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Miami Herald
a day ago
- Health
- Miami Herald
In a dusty corner of California, Trump's threatened cuts to asthma care raise fears
Esther Bejarano's son was 11 months old when asthma landed him in the hospital. She didn't know what had triggered his symptoms - neither she nor her husband had asthma - but she suspected it was the pesticides sprayed on the agricultural fields near her family's home. Pesticides are a known contributor to asthma and are commonly used where Bejarano lives in California's Imperial Valley, a landlocked region that straddles two counties on the U.S.-Mexico border and is one of the main producers of the nation's winter crops. It also has some of the worst air pollution in the nation and one of the highest rates of childhood asthma emergency room visits in the state, according to data collected by the California Department of Public Health. Bejarano has since learned to manage her now-19-year-old son's asthma and works at Comite Civico del Valle, a local rights organization focused on environmental justice in the Imperial Valley. The organization trains health care workers to educate patients on proper asthma management, enabling them to avoid hospitalization and eliminate triggers at home. The course is so popular that there's a waiting list, Bejarano said. But the group's Asthma Management Academy program and similar initiatives nationwide face extinction with the Trump administration's mass layoffs, grant cancellations, and proposed budget cuts at the Department of Health and Human Services and the Environmental Protection Agency. Asthma experts fear the cumulative impact of the reductions could result in more ER visits and deaths, particularly for children and people in low-income communities - populations disproportionately vulnerable to the disease. "Asthma is a preventive condition," Bejarano said. "No one should die of asthma." Asthma can block airways, making it hard to breathe, and in severe cases can cause death if not treated quickly. Nearly 28 million people in the U.S. have asthma, and about 10 people still die every day from the disease, according to the Asthma and Allergy Foundation of America. In May, the White House released a budget proposal that would permanently shutter the Centers for Disease Control and Prevention's National Asthma Control Program, which was already gutted by federal health department layoffs in April. It's unclear whether Congress will approve the closure. Last year, the program allotted $33.5 million to state-administered initiatives in 27 states, Puerto Rico, and Washington, D.C., to help communities with asthma education. The funding is distributed in four-year grant cycles, during which the programs receive up to $725,000 each annually. Comite Civico del Valle's academy in Southern California, a clinician workshop in Houston, and asthma medical management training in Allentown, Pennsylvania - ranked the most challenging U.S. city to live in with asthma - are among the programs largely surviving on these grants. The first year of the current grant cycle ends Aug. 31, and it's unknown whether funding will continue beyond then. Data suggests that the CDC's National Asthma Control Program has had a significant impact. The agency's own research has shown that the program saves $71 in health care costs for every $1 invested. And the asthma death rate decreased 44% between the 1999 launch of the program and 2021, according to the American Lung Association. "Losing support from the CDC will have devastating impacts on asthma programs in states and communities across the country, programs that we know are improving the lives of millions of people with asthma," said Anne Kelsey Lamb, director of the Public Health Institute's Regional Asthma Management and Prevention program. "And the thing is that we know a lot about what works to help people keep their asthma well controlled, and that's why it's so devastating." The Trump administration cited cost savings and efficiency in its April announcement of the cuts to HHS. Requests for comment from the White House and CDC about cuts to federal asthma and related programs were not answered. The Information Wars Fresno, in the heart of California's Central Valley, is one of the country's top 20 "asthma capitals," with high rates of asthma and related emergencies and deaths. It's home to programs that receive funding through the National Asthma Control Program. Health care professionals there also rely on another aspect of the program that is under threat if it's shuttered: countrywide data. The federal asthma program collects information on asthma rates and offers a tool to study prevalence and rates of death from the disease, see what populations are most affected, and assess state and local trends. Asthma educators and health care providers worry that the loss of these numbers could be the biggest impact of the cuts, because it would mean a dearth of information crucial to forming educated recommendations and treatment plans. "How do we justify the services we provide if the data isn't there?" said Graciela Anaya, director of community health at the Central California Asthma Collaborative in Fresno. Mitchell Grayson, chair of the Asthma and Allergy Foundation's Medical Scientific Council, is similarly concerned. "My fear is we're going to live in a world that is frozen in Jan. 19, 2025, as far as data, because that was the last time you know that this information was safely collected," he said. Grayson, an allergist who practices in Columbus, Ohio, said he also worries government websites will delete important recommendations that asthma sufferers avoid heavy air pollution, get annual flu shots, and get COVID-19 vaccines. Disproportionate Risk Asthma disproportionately affects communities of color because of "historic structural issues," said Lynda Mitchell, CEO of the Asthma and Allergy Network, citing a higher likelihood of living in public housing or near highways and other pollution sources. She and other experts in the field said cuts to diversity initiatives across federal agencies, combined with the rollback of environmental protections, will have an outsize impact on these at-risk populations. In December, the Biden administration awarded nearly $1.6 billion through the EPA's Community Change Grants program to help disadvantaged communities address pollution and climate threats. The Trump administration moved to cut this funding in March. The grant freezes, which have been temporarily blocked by the courts, are part of a broader effort by the Trump EPA to eliminate aid to environmental justice programs across the agency. In 2023 and 2024, the National Institutes of Health's Climate Change and Health Initiative received $40 million for research, including on the link between asthma and climate change. The Trump administration has moved to cut that money. And a March memo essentially halted all NIH grants focused on diversity, equity, and inclusion, or DEI - funds many of the asthma programs serving low-income communities rely on to operate. On top of those cuts, environmental advocates like Isabel González Whitaker of Memphis, Tennessee, worry that the proposed reversals of environmental regulations will further harm the health of communities like hers that are already reeling from the effects of climate change. Shelby County, home to Memphis, recently received an "F" on the American Lung Association's annual report card for having so many high ozone days. González Whitaker is director of EcoMadres, a program within the national organization Moms for Clean Air that advocates for better environmental conditions for Latino communities. "Urgent asthma needs in communities are getting defunded at a time when I just see things getting worse in terms of deregulation," said González Whitaker, who took her 12-year-old son to the hospital because of breathing issues for the first time this year. "We're being assaulted by this data and science, which is clearly stating that we need to be doing better around preserving the regulations." Back in California's Imperial Valley - where the majority-Hispanic, working-class population surrounds California's largest lake, the Salton Sea - is an area called Bombay Beach. Bejarano calls it the "forgotten community." Homes there lack clean running water, because of naturally occurring arsenic in the groundwater, and residents frequently experience a smell like rotten eggs blowing off the drying lake bed, exposing decades of pesticide-tinged dirt. In 2022, a 12-year-old girl died in Bombay Beach after an asthma attack. Bejarano said she later learned that the girl's school had recommended that she take part in Comite Civico del Valle's at-home asthma education program. She said the girl was on the waiting list when she died. "It hit home. Her death showed the personal need we have here in Imperial County," Bejarano said. "Deaths are preventable. Asthma is reversible. If you have asthma, you should be able to live a healthy life." _____ Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
Yahoo
07-04-2025
- Health
- Yahoo
How Kennedy's cuts to HHS could curb ‘MAHA' agenda
Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and the Department of Government Efficiency are reshaping the U.S. health care system, starting with deep cuts to the agencies Kennedy now leads. Kennedy and his allies argue such moves are needed to change federal culture and improve efficiency in the name of long-term health improvements. But critics question how Kennedy's 'Make America Healthy Again,' or MAHA, movement can be successful with a weakened federal health department. In his first public comments about the cuts, expected to impact around 10,000 staffers, Kennedy told reporters the government bureaucracy was too bloated. 'All these programs, all of the CDC, NIH … were not doing their jobs, and there was tremendous redundancy,' Kennedy told reporters Thursday, referring to the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). 'We're streamlining the agencies. We're going to make it work for public health, make it work for the American people.' Even critics concede the sprawling health department could work better, but they see the Trump administration's approach of seemingly indiscriminate job cuts as potentially harmful to Americans, including children. Among those fired were scientists who tested food and drugs for contaminants, analysts responsible for studying ways to save money on prescription medicines, communications staff who could inform the public about outbreaks and many more. The administration also fired the entire staff of CDC's Division of Environmental Health Science and Practice, including members who fought childhood lead exposure and those who worked on cancer clusters. That division helped discover lead contamination in applesauce pouches that were popular with kids. 'They were practicing evidence-based public health. They're aligned with the chronic disease priorities of the administration. And they were just terminated,' a former agency employee told The Hill. 'The secretary is concerned about chronic disease in this country and has repeatedly mentioned asthma as a specific concern. Is he aware he fired all the experts in CDC's National Asthma Control Program?' The MAHA movement wants to refocus the nation's efforts to spend less time and attention on treating illness and instead work to fix why people are getting sick. Kennedy has talked about putting lifestyle and diet at the fore of U.S. health policy by banning artificial food dyes, eliminating soda from the Supplemental Nutrition Assistance Program, and addressing rising rates of chronic illness such as diabetes and asthma in kids. He's also pledged 'radical transparency,' and in his first address to staff, he said, 'both science and democracy flourish from the free and unimpeded flow of information.' Yet on Tuesday, Kennedy eliminated entire agency communications teams and gutted staff responsible for processing Freedom of Information Act requests. Elsewhere, top subagency heads who might have clashed with Kennedy — such as Peter Marks, the top vaccine regulator — were ousted, and entire divisions were either eliminated, including groups focused on HIV prevention and violence prevention, or moved under HHS directly in a consolidation of Kennedy's oversight. 'Even if one thought that [the Food and Drug Administration] or HHS needs a reorganization, this isn't a sensible approach to doing that,' said Patricia Zettler, a law professor at the Ohio State University College of Law who served as HHS deputy general counsel until January. 'This is a tremendous amount of expertise that the agency is losing across all areas that it regulates.' Impacted staffers as well as outside observers described most of the cuts as arbitrary. 'It's very difficult to see how this is going to move a rational agenda forward,' said Robert Steinbrook, director of the health research group at watchdog organization Public Citizen. 'Many people with great institutional knowledge, who seem to have been doing a perfectly fine job as civil servants, were selectively targeted and forced to leave.' Among those fired was the official who approved the experimental drugs given to President Trump when he was infected with COVID-19, said David Kessler, who ran the Food and Drug Administration from 1990 to 1997, and was a top adviser on the pandemic response under former President Biden. 'Someone needs to walk into the Oval Office and say, 'Mr. President, we just fired the person who may have saved your life,'' Kessler said during an April 3 interview with Rachel Maddow. 'We're less safe today because of these cuts that have happened for the last several days,' Kessler added. 'I always thought that things were fixable. I am very concerned that if these cuts are not rescinded, these will [have an] effect for decades.' While it's too early to tell exactly how such drastic changes will affect health care in the country, most experts have said they are not optimistic. 'These are reckless, thoughtless cuts that will only make American communities less healthy and less safe,' Richard Besser, CEO of the Robert Wood Johnson Foundation and a former acting CDC director, said in a statement. 'They represent an abdication of the department's essential responsibility to promote and protect health.' Some of the cuts could still be reversed. In his comments to reporters Thursday, Kennedy acknowledged some eliminated positions and programs may be reinstated, like the program that monitors blood lead levels for children. 'There were a number of instances where studies that should not have been cut were cut, and we've reinstated them. Personnel that should not have been cut were cut. We are reinstating them. And that was always the plan,' Kennedy said. 'One of the things that President Trump has said is that if we make mistakes, we're going to admit it. And we're going to remedy it.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
The Hill
07-04-2025
- Health
- The Hill
How Kennedy's cuts to HHS could curb ‘MAHA' agenda
Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and the Department of Government Efficiency are reshaping the U.S. health care system, starting with deep cuts to the agencies Kennedy now leads. Kennedy and his allies argue such moves are needed to change federal culture and improve efficiency in the name of long-term health improvements. But critics question how Kennedy's 'Make America Healthy Again,' or MAHA, movement can be successful with a weakened federal health department. In his first public comments about the cuts, expected to impact around 10,000 staffers, Kennedy told reporters the government bureaucracy was too bloated. 'All these programs, all of the CDC, NIH … were not doing their jobs, and there was tremendous redundancy,' Kennedy told reporters Thursday, referring to the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). 'We're streamlining the agencies. We're going to make it work for public health, make it work for the American people.' Even critics concede the sprawling health department could work better, but they see the Trump administration's approach of seemingly indiscriminate job cuts as potentially harmful to Americans, including children. Among those fired were scientists who tested food and drugs for contaminants, analysts responsible for studying ways to save money on prescription medicines, communications staff who could inform the public about outbreaks and many more. The administration also fired the entire staff of CDC's Division of Environmental Health Science and Practice, including members who fought childhood lead exposure and those who worked on cancer clusters. That division helped discover lead contamination in applesauce pouches that were popular with kids. 'They were practicing evidence-based public health. They're aligned with the chronic disease priorities of the administration. And they were just terminated,' a former agency employee told The Hill. 'The secretary is concerned about chronic disease in this country and has repeatedly mentioned asthma as a specific concern. Is he aware he fired all the experts in CDC's National Asthma Control Program?' The MAHA movement wants to refocus the nation's efforts to spend less time and attention on treating illness and instead work to fix why people are getting sick. Kennedy has talked about putting lifestyle and diet at the fore of U.S. health policy by banning artificial food dyes, eliminating soda from the Supplemental Nutrition Assistance Program, and addressing rising rates of chronic illness such as diabetes and asthma in kids. He's also pledged 'radical transparency,' and in his first address to staff, he said, 'both science and democracy flourish from the free and unimpeded flow of information.' Yet on Tuesday, Kennedy eliminated entire agency communications teams and gutted staff responsible for processing Freedom of Information Act requests. Elsewhere, top subagency heads who might have clashed with Kennedy — such as Peter Marks, the top vaccine regulator — were ousted, and entire divisions were either eliminated, including groups focused on HIV prevention and violence prevention, or moved under HHS directly in a consolidation of Kennedy's oversight. 'Even if one thought that [the Food and Drug Administration] or HHS needs a reorganization, this isn't a sensible approach to doing that,' said Patricia Zettler, a law professor at the Ohio State University College of Law who served as HHS deputy general counsel until January. 'This is a tremendous amount of expertise that the agency is losing across all areas that it regulates.' Impacted staffers as well as outside observers described most of the cuts as arbitrary. 'It's very difficult to see how this is going to move a rational agenda forward,' said Robert Steinbrook, director of the health research group at watchdog organization Public Citizen. 'Many people with great institutional knowledge, who seem to have been doing a perfectly fine job as civil servants, were selectively targeted and forced to leave.' Among those fired was the official who approved the experimental drugs given to President Trump when he was infected with COVID-19, said David Kessler, who ran the Food and Drug Administration from 1990 to 1997, and was a top adviser on the pandemic response under former President Biden. 'Someone needs to walk into the Oval Office and say, 'Mr. President, we just fired the person who may have saved your life,'' Kessler said during an April 3 interview with Rachel Maddow. 'We're less safe today because of these cuts that have happened for the last several days,' Kessler added. 'I always thought that things were fixable. I am very concerned that if these cuts are not rescinded, these will [have an] effect for decades.' While it's too early to tell exactly how such drastic changes will affect health care in the country, most experts have said they are not optimistic. 'These are reckless, thoughtless cuts that will only make American communities less healthy and less safe,' Richard Besser, CEO of the Robert Wood Johnson Foundation and a former acting CDC director, said in a statement. 'They represent an abdication of the department's essential responsibility to promote and protect health.' Some of the cuts could still be reversed. In his comments to reporters Thursday, Kennedy acknowledged some eliminated positions and programs may be reinstated, like the program that monitors blood lead levels for children. 'There were a number of instances where studies that should not have been cut were cut, and we've reinstated them. Personnel that should not have been cut were cut. We are reinstating them. And that was always the plan,' Kennedy said. 'One of the things that President Trump has said is that if we make mistakes, we're going to admit it. And we're going to remedy it.'
