Democratic View: Is public health dead? No, but it’s on life support

It’s about prevention

Editor’s note: The opinions expressed in this column are those of author Stewart Auyash and are not representative of the thoughts or opinions of Tompkins Weekly. 

Public health has always been a hard sell.

The public does not like regulations on their activities and politicians don’t want to spend money on anything that will not provide immediate gratification and more votes. Consider, for example, how long it took to establish and enforce smoking bans in public places and airplanes, and requiring seat belts in cars.

Many lives have been saved by these actions.

Fortunately, it does appear that the Trump administration has plans, yet, to roll back the laws that ban smoking in public places or require seat belt use. But that’s about the only good news about the current assault on public health.

The current assault on global public health

The list of the damage to public health already done by the Trump administration is long. Sadly, the resulting damage is already beginning to show, most obviously in the budget cuts to USAID (US Agency for International Development).

USAID plays a significant role in global public health programs that focus on preventing disease. Their efforts span across various areas, including maternal and child health, infectious disease control (HIV/AIDS, TB, malaria), and pandemic preparedness. 

The British medical journal Lancet found that in the absence of USAID’s funds and works, 14 million more people would die in the next five years, a third of those children under 5.

The assault on public health in the U.S. 

Vaccines

Closer to home we see the impacts of the impertinent comments and actions taken about vaccines by the Secretary of Health and Human Services, Robert F. Kennedy, Jr. (RFK). For example, the CDC reports there have been 27 measles outbreaks already reported in 2025 compared with 16 in all of 2024.

The pushback on RFK’s past comments about using vitamin A and other unproven remedies had a negative impact. He finally admitted that vaccines do provide community immunity, but the damages left by his falsehoods remain.

More recent information about vaccines is available on “What the Health?” written by Ithaca College grad, Shelley Facente.

Medicaid 

Many of you have already learned about the major cuts to Medicaid (health care for individuals, families, and children below a certain income level).  The impact on NYS and all counties will be considerable. Trump has stated that he wants the states and local governments to pick up the lost funds.

Medicaid, unlike Medicare, provides social services in addition to medical care payments. These include transportation, nurse home residency, medications, preventive care exams, and more.

According to Governor Hochul’s announcement, the cuts to Medicaid will amount to $13 billion per year. This impacts patients, hospitals, providers, nursing homes, and workers at nearly every level of care from birth to old age and death.

Over 2.5 million children are covered under Medicaid or Child Health Plus (a related program funded jointly by the state and federal government).  Many of these children and their families also qualify for SNAP (Supplemental Nutrition Assistance Program), which is also part of the cuts.

The resistance

While all the bad news (I provided merely a fraction) may seem that public health is dying, there are many who are resisting. Through legal means, writing for the public, contacting our elected representatives, organizing actions and protests, public health activists are part of the larger sphere that is pushing back hard and often.

“Defend Public Health” is an active listserve comprised of public health professionals and activists. They organize workshops, opinion essay campaigns, meetings, and data gathering groups and more. If you would like to participate, send a message to this email: general@defendpublichealth.org

A highly qualified epidemiologist, Katlyn Jetelina, designed “Your Local Epidemiologist,” which can be accessed online. You can sign up to receive her incisive and easy to read newsletter about  the damage caused by cuts, explanations and data about vaccines and other illness related topics.

At the beginning of June, a group of about 300 current employees at the National Institutes of Health wrote the “Bethesda Declaration” which warned of the damage the cuts will have.

Remember, public health actions save lives and will continue to do so. It will never die.

Stewart Auyash was chair and associate professor in the Department of Health Science and Public Health at Ithaca College from 1981 to 2025.

For those interested in reading more, here are some of the best recent sources I found.  

Medicaid: ‘Limit Save Grow’ Medicaid Work Mandate Legislation: The Worst Way To Operationalize A Bad Policy’ by Sara Rosenbaum and Alex Somodevilla.

SNAP cuts: A New Era of Hunger has Begun by Tracy Kidder.

The Entire Future of American Public Health Is at Risk by David Wallace Wells.

How to Wreck the Nation’s Health, by the Numbers, by Steven H. Wolfe.

Environment: EPA aims to cut pollution rules projected to save nearly 200,000 lives: ‘Real people will be hurt.’ By Oliver Milman and Dharna Noor.