Inside the C.D.C., a Final ‘Love Letter' Before Mass Layoffs
When every email inbox in the division pinged with a new message at 5:07 p.m. on Friday, the staff collectively held their breath.
But it wasn't the dismissal notification that these employees of the Centers for Disease Control and Prevention had been waiting for. Quite the opposite: It was, the subject line said, a 'love letter.'
The author was Sarah Roby, a health communications specialist in the C.D.C.'s injury center, and the note would be read and reread throughout the weekend by her colleagues as they awaited their fate. The recipients worked in the injury center's division of violence prevention, which focused on driving down rates of child abuse, sexual violence and gun deaths by collecting data, funding research and rolling out state and local programs that used evidence-based strategies.
Injuries are the leading cause of death for Americans under 45 years old, and interventions like bicycle helmets, car seats and crisis hotlines are considered wildly cost-effective, since the horrors they prevent down the road are so expensive to society.
But much as with vaccines, experts said, it can be a challenge to convince the public that injury prevention is worth investing in, because it is hard to help people recognize an event that never occurred.
Ms. Roby told her colleagues about what had initiated her career: a shift at a shelter in Henry County, Ga., when a woman arrived on a Greyhound bus from Oklahoma after being thrown off the balcony of her apartment.
As she drove home that night, years ago, Ms. Roby wrote, she wondered about a better way to respond to domestic violence — not just to serve those who experience it, but also to prevent it in the first place.
Recipients of Ms. Roby's email said they wept at its resonance, holding out their iPhones so that spouses could see the words or reading them aloud to friends over dinner. One showed it to a 16-year-old nephew to help him understand 'what this country is losing.'
They said Ms Roby's words had captured the dedication of public health workers at a pivotal moment in history, when the rise of anxiety, depression, social media and fentanyl have collided, driving teenage injury deaths so high that they reversed decades of a downward trend.
The injury center maintained a widely used database that tracked meticulous details of injury trends in various age groups and demographics so that effective interventions could be designed. More than 80 percent of the injury center's budget went directly to states and local governments and nonprofit organizations so they could collect the data and roll out well-designed programs.
'Talk about government efficiency: It's much better to figure out the best way to do something and replicate it 50 times than to have all 50 states trying separately,' said Dr. Mark Rosenberg, who helped found the injury center and served as its first permanent director. 'That careful coordination was the injury center's magic.'
In the end, Ms. Roby's letter made its way to the injury center's statisticians and data scientists, economists and epidemiologists. It reached grant coordinators, program officers and some of the world's leading experts on car crashes, falls, drownings, poisonings and traumatic brain injuries in sports.
By sunrise on Tuesday morning, most recipients of the letter had been terminated.
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