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Trump's Toxic Budget and Fighting for the People's Health

Follow the money. This old adage could not be more true now, as applied to the Trump Administration's budget, released on March 16, 2017 [1]. This cruel and greedy document [2-6] savages everything that we in public health and so many others know is necessary for people, communities, and our planet to thrive [7-9].

The contrast could not be more clear as achingly drawn in the new infographic  (released by Public Health Awakened [10]), which vividly contrasts the wonderful ingredients that mix and meld to generate healthy and vibrant communities with how Trump's toxic agenda poisons these possibilities. There can be no mincing of words: the Trump Administration's proposed budget is certain to harm people's health and magnify health inequities, in the US and globally [2,3,6,11,12].

To defend the wealth of crony billionaires, fossil fuel barons, privatizers of prisons and public education, and industries that recklessly exploit workers and ravage the environment, Trump's budget seeks to [2-6]:

  • Add $54 billion to an already bloated and poorly audited US military budget
  • Sharply ramp up funding for border control (both agents & The Wall) and aggressive policing
  • Dole out tax cuts to the exorbitantly wealthy
  • Eliminate funds for addressing climate change
  • Slash funds for health care, science, education, housing, and culture
  • Decimate the funds required for effective good governance and the regulatory oversight needed to counter corruption and crony capitalism

Helping bind the foul ingredients of this toxic stew are the Trump Administration's anti-immigrant, anti-Muslim, anti-abortion, and anti-LGBTQ policies, its overt appeals to white nationalist racism, and its disregard for hate crimes stoked by its hateful rhetoric, and further seasoned by its denial of any aspect of reality that contradicts its own beliefs, no matter how false or distorted [2,3,13-15]. The only thing as great about Trump's budget is the great destruction it will cause in the US and worldwide.

Trump's agenda, starkly revealed in his budget, is a clarion blast for action. We in public health cannot fight for just one piece at a time, oblivious to the larger pattern. Rather, we must challenge the big agenda precisely in order to press our claims for the programs, policies, funding, and governance we know is needed for the public's health and for communities to thrive. Look again at the Public Health Awakened infographic. We must draw the connections that our bodies make every day: the embodied truths that we see revealed in our health statistics, which show, again and again, how the different forms of social inequality and environmental degradation hurt people's health simultaneously, and not separately parceled, one exposure at a time [16-18].

Hence: as we band together to fight against the Trump Administration budget, we must remember that we fight with allies in all sectors and communities threatened by its priorities [2-6]. Sound alternatives exist: consider only the FY 2017 budget proposed by the Congressional Progressive Caucus, aptly titled: The People's Budget: Prosperity not Austerity; Invest in America [19, 20]. Consonant with the vision of creating stronger, healthier communities, this alternative budget proposes making major public investments to rebuild America by fixing our crumbling roads and bridges, improving schools, moving towards clean energy, and creating good paying jobs in the process, not to mention strengthening voting rights, protecting the environment, and supporting comprehensive immigration reform [19, 20]. How does it achieve this? By calling for strategic investments in areas that fuel job growth and reduce inequality, by reducing excessive military spending and enacting smart reforms to health care spending, and by progressively raising revenues through implementing tax policy that claws back years of reductions for the corporate sector and very high earners [20].

We must never forget: another world is possible since the point is not only to resist, but to create a better world, with respect for people's dignity, human rights, and the well-being of this one planet whose fate affects us all.

This article was originally published on the Human Impact Partners Medium channel.


1  President Donald J. Trump: Trump Administration, Office of Management and Budget. America First – A Budget Blueprint to Make America Great Again. Issued 3/16/17.

2  Cassidy J. Donald Trump’s Voldemort Budget. The New Yorker, March 16, 2017.

3  Paarlberg M. Trump’s budget: the dream of a paranoid strongman and a vicious Scrooge. The Guardian, March 16, 2017.

4  Staff and agencies. Trump’s budget overhaul: domestic programs slashed to fund military. The Guardian, March 16, 2017.

5  Aisch G, Parlapiano A. Trump’s Budget Cuts Some Agencies to Their Lowest Levels in Decades. New York Times, March 16, 2017.

6  Rappeport A. What Trump’s Budget Could Mean for the Affected Agencies. New York Times, March 17, 2017.

7  World Health Organization. Commission on Social Determinants of Health – final report. Geneva, Switzerland: WHO, 2008.

8  US Department of Health and Human Services. Healthy People 2020. Determinants of Health.

9  USGCRP, 2016: The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. Crimmins, A., J. Balbus, J.L. Gamble, C.B. Beard, J.E. Bell, D. Dodgen, R.J. Eisen, N. Fann, M.D. Hawkins, S.C. Herring, L. Jantarasami, D.M. Mills, S. Saha, M.C. Sarofim, J. Trtanj, and L. Ziska, Eds. U.S. Global Change Research Program, Washington, DC.

10  Public Health Awakened: organizing for health, equity, and justice.

11  McKee M, Greer SL, Stuckler D. What will Donald Trump’s presidency mean for health? A scorecard. Lancet 2017; 389:748-754.

12  Starrs AM. The Trump global gag rule: an attack on US family planning and global health aid. Lancet 2017; 389:485-486.

13  The first 100 days of Trump: Tracking the 45th president of the United States, one day at a time. The Guardian.

14  Bouie J. Government by White Nationalism is Upon Us. Slate, February 6, 2017.

15  Wallace-Wells B. Taking Stock of Hate Under Trump. The New Yorker, March 14, 2017.

16 Krieger N (ed). Embodying Inequality: Epidemiologic Perspectives. Amityville, NY: Baywood Publishing Co, 2005.

17  Krieger N. Epidemiology and The People’s Health: Theory and Context. New York: Oxford University Press, 2011.

18  Krieger N. Living and dying at the crossroads: racism, embodiment, and why theory is essential for a public health of consequence. Am J Public Health 2016; 106:832-833.

19  Congressional Progressive Caucus. The People’s Budget: Prosperity Not Austerity; Invest in America FY 2017.

20  Blair H. “The People’s Budget†: Analysis of the Congressional Progressive Caucus Budget for Fiscal Year 2017. Challenge 2016; 59:298-326.

Nancy Krieger is Professor of Social Epidemiology, Department of Social and Behavioral Sciences, at the Harvard T.H. Chan School of Public Health and Director of the HSPH Interdisciplinary Concentration on Women, Gender, and Health. She has been a member of the School’s faculty since 1995. Dr. Krieger is an internationally recognized social epidemiologist (PhD, Epidemiology, UC Berkeley, 1989), with a background in biochemistry, philosophy of science, and history of public health, plus 30+ years of activism involving social justice, science, and health. In 2004, she became an ISI highly cited scientist, a group comprising “less than one-half of one percent of all publishing researchers, with her ranking reaffirmed in the 2015 update.†In 2013, she received the Wade Hampton Frost Award from the Epidemiology Section of the American Public Health Association, and in 2015, she was awarded the American Cancer Society Clinical Research Professorship. In 1994 she co-founded, and still chairs, the Spirit of 1848 Caucus of the American Public Health Association, which is concerned with the links between social justice and public health.

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