Introduction
On January 25th 2025, the Trump administration issued an executive order titled "Ending Radical and Wasteful Government DEI Programs and Preferencing," aiming to dismantle diversity, equity, and inclusion (DEI) initiatives within federal agencies. This order has led to the removal of critical public health data from federal websites, including datasets from the Centers for Disease Control and Prevention (CDC) such as the Behavioral Risk Factor Surveillance System, Youth Risk Behavior Surveillance System, and the Social Vulnerability Index. These actions will have significant implications for all efforts to protect the health of Americans, including medical care, policy development, and public health research.
Methodologic Challenges
The recent executive order's mandate to eliminate DEI-related content has led to the removal of essential datasets and health guidelines from federal websites. This data purge hinders clinicians’ and researchers' ability to care for patients, provide accurate, evidence-based information to patients and the public, research why some groups have systematically worse health than others, and develop informed interventions. These changes impede progress toward health and equal opportunities for all people to live healthy lives. All Americans will potentially suffer from these changes, but individuals from some communities will bear disproportionate harm from these changes, including Indigenous communities. The absence of comprehensive data exacerbates challenges in understanding and addressing the unique health needs of diverse populations. Moreover, the potential data deletions risk erasing decades of research that have provided evidence for policy solutions and health interventions for structurally and historically marginalized groups. The removal of accessibility, gender, and DEI-related data will bias study results, as the lack of data on specific populations distorts findings and contributes to misinformed policy decisions that fail to address systemic inequities. Furthermore, it creates a chilling effect on research and public health initiatives. Researchers may become hesitant to pursue studies involving said topics, fearing political repercussions or loss of funding. This environment stifles innovation and discourages the exploration of critical issues affecting our communities.
The deletion of data also poses significant challenges for documentation and data collection. The removal of datasets related to gender, DEI, and accessibility from the CDC and other federal websites affects various vital information sources, potentially erasing essential demographic insights crucial for public health efforts. This loss of data undermines the ability to appropriately address health disparities across communities, affecting disease tracking, intervention development, and funding allocations. Additionally, funding cuts and policy changes ended training resources designed to eliminate economic, social, geographic, and cultural barriers that prevent promising early career scientists from pursuing research careers. Removing those supports will further exacerbate disparities in academic and professional opportunities and over the long run, health and well-being.
The absence of data for targeted groups often translates into the absence of programs and interventions. For example, when documentation status is not accounted for in research, policies fail to address the needs of immigrant populations, leading to exclusion from essential health and social services. Similarly, the elimination of accessibility, gender, and DEI-related data prevents the development of targeted programs that may address racial and health disparities. From 1900 to 1990, the United States clocked an extraordinary and almost uninterrupted increase in life expectancy. This progress slowed and then reversed in recent decades, leading to declines in life expectancy in the United States, especially in comparison to other high income countries. The elimination of research progress targeted to address racial and social disparities in health will accelerate the health declines of recent years.