US public health system is flying blind after major cuts

Crucial public health research in the United States is facing deep cuts after a series of layoffs affecting government employees working on key nationwide data systems. These data sets, which measure everything from fertility and mortality to nutrition and substance use, have guided health policy for decades. Without them, it will be nearly impossible to identify, track and respond to health threats across the country.

“It's like trying to fly a plane, but you don't have a speed sensor, you don't have an altimeter, you don't know your altitude, you don't know how far it is to the nearest airport. You don't have any information you need,” he says. Susan Mainformer director of the Center for Food Safety and Applied Nutrition at the US Food and Drug Administration.

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

Most of the cuts were to staff in human resources, information technology and communications, but some also affected those conducting critical public health research. HHS did not respond to New scientistThe question is about the total number of layoffs, so it is unclear how many public health surveys were affected and to what extent. At least five people have been injured so far.

The National Survey on Drug Use and Health (NSDUH) was one of the first on the chopping block. HHS ceased operations in April all 17 people its launch, damaging the country's only national poll drug useaddiction and mental health. For more than half a century, she has helped policymakers allocate funding to the regions most affected by these problems. The latest report did come out in July, thanks to contractors from RTI International, the independent research institute tasked with collecting the NSDUH data. But it's unclear what will happen next year. “Eventually all our plans will be exhausted. Who then at HHS will influence the direction of the research?” former NSDUH director Jennifer Hoenig said on social media. mail.

Then, in September, the government stopped producing the Household Food Security Reports, which track food insecurity across the country, saying statement that “these redundant, expensive, politicized and extraneous studies do little more than fuel fear.”

But the poll has had bipartisan support for decades, he said. Georgia Machell at the National WIC Association, a nonprofit organization supporting the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). This government program provides food assistance and nutrition education to low-income families. “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,” Machell said in the report. statement.

Most recently, HHS gutted the National Center for Health Statistics (NCHS), eliminating nearly 100 positions, according to Data Foundationis a Washington, D.C.-based nonprofit organization that advocates for open data and evidence-based policy. This includes much of the staff of the National Vital Statistics System, which tracks U.S. births and deaths and tracks the nation's leading causes of death and maternal mortality rates.

The entire National Death Index team also suffered, according to the former NCHS director. Charles Rothwell. This little-known 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 reliable tracking. “This is the only data set like this available,” says Rothwell.

Since it stores very sensitive data, it does not publish any reports. Instead, it helps other agencies and researchers conduct long-term studies, Rothwell says. For example, the Department of Veterans Affairs is working with its staff to compare mortality rates between veterans and non-veterans. Researchers outside the government also use it to confirm whether their participants have died or simply moved to another location. This is especially true for long-term studies of older people, such as the Health and Retirement Study, which tracks well-being of aging Americans. So a hit to the National Death Index would have implications for a range of public health research, Rothwell says.

HHS reported New scientist it is “not currently taking action to implement or manage” the NCHS layoffs, citing a recent court order. However, he did not answer questions about whether he would do so after the government shutdown ends, and if so, how he would maintain those databases.

Staff responsible for planning the National Health and Nutrition Examination Survey (NHANES) were also laid off in October. This study is one of, if not the most comprehensive analysis of health, nutrition and disease in the United States. It is deploying a fleet of mobile clinics to conduct blood and urine tests, bone density scans and oral examinations to monitor nutrition, environmental exposure and disease prevalence across the country. “It really lays the groundwork for nutrition and public health policy,” Main says. For example, it informs national dietary guidelines, environmental regulations, and even updates food labeling. “If we don't know what's happening in the population regarding health and nutrition, we don't know how to prioritize our public health work,” she says.

HHS appears to have reversed the furloughs of NHANES employees, according to the Data Foundation. But the fact that these positions have been cut is deeply concerning – and the same goes for those working on other major public health research. These datasets guide public health policy in the United States. Weaken or remove them and the entire system can collapse.