This administration has contempt for public health

This administration has contempt for public health
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The Trump administration may have leaks (and leakers) in its cross-hairs, but the fact is that leaked documents continue to fill the information void left by an administration as uncommitted to transparency as any in living memory. How else would we know about the pressure the president put on James Comey to go easy on Michael Flynn, or Donald TrumpDonald John TrumpEsper sidesteps question on whether he aligns more with Mattis or Trump Warren embraces Thiel label: 'Good' As tensions escalate, US must intensify pressure on Iran and the IAEA MORE Jr.’s enthusiasm for Russian dirt on Hillary ClintonHillary Diane Rodham ClintonWhy Trump's bigoted tropes won't work in 2020 The Hill's Morning Report - Presented by JUUL Labs - House to vote to condemn Trump tweet GOP put on the back foot by Trump's race storm MORE?

In that by-now-hallowed tradition comes the latest White House leak, this out of the Domestic Policy Council, which gives a pretty good overview of the Trump regulatory agenda. Its boundless ambition is matched only by its craven subservience to longstanding corporate goals and its overweening contempt for the public’s health.

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I’ll leave it to others to comment on the assaults on unions and federal workers, for example, and confine myself to just those related to public health.

 

For the Centers for Disease Control and Prevention (CDC), the Trump White House is big on fighting mosquitoes and ticks and other communicable diseases. But heart disease and cancer? Here the leaked memo recommends that the agency, “shift money away from chronic diseases (esp playgrounds/nutritional nannying) state grant programs and put it in the HIV/Hep/TB/STI division.” I’m all for addressing those infections, but at the expense of chronic diseases that actually kill far more Americans?

You don’t have to take my word for it. Here’s what the CDC says on its own website:

  • “Chronic diseases are responsible for 7 of 10 deaths each year, and treating people with chronic diseases accounts for most of our nation’s health care costs.”
  • “As of 2012, about half of all adults—117 million people—had one or more chronic health conditions. One in four adults had two or more chronic health conditions.”
  • “Eighty-six percent of the nation’s $2.7 trillion annual health care expenditures are for people with chronic and mental health conditions. These costs can be reduced.”

Maybe the Trump administration is in possession of alternative facts.

In short, the Trump White House is calling for the nation’s premier public health agency to shortchange the main risks to our health, and, in so doing, to drive up the health care costs it professes to be concerned about. Not to mention, these health care costs are already making it difficult for government at the federal, state and local levels to address other needs such as education, worker training, roads, bridges, clean water and clean air.

And as if that were not enough, the leaked White House memo goes on to call for cutting CDC resources for “environmental health, injury prevention (except opioids work), Occupational health.”

These are all favorite targets of business lobbyists willing to advance their bottom lines at the expense of the public’s health. Lead poisoning from paints in inner city homes? Mercury spewing from smokestacks? Better not to study them, lest businesses be called upon to abate them.

Injury prevention seems like an unlikely target—injuries exact a particular cost among the young— until one realizes that this is where the CDC would conduct research on motor vehicle crashes and firearms.

Perhaps the leaked memo’s biggest head-scratcher is this: “Childhood obesity: this is a priority of the Secretary for inexplicable reasons … Not a priority of this administration.”

The CDC recently reported an all-time high prevalence of obesity for youth aged 2 to 19: 18.5 percent in 2015-2016, compared to 13.9 percent in 1999-2000. Why does this matter? Because obesity contributes to diseases like heart disease, stroke, type 2 diabetes, and some types of cancer.

Whatever else may be said of high-flying former Secretary of Health and Human Services Tom PriceThomas (Tom) Edmunds PricePress: Acosta, latest to walk the plank 'I alone can fix it,' Trump said, but has he? Chaotic Trump transition leaks: Debates must tackle how Democrats will govern differently MORE, at least his focus on childhood obesity was on the money. 

Peter Lurie, MD, MPH, is the president of the Center for Science in the Public Interest, a strong advocate for nutrition and health, food safety, and sound science