The US public health system is flying blind after major cuts

Important public health surveys in the United States are facing deep cuts after a series of layoffs hit government employees working on key data systems nationwide. These data sets, which measure everything from births and deaths to nutrition and drug use, have guided health policy for decades. Without them, it would be nearly impossible to identify, monitor, or respond to health threats across the country.

“It’s like trying to fly a plane and you don’t have a speedometer, or an altimeter, or your altitude, or your distance to the nearest airport. You don’t have any of the information you need,” he says. Susan Mayneformer director of the Center for Food Safety and Applied Nutrition at the US Food and Drug Administration.

During his second term, President Donald Trump has made a concerted effort to shrink the size of the US government. The US Department of Health and Human Services (HHS) was one of the main targets of his administration. In March, the agency’s workforce decreased from 82,000 employees to 62,000. Nearly 1,100 additional layoffs were announced in October, though a court order temporarily halted them amid the ongoing government shutdown.

Most of the cuts targeted staff in human resources and ICT, but some hit those running important public health surveys as well. The Department of Health and Human Services did not respond New worldQuestions about the total number of layoffs, so it is unclear how many public health surveys were affected and to what extent. So far, at least five have been affected.

The National Survey on Drug Use and Health (NSDUH) was one of the first studies on the chopping block. In April, the Department of Health and Human Services terminated all 17 people who had been running it, crippling the country’s only national study on drug use, addiction and mental health. For more than half a century, it has helped policymakers allocate funding to the areas most affected by these problems. The latest report was released in July, thanks to contractors from RTI International, an independent research institute tasked with collecting NSDUH data. But it is not clear what will happen next year. “Eventually, all the planning we’ve done will run out of steam. So who at HHS will influence the direction of the survey?” Former NSDUH Director Jennifer Honig said in a social media post mail.

Then, in September, the government ended the Household Food Security Reports, which monitored food insecurity across the country, claiming statement “These redundant, expensive, politicized, and outlandish studies do nothing more than fear mongering.”

However, it has had bipartisan support for decades, the poll said Georgia Machil The National WIC Association, a nonprofit organization that supports the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This government program provides low-income families with food assistance and nutrition education. “Programs like WIC rely on this national-level data to understand the broader picture of hunger and food insecurity in our country, allowing resources to be directed where they are needed most,” Machel said in a report. statement.

Most recently, the Department of Health and Human Services gutted the National Center for Health Statistics (NCHS), eliminating about 100 jobs, according to a HHS report. Data Foundationa Washington, D.C.-based nonprofit that advocates for open data and evidence-based policy. This includes most of the staff behind the National Vital Statistics System, which tracks births and deaths across the United States and monitors the leading causes of death and maternal mortality rates in the country.

The entire team that runs the National Death Index was also affected, the former NCHS director says Charles Rothwell. This anonymous database contains identifying information about every death in the United States, including the person’s name, place of residence, cause of death, and, in many cases, their Social Security number, allowing for robust tracking. “This is the only data set like this available,” Rothwell says.

Because it stores highly sensitive data, it does not publish any reports. Instead, they help other agencies and researchers conduct long-term studies, Rothwell says. For example, the Department of Veterans Affairs works with its employees to compare deaths between veterans and non-veterans. Researchers outside the government also use it to confirm whether participants have died or simply moved elsewhere. This is especially true for long-term studies of older adults, such as the Health and Retirement Study, which monitor the well-being of older Americans. As such, any hit to the national mortality index would have knock-on effects on a range of public health surveys, Rothwell says.

The Department of Health and Human Services said New world It “is not currently taking action to implement or manage” NCHS’s layoffs, citing a recent court order. However, it did not respond to questions about whether it will do so once the government shutdown ends, and if so, how it will maintain these databases.

Staff responsible for planning the National Health and Nutrition Examination Survey (NHANES) were also laid off in October. This survey is one of, if not the, most comprehensive assessment of health, diet, and disease in the United States. It deploys a fleet of mobile clinics to conduct blood and urine tests, bone density screenings, and oral health screenings to monitor diet, environmental exposures, and disease prevalence nationwide. “It lays the foundation for nutrition and public health policies,” Mayne says. For example, it provides information on national dietary guidelines, environmental regulations, and even updates on food labeling. “If we don’t know what’s going on in a population in terms of health and nutrition, we don’t know where to prioritize our public health work,” she says.

The Department of Health and Human Services appears to have reversed the terminations of NHANES employees, according to the data organization. But the fact that these positions were rescinded in the first place is deeply troubling – and the same is true for those working on other major public health surveys. These datasets guide public health policy in the United States. Weaken or remove them, and the entire system may collapse.

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• US/
• public health