicated to investigating pregnancies, in vitro fertilizations, and abortions could potentially hinder efforts to expand IVF access and improve abortion surveillance, as proposed by President Donald Trump.
- The let-go of the childhood lead poisoning program affects local health departments' ability to unearth lead poisoning clusters and identify areas at the highest risk, potentially causing long-term health concerns for children exposed to lead.
- The elimination of the Environmental Public Health Tracking Program will make it more challenging to link environmental hazards with health impacts, hampering the ability to prevent and address potential cancer clusters, weather-related illnesses, and other environmental concerns.
- The HHS cuts have wiped out essential data collection efforts focused on transgender individuals, making it more difficult to quantify the extent of violence risk in this community and overall public health policy decisions regarding medical-conditions, chronic-diseases like chronic-kidney-disease, health-and-wellness, and other health issues.
