The Washington Post published a story Saturday that revealed the Trump administration banned budget staff at The Centers for Disease Control and Prevention from using the following seven words: “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.”
Although the CDC Director Dr. Brenda Fitzgerald tweeted on Sunday that there are no banned words at the agency, it is important to discuss the meaning of these words. Why is it they are so powerful in maintaining and improving the nation’s health?
VULNERABLE. The World Health Organization defines vulnerability as “the degree to which a population, individual, or organization is unable to anticipate, cope with, resist and recover from the impact of disasters.” This term may be referring to those facing economic disadvantages, racial/ethnic minorities, those living in poverty, or those with a chronic illness such as HIV. All of these groups disproportionately experience health impacts and thus need more assistance from public health professionals.
ENTITLEMENT. Entitlement programs are government-funded programs that provide a service or benefit to someone who meets eligibility requirements. Examples include Medicare, Medicaid, unemployment and Supplemental Nutritional Assistance Program. SNAP provides food stamps to individuals and families, and has proven to reduce the number of Americans living in extreme poverty.
DIVERSITY. President Donald Trump’s campaign slogan, Make America Great Again, was intended to rally Americans behind improving the economy and creating jobs. What actually makes America great is our diversity. Between 2000 and 2010 the Hispanic population increased by 43 percent. By 2050, minorities will be the majority in the United States, including a doubling of persons over age 65. In public health, we value and embrace diversity, not ignore it, because it empowers us to be inclusive and makes us more receptive to different ideas.
TRANSGENDER. Transgender persons are those whose gender identity is not consistent with the biological sex assigned at birth. It is well documented in scientific literature that transgender people experience disproportionate rates of stigma and discrimination, lack of access to health care and prevention services, and experience higher rates of homicide, bullying, mental health illnesses, substance misuse and HIV. Public health professionals are striving to promote inclusive policies to reduce disease transmission and increase well-being and the quality of life for individuals of trans experience.
FETUS. The fetal stage of development is from conception to eight weeks. Noncontroversial, right? Wrong. The controversy lies in the following questions: Does a fetus have the status of a legal person? Does a fetus have a right to life? Is abortion a violation of a fetus’ right to life? Our nation’s prevention agenda aims to improve the health and well-being of women, infants, children and families. Women’s health should include a woman’s right to decide what is best for her and her unborn baby. Public health supports a woman’s legal right to a safe abortion.
EVIDENCE-BASED. In our graduate public health programs at Hofstra University, we teach students to use evidence-based decisions about which policies, strategies and interventions to plan, implement, and evaluate. This involves synthesizing research and evaluation findings to develop our scientific reasoning and inform decision-making. Let’s practice what we teach!
SCIENCE-BASED. To advance medicine, health care and public health we need to conduct rigorous research to see what works and what does not. This involves developing hypotheses, designing studies to test the hypotheses, observing results, and disseminating results so that others can learn from our successes and challenges. The Trump administration should allow public health scientists at the CDC to use their advanced training to fulfill the agency’s mission of saving lives and protecting people from health, safety and security threats.
It is dangerous when an administration’s ideology interferes to this degree with the ongoing work of science and public health. Let’s remember, it’s all about science, not silence!
Anthony J. Santella is an associate professor of health professions and director of graduate public health programs at Hofstra University.