How the CDC’s widespread layoffs cut lifesaving health programs
Drowning prevention. Hotlines to report school shootings. Contraceptive guidelines. Tips from former smokers on how to quit.
Hundreds of employees who worked in these programs at the Centers for Disease Control and Prevention were laid off Tuesday, part of widespread job cuts across the Department of Health and Human Services designed to streamline the federal bureaucracy.
The programs have lower profiles than the CDC’s infectious-disease investigations of the ongoing measles outbreak in Texas and New Mexico, or last year’s E. coli illnesses from contaminated onions on McDonald’s Quarter Pounders.
But these efforts reflect the ways the CDC’s portfolio has broadened over time to include a wider range of health issues as leading causes of death in the United States have shifted over decades, from infectious disease to accidents, suicides, overdoses and chronic illnesses.
Employees who were laid off worked on measures to prevent drowning, gun violence and smoking. Scientists researched asthma, climate change and worker safety.
“This is where a lot of the unsung work lives,” said a CDC employee in the agency’s center on injury prevention who spoke on the condition of anonymity out of fear of retaliation. More than 200 staff in the center, which includes drowning prevention and firearm injury and death research, were fired.
Health and Human Services Secretary Robert F. Kennedy Jr. and GOP health policy analysts have said they want the Atlanta-based CDC, founded in 1946 to fight malaria, to focus on infectious diseases. As part of sweeping job cuts announced Tuesday, about 2,400 CDC employees - almost 1 in 5 - were terminated without consulting the CDC’s senior leaders, numerous officials said. That is the largest workforce reduction in the agency’s modern history.
The CDC would focus “on returning to its core mission of preparing for and responding to epidemics and outbreaks,” according to an HHS fact sheet. Overhauling the HHS is aimed at focusing on what Kennedy says is its mission of combating chronic disease and making America healthy again.
Spokespersons for the CDC and HHS did not respond to requests for comment.
Many staff working in some of the hardest hit CDC centers said they view their job eliminations as flying in the face of Kennedy’s stated goals.
“It’s unclear how you can stop the flood of chronic diseases without turning off the faucet that is tobacco,” said a staff member in the CDC’s Office on Smoking and Health, one of about 150 people laid off Tuesday in the agency’s chronic disease and prevention center. Employees working in four of the center’s nine divisions were laid off.
Some of the biggest job losses took place in the CDC center that tries to prevent injury and violence, by providing advice on appropriate use of car and booster seats to guidance on fall prevention for older adults. The injury prevention division lost all but 12 of its 130-member staff.
The CDC’s guidance pages for the public and professionals receive about 73 million views a year, according to a person familiar with the agency’s digital metrics, who shared the information on the condition of anonymity for fear of retaliation.
Drowning is the leading cause of death for children aged 1 to 4, according to CDC data. About 4,000 fatal unintentional drownings occur every year, an average of 11 per day, according to CDC data.
Staff in the injury prevention division funded community organizations across the country, including YMCAs, to teach basic water safety skills to children.
“Nobody outside of CDC in the federal government works on drowning prevention,” said a staff member of the injury center.
Florida, which has an average of 533 drowning deaths a year, the second-largest number after California, relies heavily on CDC funds for its year-round water safety classes. Instructors visit schools during gym class and schools send children to pools at 138 locations across the state to learn water safety.
“We teach them, ‘if your friend falls in to a pool or water and you don’t know how to swim, don’t go in, find something to reach out to them,’” said Christian Engle, chief executive of YMCA of the Suncoast in Clearwater, Florida. In the pools, children learn how to jump in and float for the first time, he said.
“We’re nervous the funding is going to disappear,” Engle said.
The CDC staff also developed guidelines for traumatic brain injury prevention and training curriculum on concussion safety for coaches and athletes.
The center’s violence prevention division has been under close scrutiny because it conducts firearm injury and death research. Of the 180 positions there, 89 staff were fired, a loss of about 50 percent, according to current and former CDC employees.
Firearm-related injuries are the leading cause of death among children and adolescents in the United States, according to CDC data. Under the first Trump administration, researchers were asked to study whether anonymous tip lines to report school shootings have impact.
One project funded by the CDC found that anonymous reporting used in the North Carolina school system between 2019 to 2023 led to more than 1,000 mental health interventions, more than 100 lives saved from imminent suicide, and 38 acts of school violence prevented, according to a study published in the journal Pediatrics.
“We know what happened to the staff,” said one employee. “We don’t know what may happen to the funding.”
Statisticians and researchers across the center who worked on analyzing data also lost their jobs. “We lost our entire informatics team, who were doing work to really speed up provisional data when it’s available,” the staff member said.
Because deaths from accidents disproportionately affect young people, “preventing injury deaths gives you a lot more bang for your buck than chronic disease [prevention],” another researcher said. “I don’t know of any place else that does what we do. Where are policymakers going to get their data to make informed decisions if our center goes away?”
At the center for chronic disease prevention, the office on smoking oversees a long-running and successful campaign that features tips from former smokers in commercials. The office also funds tobacco control and smoking cessation work at state and local health departments and community organizations.
Like many other programs across the CDC, it’s unclear whether the programs will continue, and if they do, whether the public health agency will continue to fund state, local and community organizations. On their last day, staff members were trying to determine how they could legally transfer files to other offices working on cancer and diabetes so some of the work could continue.
Other employees who lost their jobs worked on reproductive health issues, Alzheimer’s disease and water fluoridation. CDC staff administered a state-based surveillance system known as PRAMS that collects data on maternal behaviors, attitudes and experiences before, during and shortly after pregnancy, to improve the health of mothers and infants.
“We cannot understand factors associated with poor pregnancy outcomes without surveillance like PRAMS,” said one employee who was laid off in the reproductive health division.
The staff also worked on contraception guidelines used broadly by clinicians, nurses and midwives. The guidelines spell out safe and effective use of contraception for a variety of medical conditions that may make pregnancy more dangerous.
About 80 of the division’s employees were laid off, according to two CDC employees, who spoke on the condition of anonymity to avoid jeopardizing their administrative leave status.
Some reproductive health staffers had more than 20 or 30 years of experience. They chose not to retire when the government offered buyouts in late January, one employee of that division said. “They were playing Russian roulette, hoping they would get to stay and hopefully save the program.”
In another part of that center, all 20 members in the Healthy Aging branch, whose jobs focused primarily on Alzheimer’s awareness and prevention, lost their jobs. The branch provided $30 million in annual funds for programs to increase early detection and diagnosis of dementia, one staff member said.
In many communities, primary care providers “aren’t aware of how much prevention can be done for Alzheimer’s disease,” the employee said. An estimated 45 percent of cases of Alzheimer’s can be prevented or delayed by properly managing risk factors, including high cholesterol, high blood pressure and hearing loss, the employee said. The funds for this year have already been sent to communities.
But when it’s time to reapply, the CDC would need new staff to process the paperwork.
“The entire branch no longer exists,” the staffer said. “Not one employee was kept.”