Feb. 11 2021

Lancet Report Shines Light on Health Harms of Trump Era

A new report assesses the many negative repercussions of President Donald Trump’s policies on the health of people living in the United States and beyond while suggesting that the renewed energy of contemporary social movements may presage a more progressive future. Merlin Chowkwanyun, PhD, assistant professor of sociomedical sciences, is one of thirty-three contributors to The Lancet Commission on Public Policy and Health in the Trump Era published today.

The 49-page report begins with a section on “missing Americans”—including both those who died due to the abysmal national response to the COVID-19 pandemic, as well as those lost to worsening economic inequality (see diseases of despair) and racial injustices. Other sections detail regressive policies toward immigrants, climate and the environment, reproductive rights, food security, as well as resurgent white supremacy and authoritarianism.

“During the Trump era, the U.S.A. was led by a president whose disdain for science and manipulation of hatred jeopardize the health of the world and its people,” the authors write. President Trump’s rhetoric on restoring the nation to greatness, “camouflaged policies that enriched people who were already very wealthy and gave corporations license to degrade the environment for financial gain.”

More Than a Reversal of Trump Policies

The authors commend the Biden Administration for steps taken to rescind some of President Trump’s health-harming executive actions, for example, by rejoining the World Health Organization and the Paris Climate Agreement. “But the new administration and Congress must go beyond simply repairing Trump’s damage,” they write. “They must initiate thoroughgoing reforms to reverse widening economic inequality and the neoliberal policy drift that pre-dated Trump, and redress longstanding racism—root problems that harm health and have fomented threats to U.S. democracy.”

The Commissioners call for bold action to combat climate change, raise living standards, and empower oppressed communities, paid for by taxes on the rich and deep cuts in military spending. They also advocate for a reversal of policies that cede power and resources to the corporate sector, writing, “government must be a doer, not just a funder—e.g., directly providing health coverage and engaging in drug development rather than paying private firms to carry out such functions.”

Mobilizing for Change

Professor Chowkwanyun, a historian in the Center for History and Ethics, contributed to a section of the report on historical and recent activism, from reproductive rights movements to Occupy Wall Street to the Movement for Black Lives and many others. He and his co-authors make a case that healthcare scholars and practitioners should do more than document health injustices. “Analysis must be coupled with action,” they write. “Healthcare professionals alone cannot transform the policy environment but can lend expertise, voice, cultural capital, and their presence in public protests with others to bolster movements for change.”

Indeed, many health professionals are already active in this way, for instance, by helping frame social justice problems like mass incarceration and police violence as public health hazards, in accord with the tenets of the Health in All Policies framework. Moreover, health workers have joined various causes, such as March for Our Lives, a series of student-led demonstrations and teach-ins for gun control, and White Coats for Black Lives, which organized so-called die-ins on international Human Rights Day at more than 80 US medical schools. They have also embraced creative tactics. To advocate for drug price regulation, health professionals and grieving parents with Right Care Alliance delivered the ashes of a young diabetic who died because he couldn’t afford insulin to executives of pharmaceutical company Sanofi.

Chowkwanyun teaches a class on health advocacy and said his experience teaching it underscored the need to not just say what’s wrong with the world but what’s potentially promising, too. A speaker series he helps organize has recently brought to campus a number of figures, like union leader Sara Nelson and New York State Senator Julia Salazar, whose achievements he names as important signs that even the Trump years couldn’t impede some discernible progress.

The report’s section on activism ends on a cautiously optimistic note, with the authors writing, “eras of enlightened health and social policy change have often followed difficult periods.” The horrors of the Trump presidency might be followed by a period of social progress with the participation of healthcare workers, including scholars. “Movements for social justice are, along with scientific advances and exemplary medical care, key to health improvement. It is incumbent on healthcare professionals to offer their expertise and support to all such health-enhancing efforts,” they conclude.