Government health-monitoring initiatives slashed, resulting in the abolishment of over a dozen projects within the U.S.

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In the Heart of the Storm: Trump's Budget Cuts Threaten Public Health Surveillance

In the tumultuous first 100 days of the Trump administration, hordes of critical public health surveillance programs have been swept up in an unexpected tornado of layoffs and proposed budget cuts, casting a dark cloud over the nation's health data.

The Associated Press scrutinized draft and final budget proposals, and spoke to more than a dozen current and former federal employees to delve into the devastating scope of the cuts to programs that collect essential health data for Americans.

Among the casualties at the Centers for Disease Control and Prevention were experts tracking reproductive health, occupational injuries, lead poisoning, sexual violence, and youth smoking, as revealed by the AP.

"If you don't have staff, the program is gone," said Patrick Breysse, a former head of environmental health programs at the CDC.

Strikingly, federal officials have been tight-lipped about the specific surveillance programs facing elimination. Instead, a spokeswoman from the Department of Health and Human Services pointed to the Trump administration's budget proposal, which only vaguely hinted at cutting the CDC's core budget by over half and focusing all CDC surveillance solely on emerging and infectious diseases.

Politician Robert F. Kennedy Jr., who advocates for health reform under his "Make America Healthy Again" motto, defends the spending reductions as a way to weed out waste in a department that has witnessed a pronounced growth in recent years.

Yet, health experts argue that these axed programs are not redundant and that eradicating them will leave citizens in the dark.

"If the United States wishes to make itself healthier again, how will it know if it erases the programs that help us comprehend these illnesses?" pondered Graham Mooney, a public health historian at Johns Hopkins University.

The CDC's National Center for Health Statistics takes center stage in the nation's health surveillance. It generates information on birth rates, death trends, and life expectancy through birth and death certificates, in addition to its long-standing health surveys that offer indispensable data on obesity, asthma, and other health problems.

Yet, the AP uncovered numerous other programs facing the CDC's chopping block. For instance:

Pregnancies and Abortions

The Pregnancy Risk Assessment Monitoring System, which collects data from women across the nation, officially lost its entire staff of approximately 20 employees. This system offers an extensive overview of the health behaviors and outcomes before, during, and after childbirth. Researchers have used this information to explore the nation's escalating maternal mortality dilemma.

Recent layoffs also extinguished staffs collecting data on in vitro fertilizations and abortions. These cuts contrast with President Trump's pledges to expand IVF access and increase abortion surveillance.

Lead Poisoning

The CDC has discontinued its program on lead poisoning in children, which helped local health departments investigate lead poisoning clusters and pinpoint areas of highest risk. Lead poisoning in kids is often caused by exposure to deteriorated paint, contaminated dust or water passing through lead pipes. The program's staff mishaps weren't limited to the discovery of lead-tainted applesauce affecting 500 children - they also played a crucial role in unearthing lead dangers in peeling paint found in aging local elementary schools.

City officials are anxious about the loss of expertise to help them track the long-term effects. "We don't know what we don't know," said Mike Totoraitis, the city's health commissioner.

Environmental Investigations

The 23-year-old Environmental Public Health Tracking Program has also bit the dust. This program offered data on various environmental concerns, including possible cancer clusters and weather-related illnesses.

"The dissolution of this program is going to seriously diminish the capacity to establish links between what might be in the environment and what health may be affected by that," Breysse said.

Data Broken Down:

Transgender Data

In some cases, the elimination of staff has replaced the end of specific data collection. Transgender status will no longer be recorded in health-tracking systems, including ones focused on violent deaths and on risky behaviors by children. As a result, experts will struggle to quantify the extent to which transgender people are victims of violence.

Violence

While staff and funding remain intact for a CDC program uncovering insights into homicides, suicides, and accidental deaths involving weapons, violence-prevention programs that employed this data have been halted. Work on a system that gathered data on non-fatal injuries from causes like shootings, crashes, and drownings was also stopped. Moreover, the CDC's National Intimate Partner and Sexual Violence Survey seems to be on its way out. This system collects information not found in law enforcement statistics. Health officials believe this data is important, as not all victims of sexual violence seek legal recourse.

Work Injuries

The National Institute for Occupational Safety and Health, which tracks job-related illnesses and deaths and makes recommendations to prevent them, was severely pruned by the cuts. Robert F. Kennedy Jr. has stated that 20% of the laid-off staff might be reinstated. Yet, the reinstatement remains unconfirmed, leaving the state of other programs, such as one examining workplace deaths in the oil and gas industries or research into hearing loss in that sector, uncertain.

Smoking and Drugs

The Health and Human Services cuts eliminated the 17-member team responsible for the National Survey on Drug Use and Health, one of the primary ways the government monitors drug use. Axed were also the CDC staff responsible for the National Youth Tobacco Survey. While other surveys examine youth substance use, these federal studies tracked both adults and adolescents. Additionally, they covered issues like specific vaping and tobacco product trends not explored by other surveys, serving as a key driver in federal efforts to better regulate electronic cigarettes.

Data Modernization and Predictions

Work to modernize data collection has stalled, including improvements to a 22-year-old system that assists local public health departments in tracking diseases and helps the CDC construct a national health picture. Another causality was the Center for Forecasting and Outbreak Analytics, which aimed to predict disease trends. This center, created during the COVID-19 pandemic, had been working on predicting the current multistate measles outbreak. However, the layoffs might have caused a delay in publishing the forecast.

Mixed Messages From the Top

While the Trump administration hasn't always supported widespread testing for health issues, it's unclear whether this reluctance extends to reporting on health problems. Mooney, the Johns Hopkins historian, wonders if the administration seeks to minimize public awareness. "One could argue that it's deliberate," Mooney said. "If people remain ignorant, they're less likely to be concerned."

Stobbe writes for the Associated Press.

Enrichment Insights:

The Trump administration's budget cuts have targeted numerous public health surveillance programs, impacting data collection on various critical health issues, including:

Reproductive and Maternal Health: Eliminated programs include the Pregnancy Risk Assessment Monitoring System, as well as data collecting on in vitro fertilizations and abortions, all of which contribute to an understanding of maternal health and mortality trends.
Occupational Hazards: The National Institute for Occupational Safety and Health was gutted, weakening oversight of workplace injuries and illnesses, particularly affecting 9/11-related health programs for survivors.
Youth Behavior: Cuts to programs tracking youth smoking and substance use erase early warning systems for identifying potential addiction trends.
Lead Poisoning Prevention: Reduced tracking capacity impedes the ability to locate lead poisoning risks, particularly in low-income housing.
Pandemic Preparedness: $11.4 billion in public health grants for infectious disease tracking and mental health services were rescinded, undermining the ability to address current and future pandemics.

The losses of these programs have resulted in blind spots for chronic disease management, delayed response capabilities, and fragmentation of historical data records. While some critical programs, such as the CDC's National Center for Health Statistics, remain relatively intact, the targeted cuts have created broader vulnerabilities in public health intelligence.

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Trumps administration's initial 100 days witnessed the apparent elimination of over a dozen health and mortality data-monitoring programs, due to layoffs and proposed fiscal restraints.

Government health-monitoring initiatives slashed, resulting in the abolishment of over a dozen projects within the U.S.