The Ongoing Controversy Over Diversity and Inclusion in the Trump Administration
The Trump administration’s efforts to curb diversity, equity, and inclusion (DEI) initiatives have sparked intense debates within the federal government and the public health sector. At the heart of this controversy is the question of whether terms like “race,” “equity,” and “disparity” have become politically charged to the point of being unusable. This debate recently came to a head when the Centers for Disease Control and Prevention (CDC) in Atlanta instructed its employees to avoid using certain terms in their performance evaluations. While the CDC later clarified that the words were not outright banned, the incident revealed deeper tensions over the administration’s push to redefine how federal agencies address issues of race and inequality.
The CDC Email Incident and Its Aftermath
The controversy began when CDC employees received an email advising them to avoid using more than a dozen terms, including “health equity,” “race,” “bias,” “disparity,” “culturally appropriate,” and “stereotype,” when drafting their annual performance goals. The email, which was reportedly intended to comply with President Trump’s executive orders targeting DEI programs, caused widespread confusion and concern among staff. The CDC’s parent agency, the Department of Health and Human Services (HHS), quickly denied claims of a banned word list, accusing CDC officials of misrepresenting guidance to undermine the administration. However, the incident has cast a spotlight on the challenges faced by federal agencies trying to navigate the shifting political landscape under President Trump.
The Broader Context: Trump’s Assault on Diversity Initiatives
President Trump’s efforts to dismantle DEI programs mark a significant departure from the policies of his predecessor, President Biden. While Biden emphasized racial equity as a core component of his coronavirus response, Trump has framed DEI initiatives as “woke ideology” that is both discriminatory and wasteful. This ideological shift has left federal agencies like the CDC in a difficult position, as they are now being asked to limit their use of terms that are central to their mission of promoting health equity. The CDC’s work, for example, focuses on addressing health disparities between different groups, including racial and socioeconomic disparities. However, discussions of race in public health are inherently charged, particularly in a nation where life expectancy for Black people is, on average, nearly five years shorter than for white people.
The CDC’s Struggle to Balance Politics and Public Health
The CDC’s strategic plan, adopted in 2022, explicitly calls for reducing health disparities by 2024, with a specific focus on narrowing racial disparities in blood pressure control among Black adults with hypertension. Yet, under the Trump administration, the agency has faced pressure to downplay the role of race in its work. The CDC’s Office of Health Equity, which defines health equity as “the state in which everyone has a fair and just opportunity to attain their highest level of health,” has seen its website scrubbed of most mentions of race. This erasure has been met with criticism from public health experts, who argue that race is a critical factor in understanding and addressing health disparities.
Expert Perspectives: The Role of Race in Public Health
Public health experts are divided on how to navigate the politically charged landscape surrounding terms like “race” and “health equity.” Some, like Dr. Georges Benjamin of the American Public Health Association, argue that race is a social construct that profoundly influences health outcomes and cannot be ignored. “When we don’t use words that have such an enormous impact, it’s difficult for people to understand what you’re talking about,” Dr. Benjamin said. Others, such as Dr. Sandro Galea of Washington University in St. Louis, suggest that the charged nature of these terms may require public health officials to rethink their language and focus on the broader goal of improving health for all populations.
The Way Forward: Balancing Language and Action
The debate over language in public health reflects a larger challenge: how to address systemic inequities in a politically polarized environment. While some argue that avoiding certain terms may be necessary to avoid alienating stakeholders, others warn that doing so risks undermining efforts to address the root causes of health disparities. As the CDC and other federal agencies navigate this complex terrain, they must find a way to stay true to their mission while avoiding further polarization. The stakes are high, as the ability of public health officials to address issues like racial disparities may depend on their ability to communicate effectively—both within their agencies and with the communities they serve.
