CDC team behind top survey on health and nutrition is laid off

Protecting the nation’s public health demands data, whether it be new measles cases, a surge in ER visits, or shifting patterns in obesity. The most recent job cuts at the Centers for Disease Control and Prevention threaten the mostly unseen foundation of that research enterprise.
The CDC division within the National Center for Health Statistics that directs the National Health and Nutrition Examination Survey — a bellwether of the country’s health — lost all its planners in last weekend’s firings. Unlike the 600 out of 1,300 employees eliminated across disciplines but reinstated within 24 hours, the people in the branch that plans and disseminates the research informing public health policies from food to oral health to environmental exposures got no reprieve.
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“You’re talking about a small but extremely dedicated part of a larger division,” former planning branch chief David Woodwell told STAT. “It’s devastating, and it will be very, very difficult for the survey to continue with this group gone because as valuable and as important as the other people are, they don’t have the understanding and the experience of running the survey with the contractors in the field on a day-to-day basis. It will be tough. It’ll be extremely, extremely difficult.”
NHANES is the principal source of information measuring the health and nutritional status of people living in the community, according to the National Library of Medicine. It’s known for combining rigorous data measurements with answers to questionnaires.
Based in Hyattsville, Maryland, the statistics center has for 60 years provided information on common diseases and behaviors based on nationally representative surveys. Those surveys are conducted by contractors who measure the health and nutrition of Americans via questionnaires that are followed by health exams and lab tests. The number of people terminated across NCHS’s four divisions (data analysis, informatics, operations, and planning) adds up to about 100, including all eight who had remained in the planning branch after earlier cuts on Feb. 14 and April 1 that also spurred retirements.
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Woodwell called them “boots on the ground,” making sure day to day that each of the health exams and all the questionnaire interviews were performed as expected. They also planned future surveys and analyses.
“I worked with them for 10 years and I love them dearly. I’m in touch with them all the time,” said Woodwell, who is now retired. “So I know none of those eight have been rescinded.”
The terminations came after President Trump made good on threats to fire federal workers during a government shutdown over stalled budget negotiations. “All HHS employees receiving reduction-in-force notices were designated non-essential by their respective divisions,” HHS spokesperson Andrew Nixon told STAT,
What may be lost
Potentially among the missing: Information about health services, hospitalization, ER visits, office visits, and individual warning signs.
“Anything related to any emerging outbreaks are also going to be compromised,” Denys Lau, formerly the director of a division that tracks the nation’s health care provision and utilization, told STAT. He is now editor-in chief of the American Journal of Public Health.
The fruits of NHANES are shared with the public as well as within other federal agencies, including the National Institutes of Health and the Food and Drug Administration. There is nothing flashy about the regular NCHS reports, which scrupulously avoid speculation or even discussion in articles gleaned from survey answers supplemented by patient metrics obtained in mobile exam centers.
Like much of public health work, that labor is invisible — you don’t see the infection you didn’t get. Data gathering is even farther from the spotlight, so by extension, the people planning how to gather and share this data work even further behind the scenes.
Now Woodwell, Lau, and other former employees are speaking out, calling attention to the value of their colleagues’ work. NHANES and its stringent protocols are known and emulated around the world, Woodwell said. Historically those data have been instrumental in removing lead from gas and paint, as well as adding the nutrition labels to food packaging now taken for granted.
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“NHANES is in a lot of places,” he said. “People don’t appreciate the value that it has added to the country for decades.”
Working with researchers at NIH, members of the planning branch knew what the scientists were looking for and would make it happen, Woodwell said. That meant following through on a day-to-day basis with the contractors in the field, then editing the data, and later publicly releasing it.
While it has never been the main goal of NHANES, the survey can benefit its roughly 5,000 participants.
“We can see undiagnosed hypertension or diabetes, things that people don’t know about until they come into our mobile exam centers,” Woodwell said. “We are able to provide them with health data that would cost them thousands of dollars if ever they would have some of these exams or blood work done.”
What’s next?
Now that the NCHS communications office has also been eliminated, Lau told STAT, he wonders how the center will fulfill its mandate to provide data in an objective, nonpartisan way.
In the past, reports had to go through NCHS Office of Science, where they were reviewed for fidelity to the data. Information coming out of NCHS now goes through a new clearance procedure at the CDC that Lau fears can be influenced by politics. In a statement offered to media outlets, Lau and colleague Jennifer Schoendorf, former NCHS director of research and methodology who is now senior deputy editor at the public health journal, cited as examples recent federal public health policy recommendations on vaccines, fluoridation in drinking water, and ultra-processed food.
Lau is puzzled by the lost ability to track concerns health secretary Robert F. Kennedy Jr. has prioritized, such as obesity, nutrition, oral health, and environmental exposure to chemicals health.
Most of all, Woodwell and Lau fear what won’t be known after the reductions in force that have hollowed out the CDC they once knew.
“The RIFs may have left some parts of NCHS intact, but a car cannot drive missing a tire or the steering wheel,” Lau said.
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