The protection of public health across the nation relies heavily on data, whether it be tracking new measles cases, increases in emergency room visits, or evolving obesity trends. Recent layoffs at the Centers for Disease Control and Prevention (CDC) pose a significant threat to the largely invisible backbone of public health research.
The CDC’s division within the National Center for Health Statistics (NCHS), which oversees the National Health and Nutrition Examination Survey (NHANES)—a critical indicator of the country’s health—suffered the loss of all its planning staff in the latest round of firings. Unlike the 600 out of 1,300 employees laid off across various departments who were reinstated within 24 hours, the personnel responsible for orchestrating and disseminating research that guides public health policy—from nutrition to environmental health—received no such reprieve.
“We’re discussing a small but highly committed segment of a larger division,” former planning branch chief David Woodwell stated to STAT. “This is devastating, and it will be incredibly challenging for the survey to proceed without this group because, as skilled as the remaining staff may be, they lack the deep understanding and experience required to manage the survey’s operations with field contractors on a daily basis. This will be a daunting task—extremely, extremely difficult.”
According to the National Library of Medicine, NHANES serves as the primary source of data measuring the health and nutritional status of the community, well-known for its combination of rigorous data measurements and comprehensive questionnaires.
Located in Hyattsville, Maryland, the NCHS has been providing data on prevalent diseases and health behaviors through nationally representative surveys for 60 years. These surveys are conducted by contractors who assess the health and nutrition of Americans through questionnaires, followed by health assessments and laboratory tests. The total number of employees terminated across NCHS’s divisions (data analysis, informatics, operations, and planning) is approximately 100, including all eight staff members who had survived previous cuts on February 14 and April 1, which had also encouraged retirements.
Woodwell referred to them as “boots on the ground,” ensuring that all health exams and questionnaire interviews were conducted as intended on a daily basis. They were also responsible for planning forthcoming surveys and analyses.
“I have worked alongside them for a decade, and I hold them in high regard. I remain in contact with them frequently,” said Woodwell, who is now retired. “So I am aware that none of those eight positions have been restored.”
The layoffs followed President Trump’s commitment to firing federal employees during a government shutdown over stalled budget discussions. “All HHS employees receiving reduction-in-force notices were deemed non-essential by their divisions,” HHS spokesperson Andrew Nixon conveyed to STAT.
What may be lost
Potentially at stake: crucial information regarding health services, hospitalizations, emergency room visits, office visits, and individual health indicators.
“Any data pertaining to emerging outbreaks will also be jeopardized,” expressed Denys Lau, a former director of a division tracking national health care delivery and usage, now editor-in-chief of the American Journal of Public Health, in an interview with STAT.
The insights gained from NHANES are disseminated to both the public and various federal agencies, including the National Institutes of Health and the Food and Drug Administration. The routine NCHS reports are characterized by their meticulous avoidance of speculation or discourse, relying on survey responses augmented by patient metrics obtained in mobile exam centers.
Much like many aspects of public health initiatives, this effort often goes unnoticed—people do not see the infections they did not acquire. Data collection is even less visible, so naturally, the roles of those organizing this process operate further from public view.
Now Woodwell, Lau, and other former staff are advocating for awareness of the significance of their colleagues’ contributions. NHANES and its stringent protocols are recognized and replicated globally, Woodwell pointed out. The data collected historically facilitated the removal of lead from gasoline and paint and led to the nutritional labels now standard on food packaging.
“NHANES has a far-reaching impact,” he mentioned. “The value it has imbued to the nation over decades is often underappreciated.”
Collaborating with researchers at NIH, members of the planning branch were equipped with insights into research needs and ensured their fulfillment, Woodwell shared. This involved overseeing daily contractor activities, data editing, and subsequent public releases.
While benefiting its approximately 5,000 participants was never the primary aim of NHANES, it has yielded tangible health benefits.
“We can detect undiagnosed conditions like hypertension or diabetes—issues that participants may remain unaware of until they visit our mobile exam centers,” Woodwell explained. “We can provide them with essential health information that could otherwise cost thousands if they sought such testing privately.”
What’s next?
With the elimination of the NCHS communications office as well, Lau expressed concern about the center’s ability to meet its responsibility to deliver data in an unbiased, nonpartisan manner to STAT.
Previously, reports underwent review by the NCHS Office of Science for accuracy in data representation. Now, information from NCHS must navigate a new clearance process at the CDC, which Lau fears could be swayed by political influences. In a statement to the media, Lau and his colleague Jennifer Schoendorf, former NCHS director of research and methodology who now serves as senior deputy editor at a public health journal, cited recent federal public health policy recommendations regarding vaccines, drinking water fluoridation, and ultra-processed foods as examples of potential bias.
Lau is perplexed by the diminished capacity to monitor the public health concerns prioritized by Health Secretary Robert F. Kennedy Jr., including obesity, nutrition, oral health, and environmental chemical exposure.
Ultimately, both Woodwell and Lau express profound concern over the data gaps that will emerge following these staffing reductions at the CDC they once recognized and valued.
“The RIFs may have spared certain sections of NCHS, but a vehicle can’t operate if it’s missing a tire or the steering wheel,” Lau remarked.
STAT’s reporting on chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters do not partake in any editorial decisions.
