Robert F. Kennedy Jr., the secretary of the health of the nation, said that facing a “epidemic” of a chronic disease would be a milestone of his agenda to make America healthy, often invoking alarming statistics such as an urgent reason to reform public health in this country.
On Friday, President Trump published a proposed budget that asked to cut the financing of the centers for the control and prevention of diseases of almost half. Its center of chronic diseases has been entirely foreseen for the elimination, a proposal that has been a shock for many state health officials and citizens.
“Most Americans have a sort of disorder that could be considered chronic,” said dr. Matifadza Hlatshwayo Davis, director of the health of the city of St. Louis.
Of the proposed cuts, he said: “How do you reconcile with the attempt to make America healthy?”
The Department of Federal Health last month cut 2,400 jobs from the CDC, whose National Center for the prevention of chronic diseases and the promotion of health takes place with the major budget within the Agency.
Lead poisoning programs, termination of smoking and reproductive health were affected in a reorganization last month.
Overall, the proposed budget would have reduced the financing of the CDC to approximately $ 4 billion, compared to $ 9.2 billion in 2024.
The budget project does not mention the prevention and public health fund, a 1.2 billion dollar program. If that figure is taken into consideration, the cut could even be larger than Mr. Trump's proposal indicates.
The agency would also lose a center focused on the prevention of accidents, including those caused by firearms, as well as on the programs for the surveillance and prevention of HIV and the subsidies to help states prepare for the emergencies of public health.
According to the proposed budget, the cuts are necessary to eliminate the “duplicative programs, dei or simply unnecessary”. The congress elaborates the federal budget, but given the republican majority and his loyalty to Mr. Trump, it is not clear how much his proposal will change.
The officials of the CDC had been said that the functions of the center of chronic diseases would be moved to a new organization within the health department called administration for a healthy America.
And the proposal released on Friday seems to allocate $ 500 million to the Secretary of Health in part “to deal with nutrition, physical activity, healthy lifestyles, excess drugs and treatments”.
But on the CDC, the budget of the chronic center was almost three times larger. And even if part of the center for chronic disease is revived in the ha, it is unlikely that the new iteration involves the scientists of the CDC transferred from Atlanta.
“The actual experts of matter, who administer programs, may no longer be present on the CDC,” said dr. Scott Harris, state health officer of the Public Health Department of Alabama. “We certainly don't have the same level of competence in my state.”
The Department of Health and Human Services did not respond to a commentary request.
The CDC chronic disease center has managed programs aimed at preventing cancer, heart disease, diabetes, epilepsy and Alzheimer's disease. But the center also sowed the most distant initiatives, ranging from the creation of rural and urban excursions paths to the guarantee that health options such as salads are offered. He also promoted wellness programs in marginalized communities.
Dr. Davis, director of the Health of St. Louis, said that his department was already filling himself from the cuts to the programs to curb the smoke and reduce the leading poisoning and the health disparities, as well as the revocation of over 11 billion dollars that the CDC had provided to the state health departments.
“I would have resumed Covid-19 in a heartbeat on what is happening right now,” said dr. Davis.
In the proposed budget, the administration suggested that the eliminated programs would have been better managed by the States. But the state health departments already manage most of the chronic disease programs and the three quarters of the funding of the CDC Center go to support them.
The loss of those funds “would be devastating for us,” said dr. Harris, health manager in Alabama.
The state has one of the highest tassi of chronic diseases in the country and about 84 percent of the budget of the public health department comes from the CDC, said dr. Harris. About 6 million dollars go to chronic disease programs, including blood pressure screening, food education for diabetes and promotion of physical activity.
If those funds were cut, “they are at loss at this moment to tell you where it would come from,” he added. “It just seems that nobody really knows what to expect, and we are not really asked for any input about it.”
The Department Department of Minnesota has already fired 140 employees and hundreds of more could be interested if more CDC funding is lost. The cuts to the prevention of chronic diseases will influence nursing homes, clinics for vaccines and public health initiatives for Native Americans in the state.
“The actions of the Federal Government left us on a fragile limb without a security network below us,” said dr. Brooke Cunningham, state health commissioner.
Until recently, “there seemed to be a shared understanding at the local, state and federal level in which health was important to invest,” said dr. Cunningham.
The work of the chronic of the CDC chronic touches American life in many unexpected ways.
In the village of Prairie, Kan., Stephanie Barr learned of the center 15 years ago, when, working as a waitress without health insurance, he discovered a lump in the breast of the size of a lemon.
Through the national breast and cervical cancer program of the CDC, she was able to obtain a mammography and an ultrasound and staff members helped her enroll in Medicaid for treatment after a biopsy determined that the lump was evil, said Mrs. Barr.
“It was captured in the Nick of Time,” said Mrs. Barr, now 45 and free from cancer.
From that program it began in 1991, he provided over 16.3 million screening exams to over 6.3 million people without other access to affordable prices, said Lisa Lacasse, president of the American Cancer Society Cancer Action Network.
The organization is one of the 530 health associations that have signed a petition that asks for legislators to refuse the proposed HHS budget, which reduces the discretionary costs of about a third. The signatories said that the cuts would “actually devastate” the Nation's research and public health infrastructures.
The budget also proposes to dismantle diseases of diseases and surveillance systems.
“If you don't collect information or keep these surveillance systems, you don't know what's going on, you don't know what trends are,” said dr. Philip Huang, Director of Dallas County Health and Human Services in Texas.
“You are losing all that story,” he said.
In a previous position as director of chronic diseases for Texas, dr. Huang said he had worked in close contact with CDC experts who successfully reduced the use of tobacco among the Americans.
“Eliminating the office and health office is only madness if you still want to face chronic diseases,” he said.
Smoking is still the main cause of preventable death in the United States, causing over 480,000 deaths every year, according to the CDC
More than one in 10 American adults still smoke cigarettes regularly, but rates vary drastically by region and the surveillance of the CDC helps to hit the cessation programs in the areas where they are most necessary.
“Smoking rates have decreased, but if the federal government removes the foot from the gas, the tobacco companies are ready to repay again,” said Erika Sward, vice -president for the defense of the American Lung Association.
He warned that tobacco companies constantly develop new products such as nicotine bags, whose use by teenagers doubled last year. “It will take a lot more money to put their genius back in the bottle,” he said.
The CDC chronic disease center works with communities and academic centers to promote effective programs, from the creation of Howline for the possibility of reaching young Iowan in rural areas to the formation of members of the black churches in Columbia, SC, to guide the operating and nutrition lessons for their congregations.
In the rural Missouri, dozens of walking paths were developed in the “start -up heel” in the southern -east of the state, an area with high rates of obesity and diabetes, said Ross Brownson, a public health researcher at Washington University in St. Louis who directs the Research Center on Prevention in collaboration with the CDC
“Now there is evident evidence that if you change the path of a community, people will get more physical activities,” said dr. Brownson. “There will be no health club in rural communities, but there is nature and the ability to have walking paths and the earth is relatively cheap.”
With the support of the CDC, in Rochester, New York, the deaf people and people are severely trained to guide exercises and well -being programs for other people with hearing problems that cannot easily participate in other gym lessons.
In San Diego, researchers are testing ways to protect agricultural workers from exposure to ultraviolet rays and heat -related diseases.
“Once taken and started, they are guided by the community and do not depend on the government,” said Allison Bay, who recently lost his work by managing these projects at the CDC
The reorganization of the CDC has also eliminated the lead poisoning programs. Lead poisoning is also “one of our greatest public health threats in the city of Cleveland”, said dr. David Margolius, director of public health for the city.
The CDC does not directly finance Cleveland's main programs: the loan comes from the state. “But only to have the federal competence to ask to help us a lead future, I mean, yes, that he has a great impact on us,” he said.