Recent job and funding cuts at the U.S. Department of Health and Human Services (HHS) under the current administration have sparked widespread concern over the future of public health in America. Significant reductions affecting vital institutions like the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Office of Minority Health raise questions about whether there is a sincere plan to improve America’s health or if the intent is simply to dismantle existing infrastructures.
Current administration members defend these cuts, seemingly oblivious to the personal and societal harm they cause. Yet it’s critical to understand public frustration with the status quo; the U.S. has the world’s most expensive health care system but some of the worst health outcomes. While controversial, these cuts stem from a broader recognition that the current system isn’t working.
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However, analyzing these cuts reveals little evidence that such reductions will improve health outcomes. The surge in vaccine-preventable diseases, including two pediatric measles deaths in Texas and two more from whooping cough in Louisiana, highlights a worrying trend. These outbreaks, combined with severe cuts to public health infrastructure, could reverse decades of progress in life expectancy and well-being. Public health experts and community leaders are deeply concerned that we’re standing on the edge of a public health disaster.
As a former U.S. surgeon general, many health advocates have turned to me for guidance. My advice is simple—rather than panic or paralysis, we must focus on larger health goals and prepare for the challenges ahead. Though difficult, there is still hope, and together, we can work to improve the system in meaningful ways.
1. Elections Matter—and Accountability Is Key
Elections reflect the beliefs and frustrations of the American people. While democracy means accepting electoral outcomes even when we disagree, it’s essential for health advocates to raise awareness about the real-world consequences of decisions in Washington. We must ask: Are more Americans getting sicker? Are hospitalization rates increasing? Are health care costs rising for employers?
By gathering and disseminating data on how policies affect communities, we can empower citizens to advocate for change. Accountability extends beyond elections every four years; civic engagement should continue at the local level through town halls, state and local elections, and direct communication with policymakers. These actions often yield more immediate results than waiting for a chance to elect a new president.
2. Redefining the Status Quo
A key step toward improving American health is acknowledging that the system we have isn’t working. As the saying goes, “The definition of insanity is doing the same thing and expecting different results.” That’s why we can’t just complain about disruptions; we must propose viable alternatives to the issues plaguing our health care system.
The frustration many Americans feel has created an environment where drastic changes, even when harmful, are seen as preferable to the status quo. People didn’t vote for disruption for disruption’s sake; they voted against a system perceived as unwieldy and uncaring. To create real change, we must articulate a vision of a health care system that is accessible, effective, and empathetic.
3. Local Responsibility—a Larger Role for States and Communities
With the federal government scaling back its role in public health, responsibility for improving health outcomes will increasingly fall on states and localities. Health advocates must engage local officials, helping them understand the challenges citizens face, and ensuring resources are allocated appropriately and efficiently. Local policymakers must in turn push for sensible, evidence-based health policies at state and federal levels.
We must also collaborate with philanthropic organizations to guide evidence-based giving. These private sector contributions will be crucial as federal funding continues to decrease.
4. Empathy in Crisis—Recognizing the Human Cost
Regardless of political views, it’s crucial to recognize the human toll these decisions take. Thousands of federal health workers are losing their jobs, leaving their families in uncertainty. The ripple effects of these layoffs will undoubtedly increase anxiety, depression, and substance misuse, and cause higher rates of domestic violence and suicide.
Moreover, most working-age adults access health care through their employers. As thousands of federal employees lose their jobs, they will lose their health care coverage, further straining America’s health, and health care system.
5. Finding Hope in Adversity—a Path Forward
For those directly impacted by the recent cuts, it’s important to hold on to hope. Even in the most difficult circumstances, there can be opportunities for growth. While this may be hard to see now, a change in career or perspective can lead to new opportunities.
I believe that the scale, speed, and lack of clarity in recent HHS cuts pose an existential threat to our collective health. Yet, the status quo was unsustainable. As a former U.S. surgeon general, I implore our leaders to tackle these challenges with urgency, thoughtfulness, empathy, and long-term vision as they work to restore America’s fiscal and physical health.
I also call on health advocates to remain steadfast in the fight, critically assessing both our past and future efforts. This is not just about staving off cuts or resisting changes to a dysfunctional system; it’s an opportunity to build true health care that works for everyone. The road ahead will be difficult, but together, we can create a future where health is a shared priority, not a privilege of the few.
Jerome Adams, MD, MPH, FASA, is a distinguished professor at Purdue University. He served as U.S. surgeon general from 2017-2021, and as Indiana state health commissioner from 2014-2017.
The views expressed in this article are the writer’s own.
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