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Tufts Public Health » Disparities, Prenatal Health, Prevention, Reproductive Health, Uncategorized, Zika Virus » The CDC’s Banned Words and The Effects on Public Health

The CDC’s Banned Words and The Effects on Public Health

On December 15, 2017, The Washington Post reported that policy analysts and officials of the Center for Disease Control and Prevention (CDC) had been informed of a new list of words that were prohibited from being used in their 2019 Presidential budget documents. The seven-word list consisted of vulnerable, entitlement, diversity, transgender, fetus, evidence-based, and science-based. The origin of the ban is unknown, but it’s believed to have come from the Department of Health and Human Services (HHS) who composes the CDC’s annual budget. In certain cases, CDC budget analysts were given suggested rewordings such as replacing “evidence-based” with “CDC bases its recommendations on science in consideration with community standards and wishes.”

This ban comes at a time of massive budget cuts under the Trump administration. The CDC’s 2018 budget proposal is approximately $1 billion less than that of 2017, amounting to a 17% reduction. The largest losses resulting from these funding cuts were to Chronic Disease Prevention and Health Promotion and to the Racial and Ethnic Approaches to Community Health (REACH) program which was completely eliminated.

While the CDC generally enjoys bipartisan support, certain words on the list are associated with sensitive topics, namely transgender, fetus, and vulnerable. However, a HHS spokesperson has claimed that stating there’s a word ban is a mischaracterization of how the budget proposal works. With contradictory statements, the banned words seem to be more of a de facto censorship resulting from the politicking of the HHS around the presidential administration. Simply put, the vocabulary restrictions and rewordings are a result of the current political climate. As a result, the CDC budget proposals will use euphemisms for words related to sensitive health topics such as abortion, health equity, and transgender health.

“It creates a potentially chilling effect for people in the organization doing scientific or public health work to feel like they shouldn’t do or say something […] It’s sort of suggesting to people that they ought to avoid the whole topic. It’s more than just a language issue, it could have real action,” says Paul Hattis, JD, MD, MPH, Associate Professor of Public Health and Community Medicine at Tufts University School of Medicine.

The ban has already faced outrage. “Here’s a word that’s still allowed: ridiculous.” said Rush Holt, CEO of the American Association for the Advancement of Science (AAAS). Many academic institutions, including Boston University School of Public Health, have also made public statements against the banned words.

The results of these prohibited words on public health could be far-reaching. While CDC webpages and scientific papers will not be censored, federal funding for the issues related to these words will probably be reduced. The word fetus is a challenging word to replace with synonyms which could affect sexual and prenatal health research. For example, funding cuts to the CDC’s research on Zika virus’s effects on fetuses would greatly affect public health in U.S. territories where 611 cases of Zika were reported in 2017.

“It’s based on a particular ideology which could be driven by religious or political beliefs, but most of us would say it’s an anti-scientific or anti-health belief in terms of protecting the public’s health,” says Hattis.

Transgender health will suffer as well. Research involving minorities and health disparities has only recently addressed transgender health and it is therefore more vulnerable to budget cuts if deemed a low priority. The CDC currently collects national statistics on HIV transmission among transgender people and collects useful resources for healthcare providers with transgender patients. Funding cuts to topics related to diversity at large could have similar effects as the 2018 federal funding cut to CDC’s REACH program which has studied varying rates of obesity among white and minority Americans.

“Including the word diversity in the ban may tell researchers not to look at inequity issues by race, ethnicity, or gender so people may stop collected data on such topics […] It won’t stop all research on topics related to diversity, but it may reduce the scope and number of new ideas coming forward,” says Hattis.

It’s difficult to imagine how an organization such as the CDC can effectively communicate the need for funding for such topics when they’re told to avoid using the very words which describe them. While the unofficial word ban may affect CDC grants and consequently, public health in the U.S. and abroad, state and local governments can help fill the gap by prioritizing these public health issues and providing increased grant funding to organizations wishing to study and address the issues. This, along with increased efforts by academic institutions, can help to assure scientific integrity and equity in public health in forthcoming years.


by Donald Clermont, MPH Candidate ’18

Filed under: Disparities, Prenatal Health, Prevention, Reproductive Health, Uncategorized, Zika Virus

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