Making America (and the world) unhealthy again

States with high birth rates will get more highway money. Quitting WHO, cancelling PEPFAR will remove the U.S. from the global AIDS fight.

If one deliberately set out to undermine individual and population health at home and abroad, one could hardly do better than the actions taken by the Trump administration over the past 48 hours.

The Department of Transportation this week circulated memos stating states with higher marriage and birth rates will get preference for agency grants. The memos also indicated the Trump administration’s DOT plans to cancel projects that address climate change or help mass transit.

If implemented, these new policies will divert funding from urban areas with large minority populations to mostly white ex-urban areas. It’s hard to imagine a less friendly policy for encouraging more babies. In the first three years of this decade, about 40% of new babies were born to black and Hispanic mothers.

Perhaps the Trump administration will seek to ameliorate the effects of its new policies by requiring hospitals include asthma inhalers in the care packages they give new mothers.

Meanwhile, shutting down the U.S. Agency for International Development and the President’s Emergency Plan for AIDS Relief (PEPFAR), launched 20 years ago by President George W. Bush, is already having a devastating impact on the global fight against infection disease. As Dr. Gavin Yamey, director of the Center for Policy Impact in Glob al Health at Duke University, wrote earlier this week:

“HIV clinics around the world funded by PEPFAR … that have saved more than 25 million lives, had to cancel appointments and turn patients away. Two-thirds of the staff of the President’s Malaria Initiative—the world’s largest funder of malaria control programs, also founded by George W. Bush—have been fired. Humanitarian assistance programs in Gaza, Sudan, and Syria that provide services like clean water and cholera treatment were halted. Oxygen supplies are no longer reaching health facilities in some low-income countries.”

Money grab by GOP-run states

Former Wisconsin Congressman and reality TV star Sean Duffy, the newly-installed Secretary of DOT, is an ideal frontman for implementing a policy based on birth and marriage rates. He met his wife Rachel Campos-Duffy, a Fox News television host, in 1998 while filming an MTV show. Both are devout Catholics. They have nine children.

Ironically, Wisconsin, whose birthrate ranks it 39th among the states, will not fare well under the planned policy. The biggest beneficiaries will be Sunbelt states and states with large Hispanic populations, including California. The biggest losers will be northeast and Midwestern states. Some red states with older populations like Florida and West Virginia will also be hard hit by such a policy.

The is no groundswell of public concern about the U.S.’s falling birthrate, which reached an all-time low in recent years. A Newsweek poll conducted a year ago found that nearly half of all women in their prime child-bearing years have no plans to have children, “not now nor in the future.” Forty-two percent of the 1,500 persons polled were “not at all concerned” with another 21% only slightly concerned. Just 16% were very concerned.

Might it have something to do with MAGA culture launching a fullscale assault on women’s rights? Might it be a labor market where women are severely penalized if they take time off to have children? Perhaps the lack of affordable child care has something to do with it.

Oh, did I forget to mention climate change, which, with the Trump administration hellbent on ignoring this ever-growing threat, might discourage both young men and women from bringing children into the world? Add into the mix America’s failure to deal with gun violence, drug addiction and a political culture that celebrates male toxic behavior and what you have today in the U.S.A. is a perfect storm for discouraging women and young families from having children.

Rewarding states with higher birth rates with more highway grants will not change those realities. In fact, it will increase anxiety among the very populations that have the highest birth rates now — minority women who live in urban areas fouled by fossil fuel fumes. It is their children who suffer most from the nation’s rising asthma rates.