Changes in national health policy under the Trump administration exacerbate the health challenges faced by Black Americans.
Cuts to Medicaid and to the Supplemental Nutrition Assistance Program (SNAP), disproportionately harm the health of Black people by reducing access to preventive care and chronic disease management, increasing disparities in health outcomes, and worsening maternal and infant mortality rates.
During the COVID-19 pandemic Black communities experienced disproportionately high rates of COVID-19 infections, hospitalizations, and deaths. According to the National Institutes of Health, “This disparity is linked to long-standing social and economic inequalities, such as differences in health care access, socioeconomic status, and employment in essential frontline jobs increased exposure risk.”
COVID-19 vaccination helped to decrease the burden of the pandemic in Black communities by reducing infections, hospitalizations, and deaths, even though vaccination rates were initially lower in Black communities due to factors like hesitancy and structural inequities. Studies have shown vaccines are highly effective at reducing severe outcomes, and increasing vaccination rates in Black communities, despite existing health disparities, did help to control the pandemic within those communities.
The Centers for Disease Control and Prevention (C.D.C.), once a reliable guide in American public health, under Trump-appointed Secretary of Health and Human Services Robert F. Kennedy Jr., is in turmoil.
The new policy decisions from the C.D.C. restricting eligibility for COVID-19 vaccination and cutting federal funding, makes it harder for Black communities to access COVID-19 vaccination. The new COVID-19 vaccine guidelines limit the COVID-19 vaccine to adults over age 65 and younger people with high risk conditions. The new guidelines end the COVID-19 vaccine recommendation for children and pregnant women, putting their health at risk. These changes in the C.D.C. COVID-19 vaccine recommendations may limit insurance coverage and vaccine availability at pharmacies.
Limiting access to COVID-19 vaccination diminishes the important role that COVID vaccination plays in prevention of severe disease and death. For example, if you are unvaccinated, young and healthy you may readily recover from COVID infection or you may not have symptoms at all, but if you pass the infection to an older person or someone with underlying medical conditions, they may become severely ill. People who are vaccinated against COVID are significantly less likely to transmit the COVID virus to others. Vaccination helps protect the community as a whole.
Leading infectious disease and public health experts disagree with the recent C.D.C. curtailment in eligibility for COVID vaccination. Pediatric infectious disease expert Dr. Lakshmi Panagiotakopoulos resigned as co-leader of a C.D.C. COVID vaccine advisory group, saying this change put pregnant women and children at risk.
Extensive observational studies have found that vaccination significantly reduces the risk of severe COVID-19 infection during pregnancy, severe COVID-19 infection in pregnancy can cause maternal death and stillbirth.
The crisis in Black maternal health could be further exacerbated by restrictions in access to COVID vaccination.
As the flu season and winter approaches, it is especially important for the COVID vaccine and other immunizations such as influenza and pneumonia to be widely available.
The policies and practices of the Trump administration must be opposed and challenged, especially by doctors who care for and serve our communities.
Black leaders such as Rev. Al Sharpton have spoken out and organized against Trump’s cutting Medicaid and SNAP to fund tax cuts for wealthy businesses.
On Thursday August 28, the 62nd anniversary of the 1963 March on Washington, Rev. Sharpton led the March on Wall Street where thousands of people from all over the country protested the Trump-led corporate rollback of Diversity, Equity and Inclusion (DEI) programs and cuts to Medicaid and SNAP.
In 1966, Dr. Martin Luther King, Jr. spoke before the Medical Committee for Human Rights in Chicago and said, “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.”
The injustices of the Trump administration are innumerable but they are all aimed at destroying the determination, courage and independence necessary to fight injustice. In the spirit of Dr. King, we will keep on marching. Today more than ever, activism is necessary for our community’s health.
Dr. Jessie Fields is a primary care medical doctor in Harlem and she leads the Creating Our Mental Health social therapeutic sessions with poetry, performance, and music, building community.
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