The Health Divide: For health equity and public health programs, death by a thousand cuts
Throughout the nation, state and county public health departments and nonprofits are grappling with the latest Trump administration health funding cuts, as more than $11 billion in COVID-era funding for a variety of health issues is cancelled, as NPR and others reported.
Those cuts will further weaken beleaguered state health departments, which are struggling to address everything from chronic and infectious diseases to addiction and mental health crises, reports The New York Times. In addition to pandemic-related efforts, the revoked funding was used to address health disparities among high-risk and underserved populations, including racial and ethnic minority populations and rural communities, reports NBC News.
The latest funding cuts add to the troubling news for health equity research overall – including the cancellation of National Institutes of Health grants for health equity research, reports Roll Call. Defunded projects include efforts to reduce health disparities among Black youth with chlamydia and research on Black maternal and fetal health.
Local reporting details losses from research cuts
Local reporters are detailing the impacts of ongoing public health funding cuts in their own communities.
At the University of Utah, researchers have lost funding for work on caring for critically ill babies in rural communities, and the disproportionate rate of skin cancer in these remote areas, reports The Salt Lake Tribune. Other canceled projects include research on how cancer impacts people living in poverty and the higher prevalence of cardiovascular disease among Black people.
At the University of Pittsburgh, two professors lost funding for their efforts to explore suicide vulnerability among young LGBTQ people, reports the Pittsburgh Post-Gazette. Meanwhile, The Colorado Sun described how Colorado School of Public Health professor Annie Collier lost a grant to study vaccine hesitancy in Alaska Native communities. Collier was also building an educational campaign that would help community members who wanted to be vaccine ambassadors, an effort set to begin this year.
“It feels terrible,” she told the Colorado Sun. “I think this is life-saving work, and it’s very confusing to have a message that vaccination is no longer valued.”
Scientists ‘concerned and confused’ about health equity crackdown
The recent federal funding cuts targeting health equity programs represent a marked shift from recent years. As the pandemic laid bare vast gaps in health, researchers responded with projects to identify and address those disparities — to the point where health disparities has become “a cornerstone of medical study” in recent years, explains NPR’s Shots.
Amid the changing political climate, researchers say they feel confused and concerned – with some adjusting the language they use in hopes their research doesn’t get flagged.
Scientists point to the misunderstandings inherent in eliminating work that can improve overall population health. For example, identifying health care gaps can reduce the country’s overall mortality rate from diseases like cancer.
For now, researchers will likely proceed with caution when using language that was previously commonplace in public health. Terms such as “health disparity” and “health equity” are listed among the hundreds of words or phrases the Trump administration has directed federal agencies to remove, limit or practice caution in using in government research, reports The New York Times.
In wake of 2023 Supreme Court ruling, med school diversity plunges
If this year’s med school enrollment figures are any indication, the country’s physician workforce will be markedly less diverse in upcoming years. The Supreme Court’s 2023 ruling banning race-based college and university admissions is already having significant implications on the racial and ethnic diversity of medical students, reports Annie Sciacca at KFF Health News.
The number of American Indian and Alaska Native students in U.S. medical schools dropped more than 22% in the 2024-25 academic year from the prior academic year. During that period, the number of Black enrollees dropped nearly 12% and the number of Hispanic students declined by about 11%.
These findings come amid an atmosphere of increasing attacks on diversity, equity, and inclusion (DEI) programs, and educators fear such efforts could further reduce the diversity of med students.
The health equity implications of this shifting environment could be far-reaching. Studies have found that having a Black primary care provider is associated with lower mortality among Black patients. And providers of color were more likely to reside in underserved areas, the article explains.
Physician describes new climate – and why health equity matters
Dr. Crystal Wiley Cené, a professor of medicine and chief administrative officer for health justice, equity, diversity and inclusion at UC San Diego Health, shared a personal experience that underscores the country’s dramatically shifting DEI landscape in a commentary published in the San Diego Union-Tribune.
At a private reception, a guest questioned Cené’s role in “health equity, diversity, and inclusion,” as noted on her name badge.
“I turned towards her and smiled, ready to introduce myself, when she abruptly stated, ‘I thought those roles were eliminated. How are you still here?’” she wrote.
“I was speechless,” she added. “No introduction. No greeting. Her question felt more like an accusation.”
In the op-ed, Cené stresses the numerous benefits of health equity work — including its strong economic component, pointing to studies that demonstrate the large financial toll of health disparities.
Creating “a more diverse health care workforce is better for patients, health care providers, communities and the financial performance of hospitals,” she writes.
Black-led clinic address health disparities in Ohio
Amid the Trump administration’s attacks on health equity efforts, health care industry outlet Healthcare Brew’s Maia Anderson shares the story of a Black woman-focused health center in Cleveland and its role in reducing health disparities. There, certified nurse midwife Dána Langford set to work addressing the health disparities Black women face, with a particular focus on maternal mortality. She describes a recurring problem in the many health care discussions on Black infant and maternal mortality she took part in.
“(A)s I sat in these conversations, nobody in the room looked like the community that was being ravished by the disparities of infant and maternal mortality, and a lot of the solutions were coming from Black-led organizations, but they were being told no,” Langford told Healthcare Brew.
She responded by creating the Village of Healing, a health center designed for Black women that opened in 2022. Now, there are two clinics and a third is slated to open later this year. The Ohio clinics provide culturally sensitive care and employ providers who look like the patients they see, helping build trust and connections that influence medical experiences and outcomes.
Despite the high demand for services, the center’s funding is still a challenge, especially given the uncertain future for government research funding involving race-related inequities, Anderson writes.
What we are reading:
- “Ovarian cancer test may not work on some Black, Native American patients,” by Frances Vinall, The Washington Post
- “Newsom’s office seeks another $2.8B to plug Medicaid gap,”by Rachel Bluth, Politico
- “Trump and DOGE propel V.A. mental health system Into turmoil,” by Ellen Barry, Nicholas Nehamas and Roni Caryn Rabin, The New York Times
- “Elimination of Federal Diversity Initiatives: Implications for Racial Health Equity,” by Latoya Hill, Samantha Artiga, Akash Pillai, and Alisha Rao, KFF
- “Where Americans spend the most on health care,” by Alex Fitzpatrick, Axios