Will Humble, Author at AZ Public Health Association

This week Kennedy canceled 22 federally funded mRNA vaccine development projects, totaling nearly $500M. His decision will stop research through the Biomedical Advanced Research and Development Authority (BARDA), including projects aimed at vaccines for COVID‑19, influenza, and H5N1 bird flu.

I’ll spare you his made-up reasons for canceling the research.

His decision to eliminate federally funded mRNA vaccine research will slow down and possibly stop research to develop faster, more adaptable mRNA-based influenza vaccines, which hold the potential to be updated more rapidly and accurately in response to emerging flu strains (unlike traditional vaccines which rely on months-long egg-based production).

Kennedy is stopping the clinical trials, delaying technological refinement, and reducing the pace at which mRNA flu vaccines can be brought to market.

Editorial Note: By ending publicly funded mRNA research for infectious diseases, Kennedy is surrendering leadership in this critical biotech field to global competitors. The EU & China are heavily investing in mRNA platforms for pandemic preparedness and seasonal illness, positioning themselves to dominate future vaccine innovation and production.

In essence, Kennedy’s decision risks long-term U.S. dependence on foreign technologies and undermines America’s ability to lead in global health security.

Kennedy hasn’t canceled mRNA research for cancer immunotherapy and personalized therapeutics yet. Promising therapies in those areas stay intact at the NIH with over 120 mRNA cancer therapy clinical trials underway ($656M) including Phase 3 mRNA‑4157 studies for multiple kinds of cancers.

For example, Moderna’s melanoma vaccine and BioNTech’s personalized ‘neoantigen’ cancer therapies continue to show enormous promise for curing certain kinds of cancer including pancreatic and skin cancers… an example of the kinds of cancer trials he hasn’t canceled (yet).

Kennedy’s decision to redirect infectious disease vaccine research away from mRNA approaches will slow some progress, but it won’t end mRNA-based medicine. Private investment and biotech industry leadership as well as the EU and China recognize the promise this new technology and many U.S. companies will continue research in these areas on their own.

So much for Making America Healthy Again.

August 6, 2025August 4, 2025

Will Humble Climate Change, Wills Blog

EPA Decides that CO₂ Isn’t a “Danger” Anymore So they Can Reverse Carbon Emission Standards

This week, the EPA Administrator said he will rescind their 2009 Endangerment Finding that has underpinned the EPA’s regulation of carbon dioxide (CO₂) and other greenhouse gases. If upheld by the courts the decision will eliminate the EPA’s regulations on greenhouse gases with implications for global climate change.

How the EPA Came to Regulate CO₂

The foundation for regulating carbon dioxide traces back to the 1970 Clean Air Act which authorizes the EPA to regulate air pollutants that may endanger public health.

Initially, CO₂ and other greenhouse gases weren’t considered pollutants under the law. That changed with the 2007 Supreme Court case Massachusetts v. EPA, in which the Court ruled that greenhouse gases are air pollutants under the Clean Air Act and must be regulated if the EPA determines they pose a risk.

In 2009, the Obama-era EPA issued the Endangerment Finding, concluding that CO₂ and other greenhouse gases DO endanger public health and welfare due to their role in climate change.

That triggered regulatory requirements, starting with fuel economy and emissions standards for motor vehicles, regulations on large industrial sources like power plants, cement manufacturers, and oil refineries.

Industry Compliance and Enforcement

Over the next several years the EPA launched a suite of regulatory actions like Vehicle Emission Standards, permitting of major industrial sources, and the 2015 Clean Power Plan which focused on making electricity plants slowly shift to lower-emission sources.

Enforcement came through a mix of permit requirements, monitoring and reporting standards, and potential penalties for noncompliance.

The Decision to Overturn the Endangerment Finding

The new EPA now argues that the scientific and legal basis for the Endangerment Finding is flawed and that carbon dioxide and other greenhouse gases (methane) don’t meet that standard anymore – which if upheld by the courts would eliminate all the reduction measures developed and implemented since 2009.

Legal Challenges and the Role of the Courts

Given that the 2009 Endangerment Finding has survived multiple legal challenges, EPA’s reversal is almost certain to be challenged in court.

Expect lawsuits from states, environmental groups, and possibly some industry players who have already invested in compliance and want regulatory certainty.

Courts will scrutinize whether the EPA has a sufficient scientific and administrative record to justify rescinding a long-standing finding that has been upheld multiple times, including at the US Supreme Court.

The Post-Chevron Legal Landscape

Meanwhile, the legal playing field has changed since 2009 with the US Supreme Court’s decision to overturn Chevron deference (a decades-long doctrine that instructed courts to defer to reasonable agency interpretations.

Without Chevron in place, courts are more likely to second-guess the EPA’s interpretations of the Clean Air Act, including this decision by giving judges more leeway in questioning and staying agency decisions, like this one.

Looking Ahead

Legal challenges will likely stretch on for years and so will the uncertainty facing regulators, industries, and communities dealing with the accelerating impacts of climate change.

In the short run, much will depend on what federal District and Appellate courts decide… and whether they issue a Stay on the EPA decision.

In the long run, much will depend on the results of the 2028 presidential election.

August 5, 2025August 4, 2025

Will Humble Social Determinants, Wills Blog

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.

August 4, 2025August 4, 2025

Will Humble Public Health, Wills Blog

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

August 1, 2025August 1, 2025

Will Humble Public Health, Wills Blog

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.

August 1, 2025August 1, 2025

Will Humble Vaccination, Wills Blog

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.

July 30, 2025July 27, 2025

Will Humble Professional Development, Wills Blog

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

July 29, 2025July 30, 2025

Will Humble Behavioral Health, Wills Blog

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.

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