Report that CDC analysts can’t use certain words in budget documents raises alarm in scientific community

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Last Friday, the Washington Post reported that policy analysts at the U.S. Centers for Disease Control and Prevention (CDC) were told in a recent meeting not to use seven words when preparing documents for the next presidential budget that will be sent to Congress.

The seven words are “diversity,” “entitlement,” “fetus,” “transgender,” “vulnerable,” “evidence-based” and “science-based.”

The Associated Press subsequently reported that some CDC employees have also been told not to use the term “health equity.”

These reports immediately raised alarm and outrage in the scientific, medical and public health communities.

“This action is an obvious attempt to politicize the most fundamental tenets of medicine and research, which will have a chilling effect on the CDC’s ability to rely on science to justify the work it does to protect public health,” said Dr. Michael Munger, president of the American Academy of Family Physicians, in a released statement. 

“Actions that divert the agency from its grounding in science could compromise the progress they are making in tracking opioid overdoses, reducing teen pregnancy, protecting the elderly from the flu, and slowing HIV transmission among transgender Americans,” wrote Michael Halpern, deputy director of the Union of Concerned Scientists’ Center for Science and Democracy, in a blog.

Rush Holt, chief executive officer of the American Association for the Advancement of Science, was equally blunt. “Among the words forbidden to be used in CDC budget documents are ‘evidence-based’ and ‘science-based.’ I suppose one must not think those things either,” he said in a released statement.

“Here’s a word that’s still allowed: ridiculous,” he added.

In response to the strong backlash, Health and Human Services (HHS) spokesman Matt Lloyd quickly issued a statement to various media outlets in which he did not deny that the CDC analysts were told to avoid the seven (or eight) words. Instead, he took umbrage with the idea that the words had been “banned.”

“The assertion that HHS has ‘banned words’ is a complete mischaracterization of discussions regarding the budget formulation process,” Lloyd said. “HHS will continue to use the best scientific evidence available to improve the health of all Americans. HHS also strongly encourages the use of outcome and evidence data in program evaluations and budget decisions.”

As the Associated Press pointed out after that statement was issued, “HHS officials did not clarify or answer any other questions.”

Serious consequences

These Orwellian efforts at language modification may sound absurd, or even humorous, but they represent something quite serious.

“Such censorship is a direct blow at the essence of science: accurately describing the physical world around us,” explained science historian Gleb Tsipursky on Scientific American’s website. “Science is the best method that we as human beings have of figuring out the truth of reality, and wishing away the facts by trying to substitute them with “alternative facts” will greatly impede scientific progress.”

Tsipursky is particularly concerned with the report that the Trump administration wants the terms “science-based” and “evidence-based” to be replaced with “CDC bases its recommendations on science in consideration with community standards and wishes.” He explains why:

Apparently it wants doctors to shift away from treating people based on the best scientific research, and instead use the fuzzy standard of “community wishes.” Unfortunately, non-specialists —“community members” — are too easily fooled by false but emotionally appealing claims. For instance, the homeopathy industry is a multi-billion dollar business. Homeopathy is based on the false claim of the benefit of super-diluted substances and the principle of “like cures like.” While it has been debunked by hundreds of studies, people still want to believe in magic-like cures. Homeopathy is not harmless, yet despite the fact that it kills people every day, only recently has the federal government taken steps to address this problem. But under the new guidelines, these steps could be rolled back, and the CDC might have to take homeopathy “under consideration.”

For another example, consider the false claim that vaccines cause autism. This belief is spread widely across the US, and leads to many people failing to vaccinate their children against diseases like measles. While measles was practically eliminated in the US by 2000, in recent years outbreaks of measles have been on the rise in the US, driven by parents failing to vaccinate their children in a number of communities. Donald Trump has frequently expressed the false view that vaccines cause autism, and we should be very concerned about this being one of the “community wishes” taken under consideration. 

“The Trump administration has already taken very many steps that will result in thousands more people dying from pollution every year by rolling back government protections on pollution,” Tsipursky adds. “Its steps in censoring the science on public health will result in many, many more children, babies, and adults getting sick and dying. Yet because it will be incredibly difficult to trace a specific baby’s death to the Trump administration’s censorship, it will also get off scot-free.”

Not just words

In an email to CDC employees over the weekend (and later on Twitter), CDC director Dr. Brenda Fitzgerald tried to calm the waters by saying that the CDC “remains committed to our public health mission as a science- and evidence-based institution. As part of our commitment to provide for the common defense of the country against health threats, science is and will remain the foundation of our work.”

Some CDC officials are also now arguing that “the proposal was not so much a ban on words but recommendations to avoid some language to ease the path toward budget approval by Republicans,” according to the New York Times.

But scientists and public health officials are not placated.

“If only word choice was the worst action this administration has taken to undermine the use of science in policy-making,” writes Halperin. “They’re not just trying to downplay the phrase ‘evidence-based.’ They’re trying to ditch the whole idea of basing policy on evidence.”

“The White House has no science advisor, and the president’s Office of Science and Technology Policy is a ghost town,” he explains. “Numerous political appointees—including the CDC director and the nominee for NOAA administrator — have financial conflicts of interest that lead many to question their ability to do the jobs. The administration has shut down studies where it expects it won’t like the outcome: on climate change in the tropics, on teen pregnancy prevention, and on the health risks of surface coal mining in West Virginia. Science agencies are targeted across the board for severe budget cuts.” 

“An exhaustive list is, quite frankly, impossible,” Halperin adds. “President Trump’s attacks on science harm our environment and make all of us sicker and less safe. If the Trump administration won’t allow federal agencies to do their job, it’s time to ask Congress to step up its game, engage in meaningful oversight, and do its job.”

FMI: You’ll find the original Washington Post article on the paper’s website. For more details about how the Trump Administration has been sidelining science, you can read a report released last summer by the Union of Concerned Scientists. It covers only the first six months of the administration, however.