PI's Weekly Media digest: Trump admin releases 2018 budget proposal; school shooting in Florida; Senate votes on immigration fail
On February 14, a gunman killed 17 people and wounded many others at a high school in Parkland, Florida. Nancy LeTourneau of Washington Monthly ties this week’s school shooting to recent research published in Health Affairs (and shared in an earlier media digest) that found that “a child born in the United States has a 70 percent greater chance of dying before adulthood than kids born into other wealthy, democratic countries.” The researchers found three categories that contributed to this shameful record: “Between 2001 and 2010, researchers found that the risk of death in the United States was 76 percent higher for infants than in peer countries. In addition, the US has an infant death rate from extreme prematurity three times that of its peer countries. …children between the ages of 15 and 19 are 82 times more likely to die from gun homicide in the United States than in peer countries. US teenagers are twice as likely to die in car accidents than their peers abroad.” In his remarks on the shooting, President Trump downplayed guns, instead blaming the shooting on “the difficult issue of mental health.” German Lopez at Vox writes, “Mental health is not what makes America uniquely vulnerable to gun violence. As my colleague Dylan Matthews explained, people with mental illnesses are more likely to be victims, not perpetrators, of violence… The real problem, instead, is guns — and, specifically, America’s extraordinary stockpile of firearms. The US has by far the highest number of guns in the world: According to a 2007 estimate, the number of civilian-owned firearms in the US was 88.8 guns per 100 people, meaning there was almost one privately owned gun per American and more than one per American adult. The world’s second-ranked country was Yemen, a quasi-failed state torn by civil war, where there were 54.8 guns per 100 people.” The Trump administration’s proposed budget, released earlier this week, cuts $24 million from school safety programs and eliminates “project prevent grants” to support healthy conflict resolution and prevent violence in schools.
Earlier this week, the Trump administration released its 2018 budget proposal. The proposal would slash the Department of Health and Human Services’ budget by more than 20% next year, repeal the Affordable Care Act in its entirety, drain the CDC’s budget by $878 million next year, and eliminate the Prevention and Public Health Fund, proposing that programs under the fund be backfilled through discretionary spending, meaning that Congress would need to allocate funding each year through the appropriations process.* Medicaid, nutrition assistance, housing assistance, community development block grants, the Environmental Protection Agency, and many other health-supporting programs face steep cuts.
Sasha Abramsky of the New Yorker responded to a proposal in the Trump Administration’s budget to cut funding for the Supplemental Nutrition Assistance Program dramatically and shift a large share of spending into providing pre-selected “food boxes” to recipients who are eligible for $90 or more in SNAP benefits per month: “Proponents of this package of change might argue that it is necessary to control ballooning federal deficits in the wake of massive tax cuts. Yet snap has never represented more than 0.5 per cent of the country’s G.D.P. And, even before the Trump budget was released, the Congressional Budget Office had estimated that that number would fall, to about 0.25 per cent of G.D.P., over the coming decade. There are few federal programs that deliver such bang for their buck—snap is the single biggest reason why malnutrition has largely vanished from the United States. Trump’s “reform” package would reverse these achievements, ratcheting up the country’s misery index like few other public-policy changes of the past century. And, even if the proposal is just a fantasy, how telling it is that America’s leaders fantasize in such detail about punishing the poor for being poor.”
In a series of four votes on Thursday afternoon, the Senate failed to advance any legislation to address immigration, in particular the impending cutoff for Dreamers. After March 5, hundreds of Dreamers are expected to lose legal work permits each day. Two federal court injunctions are currently allowing DACA recipients to apply for two-year renewals. Meanwhile, in the Los Angeles area, immigration enforcement is escalating, with more than 100 arrests this week alone. An organizer with ICE Out of LA said that such operations are “becoming more routine… The way we understand it … these are political tactics being used by ICE to further terrorize communities and to weaponize what is supposed to be a law enforcement mechanism for political means.”
Senator Claire McCaskill’s office released a report on opioid manufacturers funneling almost $9 million to pain treatment advocacy organizations that, in return, promoted opioid painkillers and lobbied to loosen regulations and change prescribing practices among doctors. According to Mother Jones, “the groups that received pharmaceutical funding—like the US Pain Foundation and the Academy of Integrative Pain Management—in turn issued guidelines minimizing the risks of opioid addiction, lobbied to change laws aimed at curbing opioid abuse, and sought to protect doctors sued for overprescribing painkillers, according to the report.”
The New York Times reports that the Census Bureau may include a new question on the 2020 census that could have big repercussions for public health: “Are you a United States citizen?” “The fear is that immigrants — even those in the country legally — will not participate in any government-sponsored questionnaire that could expose them, their family members or friends to deportation. But low response rates from any demographic group would undermine the validity of the next decade of health statistics and programs, health experts warn. Scientists use census data to understand the distribution of health conditions across the United States population. In turn, officials use the data to target interventions and distribute federal funding. “Data is the lifeblood of public health; it needs to be transparent and objective,” said Edward L. Hunter, the former chief of the Centers for Disease Control and Prevention’s Washington office and now the president of the de Beaumont Foundation, which focuses on public health. “The census will have cascading effects upon every rate, every percentage, every trend we monitor over time. It’s very unsettling for people who need to use that data.”’
The New York Times asked 30 experts how they would spend $100 billion over the next five years: “One point of agreement: No panelist spent any of the hypothetical $100 billion on a border wall with Mexico,” focusing instead on expanding access to treatment, addressing the social determinants that can drive substance misuse and addiction, and harm reduction measures like safe injection sites.