As I read the new budget proposal that the Trump administration released on Tuesday, my head spun. The gutting of programs that support education, healthcare, and research is vast, its potential impact so devastating not only to the health of individuals and institutions but to our wellbeing as a society. As painful and mind-boggling as it may be to many in our field, it’s important to sift through these policies and consider their consequences. And most important, to consider what it means to us as public health educators, researchers, and practitioners.
Let’s begin with research. The National Institutes of Health and Centers for Disease Control would each sustain a whopping 21 percent cut, the National Science Foundation 11 percent. Moreover, the budget virtually eliminates those indirect costs which help to maintain the research infrastructure of universities. Temple, for example, now receives 56 cents per federal grant dollar, earmarked to facilitate research; under the proposed budget that amount would be reduced to 10 cents on the dollar. Applied across the board, a cut like this essentially reserves federal research dollars for those universities that are already the wealthiest and best-endowed.
The budget cuts are just as punishing to our students. It would eliminate the Public Service Loan Forgiveness (PSLF) program, established to lift the student-loan burden for graduates who take jobs in service organizations and professions that are historically underpaid. The budget also proposes major changes to income-based loan repayment programs and eliminates funding for 14 health-professions training programs that help to bring underrepresented minorities into the healthcare workforce and encourage health professionals to practice in geographically underserved areas. These cuts and more feel like a direct hit to the Temple CPH community and others like us.
And those individuals and communities we serve? The budget takes a particularly severe stance, with $2.5 trillion in cuts to anti-poverty programs over 10 years. Tallying the losses: food stamps, $191 billion; the Earned Income Tax Credit and Child Tax Credit, $40.4 billion; welfare, $21.6 billion; disability and Supplemental Security Income, $72 billion. Bam. Slash. Kick. Reading these numbers, it’s hard for it not to feel like an assault.
Unsurprisingly, programs that help to ensure broad population health such as the National Institute for Occupational Safety and Health and the National Oceanic and Atmospheric Administration would be zeroed out – doing nothing to reduce environmental sources of disease that perpetuate a treatment-based healthcare system and add to the burden of care and cost for everyone.
There is some hope. Experts have already started to console us, saying the budget is more position statement than working document. Clare McCann, a senior policy analyst in New America’s education-policy program, told the Chronicle of Higher Education that the president’s proposal is not likely to take hold given congressional budgeting protocol and lawmakers’ responsibility to voters. “The implications of the cuts for their constituents would be severe,” she said.
What does it all mean to us? That as public health professionals, researchers, and educators, we must speak out in support of our mission and in defense of our communities.