Author: Will Humble

From AzPHA Member Bre Thomas at Affirm

The CDC suspended data collection through the Pregnancy Risk Assessment Monitoring System (PRAMS) last week. PRAMS is a federal population-based surveillance system “designed to identify groups of women and infants at high risk for health problems, to monitor changes in health status, and to measure progress towards goals in improving the health of mothers and infants.”

Developed in the 1980s as part of a concerted effort to better understand why Black and Native American/Alaskan Native mothers and infants consistently experienced worse health outcomes than their white counterparts, the PRAMS questionnaire includes questions about racism, discrimination, and socioeconomic status.

Because the current survey and research protocol include questions about race, sexual orientation and gender identity, and class status, an overhaul is necessary to comply with the President’s executive order ending government diversity, equity, and inclusion (DEI) programs.

CDC employees who work on PRAMS have reported that the program will eventually continue without survey questions about race/ethnicity and other social determinants of health. However, the ability of a revised PRAMS questionnaire to support the program’s goal of finding groups of pregnant people and infants at heightened risk for adverse health outcomes is still unclear.

Furthermore, these revisions to the survey’s questions — some of which have been asked consistently since 1988 — will diminish the ability of program administrators, policymakers, and advocates to watch changes over time.

Currently, 26 Title X grantee agencies (all state health departments) take part in the PRAMS program, and both programs are often co-located in the same bureau or division. Even more family planning and sexual health service providers rely on PRAMS data for program planning.

Of note, PRAMS data is used to calculate unintended pregnancy and birth rates; access to and receipt of prepregnancy, prenatal, and postpartum care; patterns of health insurance coverage before, during, and after pregnancy; and performance measures on access to postpartum contraception.

Imagine waking up to a world where your local health department can’t track a measles outbreak, run immunization programs, or respond to foodborne illness outbreaks. That’s not a dystopian fantasy—it’s the reality Arizona could face if federal funds for public health are slashed.

That might not be a dream. It could eventually become a reality.

Shortly after Trump’s inauguration, his administration tried to cancel federal contracts and cooperative agreements with state and county health departments. A judge stepped in to block the move, but if that ruling is lifted—or if federal officials simply ignore it—it would be catastrophic for Arizona.

Why? Because more than 70% of county health department funding in Arizona comes from federal dollars.

Without it, the state would essentially have no functioning public health system. County health departments could still inspect restaurants (since that’s fee-based), but everything else—from infectious disease control to maternal health programs—would grind to a halt.

Infectious Disease Outbreaks: A Disaster Waiting to Happen

With no public health infrastructure, Arizona wouldn’t be able to track or respond to disease outbreaks like the recent measles cases in Texas and New Mexico. Surveillance for emerging threats like new COVID-19 variants? Gone. Efforts to contain tuberculosis? Over. Vector-borne diseases like West Nile virus and dengue? No one would be monitoring them.

Immunizations for Kids & Adults Would Collapse

Public health departments run vital immunization programs that protect children and adults from vaccine-preventable diseases. Slashing federal funds would mean fewer vaccines for low-income families, leading to outbreaks of diseases we thought were under control—like measles and whooping cough.

Foodborne & Vector-Borne Illnesses: Who’s Watching?

Public health officials investigate outbreaks of foodborne illnesses like salmonella and E. coli to keep the food supply safe. Without funding, those investigations stop, leaving the public (you) at risk. Similarly, Arizona’s fight against mosquito-borne diseases like West Nile virus would be gone, increasing the chances of widespread infections.

Maternal & Child Health Programs Would Disappear

Prenatal care programs, newborn screenings, and early childhood health initiatives rely heavily on federal funding. Without them, maternal and infant mortality rates could rise, reversing decades of progress.

No Emergency Preparedness for Pandemics, Heatwaves, or Bioterrorism

Public health emergencies—whether it’s a pandemic, extreme heat, or a bioterrorism threat—require coordinated responses. County health departments lead these efforts, ensuring Arizona can react quickly and effectively. If federal funds vanish, so does preparedness, putting millions at risk.

The Bottom Line

This isn’t an exaggeration—if these cuts happen, Arizona’s public health system would collapse. The consequences would be deadly. Public health funding isn’t just another budget line item—it’s what keeps our communities safe. Cutting it would be reckless and dangerous.