How Arizona’s Data Center Boom Could Hike Your Power Bill & Harm Public Health

Anybody who has driven around the Phoenix metro area knows that Arizona is a magnet for massive data centers. It’s those giant warehouse-looking buildings with electrical substations nearby and really small parking lots (very few people actually are employed at these giant power-hungry box buildings). Those warehouse-sized facilities you see store digital data and power AI.

Tech companies see Arizona as an ideal location due to cheap land and captive utility regulators.

The problem is that these massive facilities use gobs of electricity and water which ends up posing a threat to public health, water security, and the household budgets of everyday Arizonans.

Here’s how.

The proliferation of data centers puts pressure on monopoly utilities like Arizona Public Service and Tucson Electric Power to seek new energy sources and build out costly infrastructure (e.g., gas-fired power plants, transmission lines, substations).

The big public health concern is who pays? Will it be the data centers who are driving the demand or residential ratepayers who risk footing the bill through higher utility rates?

To meet the data center demand surge APS and TEP will likely press to build more methane-burning gas plants, which will increase greenhouse gas emissions and worsen local air pollution.

But there’s a less visible and potentially more damaging risk. The cost of building out the infrastructure to serve data centers like the power plants, substations, and transmission lines aren’t necessarily being paid for by the data centers.

Instead, the data centers cozy relationship with utilities like APS and TEP (and the ACC’s cozy relationship with APS & TEP) end up facilitating rate hikes with little assurance that costs due to data centers won’t be piled onto regular residential customers.

APS already secured an 8% residential rate increase and is now asking for another 14%. TEP is doing the same. And these hikes hit hardest where families can least afford them.

In Arizona, energy bills are often the second-largest household expense after rent. High electricity rates leaves low income families with even less money for food, school supplies, and healthcare, all while living with the stress of rising monthly bills.

A core problem? Arizona lacks clear standards to ensure data centers pay for all the infrastructure required to satisfy their demand.

In Arizona, the Arizona Corporation Commission is the regulatory body tasked with ensuring that utilities operate in the public interest. This includes:

  • Reviewing and approving rate hikes proposed by utilities;
  • Requiring utilities to justify capital expenditures;
  • Allocating costs based on who caused them (known as “cost causation”);
  • Holding public hearings where advocates can push back on unfair rate design; and
  • Making final decisions about whether to approve rate requests.

The ACC can reject rate proposals that shift disproportionate costs to residential customers. It also has authority to require special rate structures or impact fees that place more of the burden on large industrial users with political connections and the ability to provide large campaign contributions (like data centers).

But… protections for residential ratepayers are only as strong as the Commission’s willingness to:

  • Independently scrutinize forecasts and financial impacts;
  • Reject unjustified investments; and
  • Impose fair cost-allocation rules.

The tools exist for the Commission to protect residential rate payers, but that depends on the ideology and political will of the Commissioners, data transparency and whether or not Commissioners and staff use unbiased analyses.

Meanwhile, the Data Center Coalition, an industry trade group, has plainly said it doesn’t believe rate protections for residential customers are necessary. See Arizona utilities: Data centers could nearly triple energy demand

Without better safeguards to ensure data centers aren’t cost shifting infrastructure costs on to residential customers ordinary Arizonans will be stuck with the environmental and financial fallout… with damaging results for public health.

We need stronger oversight from the ACC, more transparency about who pays for what, and written policies that put health, fairness, and affordability first. Otherwise, the cost of powering Arizona data centers will come down on the people least able to afford it and who aren’t causing it.

It would surely help if voters would elect ACC commissioners who protect residential customers rather than power company executives and monopoly utility shareholders.

Summary

Arizona’s utilities are under pressure to meet growing electricity demands from data centers which cause expensive infrastructure costs. The Arizona Corporation Commission has the authority to protect residential customers from subsidizing those costs—but only if it actively enforces cost-causation principles and rejects unfair rate hikes.

Without strong oversight and transparency, residential ratepayers will be unfairly forced to pick up the tab for infrastructure that primarily benefits private data companies.

Improve Your Sleep Performance: Tools to Help You Sleep Better

These are stressful times for public health practitioners and researchers… especially those of you dealing with the barrage of changing directives from the feds and their whimsical and thoughtless budget cut decisions.

It may be even affecting the quality of your sleep…  something that’s key to keeping a work life balance and better perspective.

Beyond feeling rested, sleep helps your mood, focus, metabolism, heart health, and immune function. Over time, poor sleep can raise the risk for chronic conditions like depression, diabetes, and cardiovascular disease.

Sleep needs change across the lifespan. Adults typically need at least 7 hours per night, while teens and children need more. The quality of that sleep and how well you fall and stay asleep matters just as much as the quantity.

So, what can you do to improve your sleep performance?

Build Habits that Improve Sleep Performance

Want better sleep? Start with your daily routines. These habits can help improve your sleep performance with the combination of sleep duration, quality, and regularity that influences how well-rested you feel.

  • Keep a consistent schedule: Go to bed and wake up at the same time every day—even weekends.
  • Create a wind-down ritual: Dim lights, read, stretch, or take a warm shower an hour before bed.
  • Make your sleep space comfortable: A cool, quiet, and dark room supports deeper sleep. Consider blackout curtains, a fan, or white noise i (your phone probably has white noise in the accessibility setting).
  • Avoid screens at night: Blue light from phones and TV can disrupt your body’s melatonin production. Avoid your phone and especially doomscrolling before bed.
  • Watch food and caffeine: Avoid large meals, alcohol, and caffeine in the hours before bed.
  • Be active, but time it right: Regular exercise promotes better sleep but try to finish intense workouts at least 2–3 hours before bed.

Track Your Sleep with Wearables

Many people are now using smartwatches, rings, and fitness trackers to monitor their sleep. Devices from brands like Fitbit, Apple, Garmin, WHOOP, and Oura can give you data about:

  • Sleep duration: Total hours slept each night
  • Sleep stages: Light, delta, and REM cycles
  • Sleep regularity: Consistency of sleep/wake times
  • Sleep interruptions: Wake episodes during the night

These tools will help you quantitatively measure how well you’re sleeping and help you recognize trends. If you keep a journal that tracks what you did before bed and match that up with the results you get for that night it will give you some clues about what you can improve.

Troubleshooting

If you’re still tired after 7–8 hours in bed, snore heavily, or often wake during the night, you could have a sleep disorder like sleep apnea and it’s worth seeing a medical professional.

Note: I discovered that I had sleep apnea about 15 years ago. I saw my ENT and he assessed that I had a ‘world class uvula’ and suggested that I vaporize it. He used a laser beam to burn off my uvula and some of my soft palate and my sleep has been MUCH better since.

For short-term sleep support, melatonin supplements might help reset your body clock or ease jet lag. CBN (cannabinol), a cannabis-derived compound available at dispensaries, is also an effective sleep aid for some people. They’re not magic solutions and work best when paired with good sleep hygiene.

Sleep Performance: A Skill You Can Build

Start by quantitatively measuring your sleep performance, make one or two small changes, and evaluate the result with the data you collect… then experiment with other sleep hygiene strategies until you get results.

More: Sleep Hygiene | CDC

Senate Confirms New CDC Director: What’s She Like?

The U.S. Senate confirmed Susan Monarez, PhD as Director of the CDC this week on a 51–47 party-line vote. I did some checking with my CDC sources… and from what I can tell, the appointment choice was about as good as we could expect from Kennedy.

Kennedy Swears in Susan Monarez as CDC Director | CDC Newsroom
Susan Coller Monarez | LinkedIn

Monarez has a Ph.D. in microbiology/immunology from the University of Wisconsin–Madison and has done postdoctoral work at Stanford.

While she took some heat for not being an MD at her hearing, that’s not a big deal to me. I’m more interested in whether a person has a reputation of using evidence to drive the agency’s decisions and has shown they can effectively manage a large organization with integrity and fidelity to evidence.

From what I can tell from my sources, Monarez has a reputation of basing her opinions and decisions on evidence rather than ideology. Some said she has a reputation for being too deferential to leadership. Such a personality trait is bad given that she reports to Kennedy – so that’s not so great.

At her confirmation hearing last week, she sidestepped questions related to Kennedy’s recent and proposed future budget and staffing cuts at CDC as well as the dismissal of all members of ACIP and replacing them with mostly anti-vax ideologues. That’s not good.

On the other hand, she emphasized at the hearing that vaccines save lives & said she has seen no evidence to suggest there’s a causal link between vaccines and autism. She promised to maintain vaccine availability and make policy decisions based on scientific evidence, including around mRNA vaccines. So those are good things.

Sadly, none of the Senators asked Monarez about her commitment to or opinions about the Vaccines for Children program. Those would have been important questions, as VFC is among the biggest levers Kennedy has to achieve his goal of fewer vaccinations.

Mostly folks said they were relieved that Monarez is a career public health person with research, policy, and management experience and that her decisions over her career have generally been grounded in evidence.

Time will tell but seems to me it could have been worse. A lot worse.

Arizona Again Among the Worst States for Childhood Vaccination Rates

Each year, the CDC compiles and releases data on childhood immunization rates across the country by examining school-reported data on kindergarten vaccine coverage and exemption status.

Since there’s no national requirement for individual-level vaccine reporting, the best available proxy for estimating childhood vaccination rates is the percentage of kindergartners who are not exempted from school vaccine requirements. States compile and report this data to the CDC, which typically summarizes it in a Morbidity and Mortality Weekly Report (MMWR).

Instead of an MMWR summary with trend analysis and public health context, the CDC quietly released a spreadsheet (without commentary) this year listing each state’s kindergarten coverage rates for vaccines like MMR (measles, mumps, and rubella), DTaP, polio, and varicella. You can find that raw data here: CDC Kindergarten Vaccination Data 2025 (Excel Spreadsheet)

Arizona Ranks 40th of 51 in MMR Vaccine Coverage

This year’s numbers show that just 88.6% of Arizona kindergarteners are up to date on their MMR vaccines, placing Arizona 40th out of 51 (the 50 states plus D.C.). See that Chart Here.

That’s a drop of 0.6% from last year, consistent with a trend we’ve seen for more than a decade, where Arizona’s coverage falls by roughly half a percent every year.

The national picture isn’t much better, but Arizona’s continued slide is alarming—especially considering that the MMR vaccine is essential to preventing measles outbreaks, which have been on the rise globally and domestically.

AZ Childhood Vaccination Rates Declined During the Ducey Administration: Is it Bad Luck or Bad Policy & Management?

ADHS Announces Positive Changes to their Vaccines for Children Program!

An Unusual Pattern in Public Health Rankings

Most public health outcomes tend to follow a familiar regional pattern: Northeastern and West Coast states (typically those with stronger public health infrastructure and progressive policy environments) perform well, while Southern states (those in the “SEC Conference” region) have the worst outcomes.

But vaccination rates is an exception.

For example:

  • Mississippi, a state that usually performs poorly in health rankings, has among the highest childhood vaccination rates in the country.
  • Meanwhile, Minnesota, often considered a leader in health policy, has one of the lowest vaccination rates, even worse even than Arizona.
What Explains the Difference?

Policy.

States like Mississippi don’t allow personal or philosophical exemptions to school vaccine mandates. In other words, unless there’s a medical reason, their kids need to be vaccinated to attend school.

In contrast, states like Arizona have permissive exemption policies that allow parents to opt out of school vaccination requirements for personal or religious reasons. Unsurprisingly, those states consistently rank near the bottom in vaccine coverage.

Why It Matters

The decline in vaccination rates, especially for highly contagious diseases like measles, isn’t just a bureaucratic issue. It puts entire communities at risk. MMR vaccine coverage needs to be above 90–95% to have herd immunity and prevent outbreaks. Arizona, like many other states, is now falling below that threshold.

The Bottom Line

Arizona’s persistent decline in MMR vaccination rates should be setting off alarm bells. We now rank in the bottom 20% of the country, and our trendline shows no sign of reversal. Policy decisions, especially around whether states allow personal choice exemptions are a major reason.

Thankfully, Governor Hobbs has consistently been vetoing bills that would have thrown gas on the fire.

Public health stakeholders, lawmakers, and communities need to pay attention. We know what works, no personal exemptions for school attendance.

Note: For decades, CDC published this data in the form of an MMWR report. This year, it was released only as a raw spreadsheet with no accompanying analysis or context.

Free Professional Development Opportunity: The Satcher Health Leadership Institute

ASTHO and the Satcher Health Leadership Institute with support from CDC invites qualified professionals to apply to the next cohort of the Developing Executive Leaders in Public Health program.

Qualified public health professionals must be currently employed at a local, island/territory, tribal, or state public health department. Federal employees are not eligible to take part in the DELPH program.

Applications | ASTHO

This is a 10-month program with two in-person events. A calendar of events for all virtual and in-person sessions with dates and locations will be shared during the program orientation. Participation in these events is a requirement for participation in the program.

Scholars will be expected to attend and be fully engage in DELPH programming and events.

  • Completing self-study modules and taking part in cohort discussions.
  • Actively engaging with an assigned mentor and executive coach.
  • Actively engaging as a volunteer through association leadership opportunities.
  • Serving as an ambassador to recruit and keep diverse leadership candidates for their agency.

Applications | ASTHO

New Executive Order on Homelessness: Big Talk, Small Leverage?

This week, the President issued an executive order directing a few federal agencies (DOJ, HHS, HUD, and DOT) to “crack down” on unsheltered homelessness, substance use, and untreated serious mental illness in ways that feel more like policing than public health.

Ending Crime and Disorder on America’s Streets – The White House

You can read the Executive Order here, but here’s the quick version: the EO tells cabinet agencies to: 1) Support court-ordered treatment and institutional care for people who are homeless and “unable to care for themselves”; 2) Give grant priority to cities that enforce laws against camping, drug use, and squatting; and 3) Withhold funding from harm reduction programs like safe consumption sites.

One line even encourages the collection and sharing of health data with law enforcement, “where allowed by law.”

Note: While Executive Orders give agencies formal direction from the executive, they don’t give them any additional statutory authority. They still need to act within the boundaries in federal law set by congress. If agencies use an EO in a way that exceeds their existing statutory authority it’s relatively straightforward for the judicial branch to overturn those actions.

Most of the Power Lies Closer to Home

From a public health perspective, the EO raises more questions than it answers. First, most of the real levers that impact homelessness and behavioral health lie at the state and local level.

State law determines what qualifies as grounds for court-ordered evaluation or court-ordered treatment. Local governments control zoning, affordable housing incentives, and most eviction policies. States decide whether or not to preempt city NIMBY-informed and unreasonable zoning restrictions that prevent more affordable housing. Substance use treatment systems vary widely from one state to the next.

The Federal Role: More About Funding Than Policy

Yes, the federal government plays an indirect and limited role, primarily through funding. HUD’s Continuum of Care grants, SAMHSA block grants, and DOJ reentry funding can shape what local programs are available and how they’re run.

But the biggest federal lever by far is Medicaid, specifically the 1115 waiver that allows AHCCCS (our state’s Medicaid agency) to experiment with coverage for services like behavioral health, supported housing, and community-based crisis care, including their new H2O initiative.

Striking Absence: No Mention of CMS or Medicaid

And that’s where this EO gets oddly silent. There’s no mention of CMS, 1115 waivers, or how Medicaid policy might be aligned with this new federal posture.

That’s surprising, since Medicaid pays for a huge portion of behavioral health care in Arizona, including treatment mandated by the courts for members with a Serious Mental Illness.

If the President truly wanted to change how states approach serious mental illness, substance use, and homelessness, Medicaid waivers and Medicaid agency oversight would be the place to start.

Instead, the EO is silent on Medicaid and in my opinion reads more like a political message dressed up as policy (at least so far)… except for nebulous expectations for changes in HUD’s Continuum of Care and SAMHSA block grants (which are relatively small).

What HUD and DOJ Might Do (Eventually)

The National Association of Counties issued an objective summary, noting that the EO reflects a shift in federal posture toward institutional treatment and “public safety” requirements, but with few details and unclear implications for how it’ll be implemented.

White House Executive Order Shifts Federal Approach to Homelessness, Mental Illness and Public Safety | National Association of Counties

Agencies like HUD and DOJ are instructed to prioritize enforcement-focused jurisdictions when awarding grants… but again, no specifics yet.

So, What Does This Mean for Arizona?

For now, probably not much. Unless CMS starts using its 1115 waiver authority to reshape Medicaid in ways that align with this EO (which the order doesn’t mention), the direct impacts will be limited in at least the near future. AHCCCS isn’t required to change how it funds COT or behavioral health services. Our housing programs that depend on HUD grants may face new strings attached, but we won’t know until those grant criteria are formally updated.

Public Health Needs the Right Tools, Not Just Tough Talking EO’s

Bottom line: this Executive Order may generate headlines, but it’s not likely to change much in Arizona, at least not yet.

For real progress, we need policy that’s informed by evidence, not just ideology, and that uses the right tools to support people living with serious mental illness, substance use disorder, and housing instability. These tools include Medicaid flexibility, community-based treatment capacity, and housing-first strategies, not just law enforcement crackdowns and institutional beds.

We’ll be watching to see how (or if) the cabinet agencies translate this order into actual policy… or whether a new EO extends this into the Medicaid world. In the meantime, local and state action remain the primary drivers of outcomes.

One Stop Shop for HR1 Public Health Impacts

The National Health Law Program recently published a one stop shop for finding what portions of HR1 will kick in when – things like changes to Medicaid, Marketplace Insurance and SNAP in a report called Budget Reconciliation Act Implementation Dates for Select Medicaid and Health Provisions

More relevant dates and information are found in the third column (for example, sunset dates for temporary provisions, deadlines for federal agency rulemaking or guidance, overlapping rulemaking deadlines, or areas where administrative discretion may affect implementation).

A single provision may have multiple entries to reflect multi-stage implementation across more than one deadline.

Color coding is used to distinguish between the different programs addressed Medicaid (no color), Medicare and Marketplace.

Seems like a pretty important thing to save in your favorites.

Three Ways to Reduce the Burden of Cancer and Why NIH & NCI Funding Matters

There are several effective strategies to reduce the burden of cancer, each playing a unique but complementary role in the fight against one of the world’s leading causes of death.

From high-profile breakthroughs in treatment like immunotherapy and precision medicine to prevention and early detection, research funded by the NIH and the National Cancer Institute have been reducing the burden of cancer through prevention and treatment.

Public funding for biomedical and public health research—especially through the NIH and its daughter agency, the National Cancer Institute (NCI)—has been a cornerstone of this progress.

Kennedy’s Defunding of Public Cancer Research Threatens Lives & Future Cancer Treatment & Prevention
Advancing Cancer Treatment Through Foundational Research

The most visible progress in cancer treatment are treatment breakthroughs like new immunotherapies, targeted drugs, and precision medicine.

While the companies that take the drugs the final miles attract the headlines, they’re only possible because of the foundational, long-term research funded by the NIH and NCI.

Comprehensive Cancer Information – NCI

NIH & NCI support the “bottom of the pyramid” work that industry rarely invests in like the core biology, mechanisms of disease, and early-phase research that lays the groundwork for later clinical innovation, clinical trials and finally licensing of new therapies.

Preventing Cancer Through Behavior & the Environment

In public health, our greatest wins come from prevention. Perhaps the most striking example is the decades-long campaign to reduce tobacco use.

Thanks to tobacco taxes, smoke-free laws, education, and cessation programs, smoking rates have dropped dramatically and so have lung cancer rates.

Similarly, public health improvements like food safety regulations and widespread refrigeration have led to declines in stomach cancer, once one of the most common cancers globally. Prevention through behavior change and environmental improvement saves lives before a diagnosis is even on the table.

Catching Cancer Early: Better Screening

Early cancer detection saves lives. Public health programs like Medicaid, Medicare and Marketplace health insurance (the Affordable care Act) increase access to screening like mammograms, Pap smears, and PSA tests which help find cancers when they are most treatable.

Guidelines developed through research ensure screening is both effective and safe, while programs that expand access (especially in underserved populations) ensure equity in outcomes.

A Case Study in Prevention: The HPV Vaccine

One of the most powerful cancer prevention tools is the HPV vaccine. It prevents infections with human papillomavirus, a major cause of cervical and other cancers.

The science that led to the vaccine including the discovery of HPV’s role in cancer, the development of virus-like particle technology, and the conduct of early trials was heavily funded by NIH and NCI… a textbook example of how sustained public investment in basic and translational research can produce life-saving tools.

The fight against cancer depends on a multifaceted approach and it only works when backed by robust public funding. Whether through new treatments, behavioral prevention, early detection, or vaccines like HPV, the contributions of NIH and NCI are foundational to our progress.

Sadly, all of that is now at risk because of Secretary Kennedy’s enthusiasm for dramatically cutting back on cancer prevention, screening and treatment research.

Kennedy’s Defunding of Public Cancer Research Threatens Lives & Future Cancer Treatment & Prevention

For more than 50 years, the National Institutes of Health & the National Cancer Institute have been sparking major advances in cancer prevention, diagnosis, and treatment. Sadly, those days are coming to an end.

From early chemotherapy trials to new immunotherapies and CAR T-cell treatments, public funding has driven the basic science and clinical research that private industry uses to develop new cancer therapies, prevention strategies and tools.

Without NIH and NCI, many if not most, of the lifesaving cancer therapies we rely on today wouldn’t exist.

NIH and NCI-funded research has led to thousands of patents, laying the scientific groundwork for the private sector to develop therapies with market potential. Achievements like monoclonal antibody therapies, targeted treatments for leukemia, and CAR T-cell therapy for refractory cancers all began in federally funded labs.

Three Ways to Reduce the Burden of Cancer and Why NIH & NCI Funding Matters – AZ Public Health Association

The ROI from NIH and especially NCI funding is huge (6x). For every $100M invested by NIH and their NCI, an estimated $598M in downstream product development is generated.

Private industry and equity plays an important role in therapy development too (especially in late-stage development and commercialization) BUT their focus is mostly on ‘top of the pyramid’ projects with clear market potential… not the core research that provides the foundation for those new therapies.

Without publicly funded early-stage research investment, the pipeline for future breakthroughs will atrophy. Unfortunately, that’s exactly the path the U.S. has been on for the last 6 months.

Kennedy has already slashed NIH & NCI research by an astonishing 35%, and he’s just getting started with his cuts. He has executed mass cancellations of numerous contracts & ended hundreds of research projects (over 800) and layed off ~2,500 NIH researchers.

Note: The canceled NCI research grants were arbitrary and capricious. He didn’t look at the merits of the research or its potential when he the canceled the grants…  he simply used ‘keyword-based filtering’ to find words like ‘disparity’, ‘equity’, ‘gender’, and ‘mRNA’ & summarily canceled the research because a key word was used (without any scientific peer review).

His cuts are doing both short-term damage to cancer research and long-term.

By disrupting and ending the careers of young investigators and ending early-stage research programs, his cuts will kill the careers of the next generation of cancer scientists.

Even if (when) a future, more thoughtful administration and congress restores some of the funding, the loss of research talent, abandoned trials, and broken partnerships will impair progress for decades.

Given Kennedy’s aversion to research, it’ll likely take a profound change in the makeup of Congress before we can reverse the tide… unless there’s success in the courts to stem the tide of bad decisions.

Colorado et al. v. DHHS, RFK Jr.
Arizona Attorney General’s Federal Action Lawsuits

If we’re unable to turn the decision-making tables in the 2026 mid-term election the damage will be profound and probably irreversible. In the meantime, our only backstop are the legal actions being filed in federal courts to stop some of these dangerous actions by Kennedy.

Additional Note:

In federal fiscal year 2025 Congress appropriated $7.22 billion to the National Cancer Institute, the same level as FY 2024.

Secretary Kennedy effectively cut a large portion of that cancer research funding with a freeze on NIH grant-making, delaying NCI awards to the tune of $1.5B. He ended over 240 NIH cancer-related grants, affecting approximately $355 million of NCI‑related research funds. He canceled more than $180M in NCI-specific grants during the first three months of 2025 alone.

Combined, these executive actions resulted in an NCI loss of about $2B (so far) in the current fiscal year.

Kennedy is now proposing a formal cut for next fiscal year to reduce the NCI budget from $7.2B to $4.5B (a 37% cut).