In the recent political climate, U.S. Health Secretary Robert F. Kennedy Jr.’s initiative, “Make America Healthy Again,” faces potential setbacks due to sweeping government reductions, casting doubt on the nation’s ability to track its health progress. Over the past few months, the first 100 days of the Trump administration have introduced proposals and actions leading to the elimination of numerous data-collection programs that monitored key health indicators, including mortality and disease prevalence.
Investigations into the administration’s budget plans reveal significant cuts within the Centers for Disease Control and Prevention (CDC). Noteworthy among those trimmed are teams dedicated to tracking vital health issues such as abortions, pregnancies, workplace injuries, lead poisoning, sexual violence, and youth smoking.
Patrick Breysse, a former overseer of the CDC’s environmental health initiatives, remarked on the profound impact of these cuts, stating, “If you don’t have staff, the program is gone.” Notably, federal authorities have not provided transparent details about specific surveillance programs affected. However, a glimpse into the strategic direction is offered by a recent Trump administration proposal, which outlines a dramatic reduction to the CDC’s core budget and pledges to narrow the agency’s focus to emerging and infectious diseases.
In light of these changes, Kennedy has suggested a reallocation of some CDC functions to a future entity, the Administration for a Healthy America. He argues that the aim of the budget cuts is to eliminate inefficiencies and curb administrative redundancy.
Contrary to Kennedy’s claims of unnecessary duplication, health professionals argue that the axed programs served essential roles and were far from redundant. Graham Mooney, a well-regarded public health historian from Johns Hopkins University, underscored the critical nature of these programs: “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?”
The CDC’s National Center for Health Statistics retains its crucial role in health surveillance, generating valuable data on birth rates, mortality trends, and life expectancy based on birth and death certificates. Despite remaining relatively untouched by the layoffs, major components of the health monitoring infrastructure have been targeted for downsizing.
Examples include the Pregnancy Risk Assessment Monitoring System almost entirely losing its personnel, jeopardizing comprehensive data on maternal health behaviors and outcomes. Similarly, programs documenting in vitro fertilizations and abortions have faced layoffs, conflicting with previously stated goals of expanding IVF and enhancing abortion data collection.
The CDC’s efforts in tackling lead poisoning in children—a program key to uncovering sources of exposure and aiding local health departments—has also seen its workforce eradicated. This comes on the heels of assisting with major investigations, such as lead-tainted applesauce and significant school-based lead exposures.
Essential environmental health surveillance, formerly executed by the now-defunct Environmental Public Health Tracking Program, is another casualty, raising concerns about continued oversight on issues like cancer clusters and weather-related illnesses.
Moreover, changes extend to data collection priorities, with notable cessation in updating health systems to include transgender status—critical data for understanding violence risk—and diminishing visibility into specific health issues faced by the transgender community.
The maintenance of data related to violence remains mostly unaffected, yet associated prevention programs and tools for capturing nonfatal injury data have suffered, hindering initiatives aimed at addressing issues like shootings and intimate partner violence.
Occupational safety is another area in jeopardy, with the National Institute for Occupational Safety and Health suffering major staffing reductions, although there is some potential for reinstating a portion of the workforce.
The cuts have also axed comprehensive drug and smoking surveys, essential for mapping trends among various demographics, including high school dropouts.
Progress in modernizing public health data systems has stalled, impacting the CDC’s ability to provide a comprehensive, updated nation-wide health picture and complicating efforts to produce disease predictions.
President Donald Trump’s perspective on health problem testing has at times been critical, particularly during the height of the COVID-19 pandemic when extensive testing capabilities made the U.S. appear to have a disproportionately severe problem.
As budgets tighten and health data collection programs vanish, Mooney from Johns Hopkins cautions that these movements could intentionally obscure public knowledge of the country’s health challenges, making improvements harder to gauge and address.