Robert F. Kennedy Jr., the health secretary of the nation, said that tackling an “epidemic” of a chronic illness would be a cornerstone of his Make America Remory agenda, which often evokes alarming statistics to reform public health in this country.
On Friday, President Trump published a proposed budget in which it was called to reduce the financing of the Centers for Disease Control and Prevention by almost half. The center for chronic diseases was planned for elimination, a proposal that came as a shock to many state and city health officials.
“Most Americans have a kind of ailment that can be considered chronic,” said Dr. Matifadza Hlatshwayo Davis, health director for the city of St. Louis.
From the proposed cuts, she said, “How do you reconcile that with trying to make America healthy again?”
The federal health department last month Cut 2,400 jobs Of the Centers for Disease Control and Prevention, whose National Center for Chronic Disease Prevention and Health Promotion runs on the largest budget within the agency.
Programs about lead poisoning, quitting smoking and reproductive health were thrown into a reorganization last month.
In general, the proposed budget would reduce the budget of the CDC to around $ 4 billion, compared to $ 9.2 billion in 2024. The Budget Blueprint does not report the Prevention and Public Health Fund, a $ 1.2 billion program.
If that figure is taken into account, the cut can be even greater than the proposal of Mr Trump indicates.
The agency would also lose a center that is aimed at preventing injuries, including that caused by firearms, as well as programs for HIV supervision and prevention, and subsidies to help states prepare for emergencies on public health.
According to the proposed budget, the cuts are needed to eliminate “duplication, dei or just unnecessary programs.” The Congress draws up the American budget, but given the Republican majority and his loyalty to Mr Trump, it is unclear how much the proposal will change.
CDC officials had told that the functions of the Chronic Disease Center would be moved to a new agency within the health department that would be called the administration for a healthy America.
And the proposal released on Friday seems to allocate $ 500 million to the health secretary, partly “to tackle nutrition, physical activity, healthy lifestyles, exaggerated dependence on medication and treatments.”
But on the CDC the budget of the chronic Disease Center was almost three times as large. And even if part of the Chronic Disease Center is resuscitated in the AHA, it is unlikely that his new iteration would be involved with CDC scientists who have moved from Atlanta.
“The actual experts of the subject, who manage the programs, may no longer be there at CDC,” Dr. Scott Harris, state health officer at the Alabama Department of Public Health. “We certainly do not have the same level of expertise in my state.”
The Ministry of Health and Human Services did not respond to a request for comments.
The Chronic Disease Center of the CDC has carried out programs that were aimed at preventing cancer, heart disease, diabetes, epilepsy and Alzheimer’s disease.
But the center has also sown initiatives further away, ranging from creating rural and urban hiking trails to ensuring that healthy options such as salads are offered at airports. It also promoted welfare programs in marginalized communities.
Dr. Davis, the health director in St. Louis, said that her department was already faltering from cutbacks to programs to curb smoking and to reduce lead poisoning and health differences, as well as the Withdrawal of more than $ 11 billion that the CDC had provided to state health departments.
“I would take COVID-19 in a heartbeat about what is happening now,” said Dr. Davis.
In the proposed budget, the administration suggested that the eliminated programs would be better managed by states.
But state health departments already manage most chronic disease programs and three -quarters of the financing of the CDC Center is to support them.
Loss of those funds “would be devastating to us,” said Dr. Harris, the health officer in Alabama.
The State has one of the highest rates of chronic diseases in the country, and about 84 percent of the budget of the Public Health department comes from the CDC, Dr. Harris. About $ 6 million goes to chronic disease programs, including blood pressure education, nutritional education for diabetes and promotion of physical activity.
If those funds are cut: “I am now a loss to tell you where that would come from,” he added. “It just seems that nobody really knows what to expect, and we are not really asked for that.”
The famous health department of Minnesota has already fired 140 employees and could be influenced hundreds more if more CDC financing has been lost. Cutbacks on the prevention of chronic diseases will influence nursing homes, vaccine clinics and public health initiatives for Indians in the state.
“The actions of the federal government left us on a thin limb without a safety net among us,” Dr. Brooke Cunningham, the state commissioner of the state.
Until recently, “there seemed to be a shared concept at local, state and federal level in which health was important to invest,” said Dr. Cunningham.
The work of the Chronic Disease Center touches American life in many unexpected ways.
In Prairie Village, Kan. Stephanie Barr taught the center 15 years ago when she, working as a waitress without health insurance, discovered a lump in her chest the size of a lemon.
Through the national breast and cervical cancer of the CDC, she was able to get a mammogram and an ultrasound, and employees helped her to register for Medicaid for treatment after a biopsy had determined that the clog was malignant, Mrs. Barr said.
“It was caught in the nick of time,” said Mrs. Barr, now 45 and cancer -free.
Since that program started in 1991, it has provided more than 16.3 million screening exams to more than 6.3 million people without other affordable access, said Lisa Lacasse, president of the American Cancer Society Cancer Action Network.
The organization is one of them 530 Health Associations that have signed a petition in which the legislators have rejected the proposed HHS budget that lowers the discretionary expenditure of the ministry by about a third. The signatories said that the cutbacks would “destroy” the research and public health infrastructure of the nation.
The budget also proposes the dismantling of diseases and surveillance systems. “If you do not collect the information or maintain these surveillance systems, you don’t know what is happening, you don’t know what the trends are,” Dr. Philip Huang, director of Dallas County Health and Human Services.
“You lose all that history,” he said.
In an earlier position as director of chronic diseases for Texas, Dr. Huang that he worked closely with CDC experts who have successfully reduced tobacco use among Americans. “Eliminating the office for smoking and health is just crazy if you still want to tackle chronic diseases,” he said.
Smoking is still the main cause of death to be prevented in the United States, which, according to the CDC, causes more than 480,000 deaths, every year
More than one in 10 American adults still regularly smoke cigarettes, but rates vary drastically per region, and CDC surveillance helps to focus stop programs to areas where they are most needed.
“The smoke rates have fallen, but when the federal government gets its foot off the gas, the tobacco companies are ready to pop up again,” said Erika Sward, vice -president for Lawacy for the American Lung Association.
She warned that tobacco companies are constantly developing new products such as Nicotine bags, whose Used by teenagers doubled last year. “It will cost a lot more money to put the genius back in the bottle,” she said.
The Chronic Disease Center of the CDC works together with communities and academic centers to promote effective programs, from creating stopping hotlines to achieving young Iowans in rural areas to training members of black churches in Columbia, to lead practice and food classes for their municipalities.
In the countryside of Missouri, dozens of hiking trails have been developed in the “Boot very” in the southeastern part of the state, an area with a high percentages of obesity and diabetes, said Ross Brownson, a public health researcher at Washington University in St. Louis who leads the Prevention Research Center in collaboration with the CDC
“There is now strong evidence that if you change the running of a community, people will get more physical activity,” said Dr. Brownson. “There will be no health clubs in rural communities, but there is nature and the possibility to have hiking trails, and land is relatively cheap.”
With CDC support, in Rochester, NY, people who are deaf and hard from hearing are trained to lead practice and wellness programs for other obedient people who cannot easily participate in other gym lessons.
In San Diego, researchers test ways to protect agricultural workers against exposure to ultraviolet rays and heat -related diseases.
“As soon as they have finished and started, they are community and they are not dependent on the government”
The reorganization of the CDC also eliminated lead poisoning programs. Lead poisoning is also “one of our biggest threats of public health in the city of Cleveland,” said Dr. David Margolius, director of public health for the city.
The CDC does not immediately finance the main programs of Cleveland – The financing comes from the state. “But just the federal expertise to call to help us to a lead -free future, I mean, yes, that has a big impact on us,” he said.
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