Health and science experts on their hopes and concerns for the Trump era

Public health policy became a defining – and controversial – issue for Donald Trump when the Covid-19 pandemic hit the last time he was in the White House.

Now, as he prepares for his second term as president, he has pledged to reduce the rate of chronic diseases through his “Make America Healthy Again” plan, setting up figures such as anti-vaccination advocate Robert F. Kennedy, Jr.. programs and institutions. The plan’s broad implications could affect everything from the Food and Drug Administration to academic research institutions and even grocery store shelves.

STAT asked experts in heart disease, health equity, epidemiology, and more for their thoughts on how the new system could affect the future of health research and science. Their answers are edited for length and clarity.

On the future of public health and chronic diseases

Clyde Yancy, chief of cardiology, Northwestern Medicine; former president of the American Heart Association

We benefit from health services and network technologies that are hard to build – and work well. The best aspects of the Affordable Health Care Act are now deeply embedded in American society; for example, coverage to age 26 and Medicaid expansion. AND, Medicare is sacred. Leave it alone.

Politics as we know it today is laborious and short-lived, unmotivated and short-lived. Most people want to live, but heart disease is still the biggest risk; The drive for our continued discovery, diagnosis and treatment of heart disease is unwavering and likely to continue. In the past 12 years, we’ve had three very different White House administrations, but heart health and health care have remained intact.

Dariush Mozaffarian, director, Tufts Food is Medicine Institute; cardiologist and professor at Tufts Friedman School of Nutrition Science and Policy

In the interest of [Make America Healthy Again] around food, it will be important to see if this fight will be taken by President Trump and Congress. We are facing a national nutrition crisis – to me a great challenge, and opportunity, for the country. We already invest hundreds of billions of dollars in Medicare, Medicaid, nutrition programs, farm subsidies and NIH research.

Meanwhile, the ‘F’ is sorely lacking in the FDA. I hope we can incorporate Food Is Medicine into routine clinical care, ensure nutritional safety in USDA food and aid programs, advance nutrition science at the NIH, and equip the FDA with resources and power to remove preservatives and harmful chemicals from our food.

Ziyad Al-Aly, a senior epidemiologist at the University of Washington

This is an opportunity to change the organizations that have defeated the American people from the NIH to the CDC to the FDA and others within HHS and beyond. From the obesity epidemic, to drug abuse, to reduced life expectancy, these organizations have proven ineffective, burdened/burdened by bureaucracy and largely devoted to the people of America. This is an opportunity to prepare the training. We must work together to improve the health and well-being of all Americans.

Georges Benjamin, executive director of the American Public Health Association

Everyone is shocked now. Everyone is trying to figure out, clearly, where we go from here.

There is a lot of concern about what a second Trump will look like, or whether or not it will be Groundhog Day.

Let’s start with the staff. Who will you choose? [We’re] I am confident that you will appoint people to the administration who are trained, skilled and capable… [but] RFK Jr. and [Joseph] Ladapo down in Florida is not on my list of candidates. ”

Lisa McCorkell, co-founder, Patient-Led Research Partnership

More than 20 million American adults and children have chronic Covid; millions more have other chronic infections-related illnesses and have been suffering for decades. I am deeply concerned that existing access to health care, access to the safety net, and research funding issues will worsen, which will have a negative impact on the lives of Americans, and that many people they will join our society if Covid continues to spread unchecked.

The Trump administration must prioritize ensuring that people have access to health care, that the safety net is there and strong for those who need it, that people have the right and ability to protect themselves from viruses, and that there is significant research funding. for long covid and other chronic conditions related to infection lead us to treatment and cure. These issues are not just one party — we’ve seen bipartisan support in Congress, and we’re going to need more leaders to step up and solve this problem across the state.

On the future of health equity

Daniel E. Dawes, associate dean, School of Public Health at Meharry Medical College and author of “The Political Determinants of Health”

The movement to advance health equity for all in our community does not stop at the polls.

I applaud the fact that so many people participated in our elections because voting is a powerful political sign of health. Now that we have social care, there is fertile ground to find common ground in terms of health equity, to eliminate barriers that have prevented people from achieving their health. The United States today ranks 60th in the world for life expectancy, down from 34th in 2016, and is expected to continue its downward slide.

I hope that the new administration will use this opportunity to build bridges across social, political, economic, and geographic lines because the quest for health is common across these lines.

The past few years have shown us that what we as a country prioritize in terms of health policy and health equity, sets a global agenda. Everyone expects our country to lead the way, and this election has given us the perfect opportunity to show ourselves as unsung champions of health equality.

I worry that these efforts may take a back seat because the National Academy of Medicine recently issued a report on Ending Unequal Treatment that shows that in the last 20 years we have made little progress in ending the disparity in health. beauty because it was not placed before the measure it needed. investment was inconsistent and scarce.

On the future of scientific research

Carrie Wolinetz, chair of the Health Bioscience Innovations Practice at Lewis-Burke; former senior adviser to the National Institutes of Health

Another interesting thing to watch is how the second term of the Trump Administration thinks about ARPA-H – even though it is already considered a signature initiative of the Biden Administration, which successfully established, it was a concept that appealed to President Trump in his first term. time, as he was close to Bob Wright, the agency’s chief spokesman (although it was called HARPA at the time). It was raised specifically for the purpose of research into the relationship between mental illness and gun violence, and it will be interesting to see if that changes to the agency’s performance during the second season.

Holden Thorp, editor-in-chief of the Science family of journals

It provides a strong reminder that the institution of science and higher education and the creation of knowledge in general has not captured the attention of the majority of the coalition that Trump has built.

Most of that gathering is losing trust in institutions, and science and higher education and academia and the medical establishment, these are all institutions that need to be trusted in order to restore people’s trust.

I think we have to find new ways to get scientific information into the public where it can be disseminated in strategic ways… it has a better way of debating rather than who has the evidence. at best they do a lot for anyone.

We have to do a better job of explaining how science works and working with standards that we all accept, about being prepared and representing science when it’s right.

Jennifer Jones, director of the Center for Science and Democracy at the Union of Concerned Scientists

President-elect Trump, and his Agenda 2025, have promised an all-out war against science and scientists. He and his anti-science crusaders are already working with corporate polluters to scare scientists and science aside – putting society, people and the planet at risk. The reason for this powerful and dangerous program is simple. Scientists do work that stands in the way of self-serving officials and corporate polluters who put power and profit over people.

Trump’s last presidency saw 207 attacks on science, including censorship, misinformation, political interference, and intimidation of scientists.

We expect the incoming Trump administration to continue those attacks and do everything it can to silence science and scientists who threaten its goals and those of its corporate partners. We will work to advance federal legislation that permanently establishes ethical principles and practices throughout the federal government, that prevent undue and undue influence by special business interests, and undoing the damage caused by recent Supreme Court decisions that undermined the ability of government agencies to implement equity. science-based policies.