Arizona’s public health system has been trying to navigate a storm of uncertainty due to the federal public health grant funding cuts planned by the Trump administration.
Their initiative to halt a broad spectrum of state and local public health grants and cooperative agreements has been temporarily paused by a federal judge, but the looming threat of these essential programs being eliminated remains.
Arizona’s public health system is heavily dependent on federal funding, primarily through grants and cooperative agreements with federal agencies.
Critical areas such as sexually transmitted disease prevention, high-risk perinatal programs, maternal and child health services, overdose and substance use disorder prevention, public health preparedness, SNAP education, Ryan White HIV medications, immigrant and refugee health programs, and adult vaccinations are all at risk.
The situation is further complicated by the funding structure between county health departments and ADHS (the primary grant recipient who passes the money to the counties).
Typically, county health departments run on cost reimbursement contracts, meaning they initially cover the expenses for vital public health initiatives with the expectation of being reimbursed through federal funds. With the potential freeze or reduction in federal funding, these departments face significant financial strain, jeopardizing their ability to maintain essential services.
The Trump Administration’s primary grievance with public health practice appears to be public health’s focus on health disparities and health equity – which are foundational principle of public health practice.
As reported in Governing, the Trump administration has issued orders to freeze disbursement of federal loans and grants, with language suggesting a reevaluation of programs related to diversity, equity, and inclusion.
State Health Departments Prepare for a Period of Uncertainty
The uncertainty surrounding federal funding is causing major disruptions and anxiety at the local health department level. Public health officials, their county managers and supervisors are grappling with the challenge of planning and executing programs without assured financial support.
For Arizona, the stakes are especially high. Our reliance on federal funds means that any disruption can have cascading effects on the health outcomes of Arizonans.
Sadly, despite that advocacy, it may in the end be up to judges to decide whether the administration’s goal of eliminating public health practice is a violation of law and or the constitution.
Challenging times.