Public Health Experts Warn That Federal Policies Could Widen Racial Health Disparities – Maryland Association of Counties

Report on the Impact of Federal Policy Shifts on Public Health Equity and Sustainable Development Goals

Introduction: Service Gaps and Threats to Health Equity

A report from Stateline indicates that recent federal policy shifts are creating significant service gaps and adverse outcomes for vulnerable communities across the nation. Public health agencies have raised concerns that the dismantling of programs designed to address health inequities threatens progress toward key United Nations Sustainable Development Goals (SDGs), particularly those focused on health and equality.

Alignment with Sustainable Development Goals (SDGs)

The current challenges directly impact the achievement of several critical SDGs:

• SDG 3 (Good Health and Well-being): The reduction in public health services for marginalized groups directly contravenes the goal of ensuring healthy lives and promoting well-being for all at all ages.
• SDG 10 (Reduced Inequalities): The termination of programs aimed at mitigating health disparities among racial and ethnic minorities undermines efforts to reduce inequality within the country.
• SDG 1 (No Poverty): As these policy changes disproportionately affect low-income populations, they present a setback to efforts aimed at eradicating poverty and its associated health burdens.

Key Areas of Concern

The scaling back of federal support has manifested in several ways, creating a direct challenge to the principles of SDG 3 and SDG 10. The primary areas of reduction include:

1. Program Terminations: Federal grants and offices specifically created to improve health outcomes for communities of color, low-income populations, and rural areas have been terminated or significantly scaled back.
2. Research Grant Reductions: Thousands of research grants administered through the National Institutes of Health (NIH) and associated agencies, many of which focus on health disparities, have been cut.
3. DEI Initiative Defunding: Funding for Diversity, Equity, and Inclusion (DEI) initiatives has been discontinued. These programs were instrumental in addressing historic gaps in healthcare access and mitigating the burden of chronic disease among minority groups.

Projected Consequences and Expert Analysis

The withdrawal of federal support is expected to widen existing racial and geographic health disparities, leading to a regression in public health achievements and hindering progress toward SDG 10. State, local, and nonprofit entities are reportedly struggling to compensate for the loss of federal capacity and funding, highlighting a critical challenge for SDG 17 (Partnerships for the Goals).

This situation creates a scenario of diminishing resources in the face of growing needs. According to Richard Frank, Director of the Brookings Institution Center on Health Policy, “You’ve got declining capacity, and increasing need — which is a formula for problems.” He further noted that it is “impossible to make all that up with state and local dollars,” suggesting that without federal partnership, the goals of achieving health equity will be severely compromised.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being

   • The article directly addresses public health issues, focusing on “adverse outcomes,” “service gaps,” and the “chronic-disease burden” within vulnerable communities. The core concern is the impact of policy shifts on the health and well-being of these populations.

2. SDG 10: Reduced Inequalities

   • This is a central theme of the article. It explicitly discusses the potential for “racial health disparities” to widen and highlights the dismantling of programs designed to address “inequities.” The focus on “communities of color, low-income populations, and rural areas” underscores the connection to reducing inequalities.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The article’s mention of the “chronic-disease burden among racial and ethnic minorities” directly relates to this target, as the reduction in funding for health programs could impede progress in preventing and treating such diseases in these communities.
   • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. The article’s concern over “service gaps” and “gaps in care” for vulnerable populations directly reflects the challenge of achieving universal access to quality healthcare.

2. SDG 10: Reduced Inequalities

   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status. The article points to the termination of “funding for diversity, equity and inclusion (DEI) initiatives,” which are programs specifically designed to promote inclusion and support marginalized groups, making this target highly relevant.
   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard. The article warns of a potential “regression in closing health-outcome gaps,” which is a direct reference to the inequality of outcome that this target aims to address. The federal policy shifts discussed are an example of actions that could widen these gaps.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicators for SDG 3

   • Chronic Disease Burden: The article mentions the “chronic-disease burden among racial and ethnic minorities.” This can be used as an indicator to measure progress towards Target 3.4 by tracking the prevalence and mortality rates of non-communicable diseases across different demographic groups.
   • Gaps in Healthcare Services: The text refers to “service gaps” and “gaps in care.” This implies an indicator related to Target 3.8, which could be measured by comparing access to and utilization of health services between vulnerable communities and the general population.

2. Indicators for SDG 10

   • Health Outcome Disparities: The article’s primary concern is the widening of “racial health disparities” and “health-outcome gaps.” This is a direct indicator for Target 10.3. It can be measured by comparing health metrics such as life expectancy, infant mortality, and disease prevalence across different racial, ethnic, and socioeconomic groups.
   • Funding for Equity Initiatives: The article explicitly states that “thousands of research grants” and “funding for diversity, equity and inclusion (DEI) initiatives” have been terminated. The level of public and private funding allocated to programs that address inequality serves as a clear indicator of commitment and action towards Target 10.2.

4. Summary Table of SDGs, Targets, and Indicators

Source: conduitstreet.mdcounties.org