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    Trump administration eviscerates maternal and child health programs

    Multiple maternal and child health programs have been eliminated or hollowed out as part of the Department of Health and Human Services (HHS) layoffs, prompting alarm and disbelief among advocates working to make Americans healthier.The fear and anxiety come as a full accounting of the cuts remains elusive. Federal health officials have released only broad descriptions of changes to be made, rather than a detailed accounting of the programs and departments being eviscerated.“Pediatricians, myself included, are losing sleep at night – worried about the health of the nation’s children,” said Dr Sue Kressly, president of the American Academy of Pediatrics.“The one that stands out to me is the Maternal and Child Health Bureau. There is no way to make our country healthier by eliminating expertise where it all starts, and it all starts at maternal and child health.”The health secretary, Robert F Kennedy Jr, announced HHS would eliminate 10,000 jobs as part of a restructuring plan. Together with cuts already made by Elon Musk’s unofficial “department of government efficiency”, HHS is likely to lose 20,000 workers – roughly one-quarter of its workforce.“We aren’t just reducing bureaucratic sprawl,” Kennedy said. “We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic.”Piecemeal and crowd-sourced information, which has filled the vacuum left by a lack of information from the health department, appears to show maternal health programs slated for elimination, many without an indication of whether they will be reassigned. The Guardian asked HHS to comment on the cuts but did not receive a response.The picture of cuts was further muddied on Thursday when Kennedy told reporters, according to Politico: “We’re going to do 80% cuts, but 20% of those are going to have to be reinstalled, because we’ll make mistakes.”In the aftermath of the height of the Covid-19 pandemic, there’s been much conservative criticism of public health agencies, particularly the Centers for Disease Control and Prevention (CDC). Pandemic policy continues to be an animating force within the Republican party, whose supporters are cynical about the value of federal public health programs following federal vaccine mandates.The cuts to maternal health programs may serve a second purpose for Republicans.Such programs have come under fire in some conservative states, in part because the experts involved investigate deaths that could have been prevented with abortion services – now illegal or severely restricted in nearly two dozen conservative states.As part of the restructuring, the administration announced 28 divisions would be folded into 15, including the creation of a new division, called the “Administration for a Healthy America”, or “AHA”.The administration argued the “centralization” would “improve coordination of health resources for low-income Americans and will focus on areas including, primary care, maternal and child Health, mental health, environmental health, HIV/Aids and workforce development”.Meanwhile, experts in HIV/Aids, worker health and safety, healthcare for society’s most vulnerable, and experts in maternal and child health have received “reduction in force” notices, a federal term for layoffs, or have been placed on administrative leave with the expectation of being eliminated.“It certainly appears there was a particular focus on parts of HHS that dealt with women’s or reproductive health,” said Sean Tipton, chief policy officer at the American Society for Reproductive Medicine, about the cuts.He added: “How in the world you can justify the CDC eliminating the division of maternal mortality is beyond me.”Among the divisions hard-hit was the Health Resources and Services Administration (HRSA), an operating division of HHS like the CDC, which housed the the Maternal and Child Health Bureau. HRSA lost as many as 600 workers.The CDC’s division of reproductive health, which studies maternal health, appeared to have been nearly eliminated, according to multiple reports, with some of the division’s portfolio also expected to be folded into AHA.skip past newsletter promotionafter newsletter promotionThe entire staff of a gold-standard maternal mortality survey, a program that was called the Pregnancy Risk Assessment Monitoring System, was also put on leave, Stat reported. The epidemiologist in charge of the CDC survey, Jennifer Bombard, wrote to colleagues on Tuesday: “[T]he entire CDC PRAMS team, including myself, has received the Reduction in Force (RIF) notice from HHS today.”A HRSA hotline that had fielded calls from new moms seeking mental health support was also cut, Stat reported. Layoffs at the Administration for Children and Families have jolted providers of federally backed high-quality childcare for low-income families, a program called Head Start.The CDC’s only experts on infertility were laid off, just days after Trump described himself as the “fertilization president” at an event marking Women’s History Month. The team had collected congressionally mandated statistics on fertility clinics’ success rates. Without the workers, it is unclear who at the department will help fertility clinics comply with the law.“I’m astounded, sad, perplexed,” said Barbara Collura, president of Resolve: The National Infertility Association. “Infertility impacts one in six people globally, and now we don’t have anybody at the CDC who knows anything about infertility and IVF?”A division of the CDC called the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention also appeared to be gutted, with the director Jonathan Mermin placed on administrative leave. Among the center’s many tasks, it worked to curb the spread of congenital syphilis, a debilitating disease that is on the rise in the US.The March of Dimes, an influential non-profit whose mission is to improve the health of mothers and babies, said the cuts “raise serious concerns” at a time when maternal mortality rates remain “alarmingly high”.“As an OB-GYN and public health leader, I can’t overstate the value these resources and programs – and our partners across CDC, HRSA, and NIH – have brought to families and frontline providers,” said Dr Amanda Williams, the interim chief medical Officer at the March of Dimes.“We rely on the data, research, clinical tools and partnerships built by the Division of Reproductive Health (DRH) and HRSA to protect maternal and infant health – especially in communities hit hardest.”Heads of National Institutes of Health (NIH) centers were also forced out – and, apparently, offered reassignment to the Indian Health Service to be stationed in Alaska, Montana or Oklahoma, the journal Nature reported. Such large-scale reassignments are unprecedented, according to Stat.Among those to be placed on leave was one of the federal government’s pre-eminent leaders of research, the director of the National Institute of Allergy and Infectious Diseases (NIAID) Dr Jeanne Marrazzo. Marrazzo had expertise in sexually transmitted infections and women’s reproductive tract infections – a background that gave health advocates hope of curbing the US’s sky-high STD rates. Dr Diana Bianchi, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, was also forced out.“These cuts are significant,” Kressly said. “And the policy and program changes that are made because the cuts impact real people in real communities, and I’m not just talking about the people who lost their jobs.” More

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    The Guardian view on online safety: don’t let Trump dictate the terms of debate | Editorial

    In 1858, when London could no longer tolerate the stench of raw effluent in the Thames, city authorities commissioned a system of sewers that operates to this day. A century later, when noxious fog choked the capital, parliament passed the first Clean Air Act, limiting coal fire emissions.When a dangerous toxin assails the senses, polluting public space to the detriment of all that use it, the case for legislation is self-evident. The argument is more complex when the poison has no chemical properties; when it exists in a virtual realm. This is the conceptual challenge for regulation of digital content. It is made all the more complex by conflation with arguments about free speech and censorship.The UK has a law that grapples with these questions. The 2023 Online Safety Act makes social media companies, websites and search engines responsible for harmful content published via their services. Offending material named in the statute is uncontroversially horrible – violent pornography, incitement to violence and terrorism. Such things are commonly proscribed even in very liberal jurisdictions on the basis that, with some types of communication, the state’s duty of public protection is paramount. No one argues that child abuse images, for example, are a legitimate expression of free speech.Yet implementation of the Online Safety Act is now in question because Donald Trump’s government has identified it as a symptom of wider European infringement of free expression. As the Guardian revealed this week, US state department officials expressed their concern in a meeting with Ofcom, the regulator responsible for enforcing new digital regulations.That intervention should be seen in the context of an aggressive trade policy that cannot tolerate any foreign restriction on the extension of American economic interests overseas. That explicitly includes regulation that “incentivises US companies to develop or use products and technology in ways that undermine free speech or foster censorship”.The invocation of liberal principle here is cynical and ideological. The Trump administration defines freedom of speech as the right to propagandise for the president. Any effort to correct wilful misinformation or conduct public discourse on a foundation of verifiable fact is liable to be denounced as censorship.Mr Trump’s power is bolstered by alliance with tech industry oligarchs. The unwritten deal is that the president’s cause is boosted on social media and the platforms’ commercial interests are driven by the president. That is why US trade policy is being deployed against European regulators that have tried to make the internet – or the part of it over which they have legal jurisdiction – less lawless.Yielding to that pressure would cede control of the digital information space to people who actively subvert it for the cause of American ultranationalism. It would mean accepting that a vital part of the digital infrastructure for a free society operates according to rules set by companies that are poisoning the wells of public discourse.There is a legitimate debate to be had about the boundary between safety online and censorship. The two issues are entangled because regulation of information space involves a distinction between permitted and intolerable content. But no European democracy can conduct that debate on terms dictated by a US administration that sees all digital space as its sovereign domain, and that holds tenets of liberal democracy in contempt. More

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    Trans soldiers served their country. Now the US is rolling back their healthcare

    When Savannah Blake joined the air force at 22 years old, she was looking for stable employment and a way out of poverty. For the last few years of her service, she worked as a cyberdefense operator in the intelligence squadron. But the work, which involved overseeing computers operating drone surveillance, eventually took a toll on her mental health.“If I had to watch any more of this, I was going to not be alive anymore,” Blake said, who says she experienced suicidal ideations. “I just felt like the bad guy. I felt evil.”View image in fullscreenAfter seven years of service, Blake, who is trans, left the air force with PTSD, generalized anxiety disorder and chronic depression. But she also left with the hope she could finally live as herself without fear of harassment from fellow service members. Last year, she began receiving estrogen through the Department of Veterans Affairs. Now she fears for the future of that care.“Every day, I wake up and I don’t know what the rules are anymore in the country I live in,” said Blake. “It’s becoming increasingly hard to see a future where we’re OK.”Blake is one of about 134,000 transgender veterans living in the US. It’s an alarming time to be someone like her. On his first day in office, Donald Trump issued an executive order recognizing only two sexes, stamping out gender identity in federal documents and public spaces. A series of other orders have attempted to restrict trans rights, including participation in sports, access to gender-affirming care for youth, educational materials in schools and military service.The crackdown has sent shock waves through the VA, which functions as one of the US’s largest healthcare providers, offering free or low-cost care to more than 9 million veterans. After Trump’s inauguration, some VA health centers began removing LGBTQ+ affiliated objects, including pride flags, rainbow magnets, stickers and posters.When Mary Brinkmeyer’s medical center ordered the removal of LGBTQ+ patient flyers and other affirming material days after Trump’s executive orders, she refused, and ultimately resigned. For nearly three years, she had worked as a psychologist and LGBTQ+ veteran care coordinator at the VA facility in Hampton, Virginia. Hospital leadership ordered her to stop LGBTQ+ outreach, advocacy and gender-affirming training to departments because it could be considered “gender ideology”.View image in fullscreen“We all have ethics codes in our professions that say that you’re supposed to do no harm, and that if you’re caught between institutional pressure and the ethics code, you’re supposed to resolve it in a way that’s consistent with the ethics code,” Brinkmeyer said.Brinkmeyer fears for the mental health of trans veterans, whom she saw experience “really intense suicidal crises” after Trump announced a ban on trans people enlisting in the military in 2017. After the election last November, some of her patients requested the removal of trans identifiers in medical records, and others withdrew from coverage over fears of being targeted and losing access to care. For many, those fears have become a reality.Rollbacks became official in March when the VA rescinded directive 1341, a policy that ensured “the respectful delivery of health care to transgender and intersex Veterans”, and announced the phasing out of gender-affirming medical care. The agency had been providing gender-affirming treatment including hormone therapy, prosthetics, hair removal, voice coaching and pre-surgical evaluation including letters of support for more than a decade. While cisgender veterans will still be able to access these treatments, veterans diagnosed with gender dysphoria are now excluded. Mental health services for trans patients and existing VA and military coverage for hormone therapy won’t be affected, according to the memo, which also formalizes banning trans patients from using facilities that align with their gender identity.View image in fullscreen“I am scared for the huge amount of people that are about to be forcibly separated, because the VA is not there to actually catch these people,” Blake said, referring to an influx of trans service members who could be forced out of the military under Trump’s transgender military ban. “I hate that the ladder was pulled up behind me.”‘A death sentence’The changes have put trans veterans seeking gender-affirming care in limbo. It has also created a climate of fear for the trans veterans already receiving hormone therapy, who worry it could be pulled at any time.View image in fullscreenThat’s the reality for Kaydi Rogers. While at the moment her hormone therapy will not be disrupted, she is terrified of losing access to estrogen if the VA continues its crackdown.Rogers spent about five decades acquiring estrogen pills through pharmacies in Mexico or friends with prescriptions.“I was desperate,” Rogers said. “I didn’t know any way of doing anything about what was going on with me. It was not a common thing back in the 70s and 80s to come out trans.”She finally switched to VA coverage because of the potential health risks of taking unregulated pills. But Rogers said if the VA ever stopped prescribing her estrogen, the desperation would return and she would again rely on self-medication for survival.Beyond her concerns about continued access to care, Rogers feels the loss of welcoming and safe spaces inside VA clinics. She says she tries to avoid drawing attention to herself during appointments, fearful of being harassed or attacked.“Before last year, every time I went to the VA, I went dressed as Kaydi and no one seemed to bother me or care,” Rogers said. “Now, not so much.”Other veterans share these safety concerns, including Lindsay Church, the executive director and co-founder of Minority Veterans of America. Church, who is non-binary and uses they/them pronouns, has experienced harassment and discrimination inside VA clinics in the past, and began carrying a printed copy of directive 1341 to prove they were entitled to treatment that respected their gender identity. With that directive rescinded and no guarantee of protection, they’ve canceled VA appointments and sought care elsewhere.View image in fullscreenThe veterans affairs secretary, Doug Collins, stated that trans veterans “will always be welcome at VA and will always receive the benefits and services they’ve earned under the law”. In response to questions about the new policy, the VA press secretary, Peter Kasperowicz, directed the Guardian to the press release from 17 March.Church said the discriminatory climate is having a chilling effect on trans veterans, regardless of whether their care plans have been discontinued under the VA’s new policy. “If I can’t use [my healthcare plan] because I’m scared of being harassed and intimidated, and experiencing physical violence in a bathroom, I can’t use the system,” they said.They called the policy reversal a “death sentence”.View image in fullscreen‘We tell them we will take care of you, and that’s a lie’Trans veterans face higher rates of homelessness, unemployment, PTSD and military sexual trauma compared with cisgender veterans. They are also twice as likely to die by suicide compared with cisgender veterans, and almost six times more likely than the general US population. Advocates and providers say these psychiatric and socioeconomic risk factors, when combined with the loss of an affirming medical environment, places an already vulnerable population even more at risk.One VA clinical social worker, who requested anonymity, said his LGBTQ+ patients don’t feel safe and are experiencing more suicidal ideations than before Trump took office.“I have seen an increase in suicide risk evaluations,” he said. “I’ve done more of those in the last two months than I’ve done the last two years.”View image in fullscreenAnother LGBTQ+ veteran care coordinator said a trans patient attempted suicide at her facility after Trump’s inauguration, and she fears there could be more people who attempt the same. She said notifying trans patients of the policy change has been heartbreaking.“I’ve worked for the past two and a half years to gain people’s trust, and now all of a sudden, I’m pulling out the rug from under them,” she said. “It feels terrible.”She had to tell one patient wanting to start hormone therapy that the VA could no longer help them, and is preparing the same message for trans patients on a months-long waitlist to begin treatment. While she has been looking for ways to provide alternatives, many of her trans patients live in rural areas where accessing gender-affirming care is difficult.Other VA employees see cutting trans healthcare as a betrayal of the benefits promised to service members when they enlist.“We’re asking these 17-year-olds to give their entire bodies to the US government,” said one VA nurse, who requested anonymity over fear of losing her job. “And they’re given one promise, which is that we will care for them. And this is part of care, whether you like it or not.”Gender-affirming medical care has been endorsed by every major medical association in the US, and medical providers say that politicians shouldn’t be allowed to decide how they care for their patients.“You’re giving so much to the military. You give your whole life, you have no say over where you live,” the nurse said. “Then we tell them we will take care of you, and that’s a lie. We’re lying to people – and not just trans veterans, all veterans.” More

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    Trump officials to cut Planned Parenthood family planning funds

    The reproductive health provider Planned Parenthood said the Trump administration would cut federal family planning funding as of Tuesday, affecting birth control, cancer screenings and other services for low-income people.Planned Parenthood said that nine of its affiliates received notice that funding would be withheld under a program known as Title X, which has supported healthcare services for the poor since 1970.The Wall Street Journal reported last week the US Department of Health and Human Services planned an immediate freeze of $27.5m in family planning grants for groups including Planned Parenthood.Planned Parenthood says more than 300 health centers are in the Title X network and Title X-funded centers received more than 1.5m visits in 2023. It not say how much funding would be halted by the Trump administration.The White House and HHS did not immediately respond to a Reuters request for comment. An HHS spokesperson said last week the department was reviewing grant recipients to ensure compliance with Donald Trump’s executive orders.Alexis McGill Johnson, president and CEO of Planned Parenthood, predicted that cancers would go undetected, access to birth control would be severely reduced, and sexually transmitted infections would increase as a result.“President Trump and Elon Musk are pushing their dangerous political agenda, stripping health care access from people nationwide, and not giving a second thought to the devastation they will cause,” McGill Johnson said in a statement.Trump has named billionaire Musk, who helped the president get elected, to head up an initiative to target government agencies for spending cuts.Conservatives have long sought to defund Planned Parenthood because it also provides abortions. However, US government funding for nearly all abortions has been banned since 1977. More

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    RFK Jr says they are poisoning us, influencers call them unnatural – but what is the truth about seed oils?

    It’s curious that something so bland could cause so much controversy. Most of us have a bottle of seed oil, normally called vegetable oil in the UK, in our kitchens – a nearly tasteless but very useful fat that has been a commonplace cooking ingredient for decades.And yet this previously unremarkable golden liquid has sparked online furore and vicious debate. Nutrition influencers on social media have described it as “toxic”, “inflammatory”, “unnatural” and the root cause of the obesity epidemic.The US health secretary Robert F Kennedy Jr, who has caused controversy with his views on subjects from vaccines to fluoride in drinking water, has said the population is being “unknowingly poisoned” by seed oils and urged people to revert to “traditional” fats such as butter, lard and beef dripping for better health.Last month the Wall Street Journal reported that fast food chains were promoting their shift away from seed oils after Kennedy’s criticisms. He even made a televised visit to a branch of Steak ’n Shake to praise its decision to cook fries in beef tallow instead.So should we really be ditching our bottles of vegetable and sunflower oils and covering everything in lard?Seed oils have been in widespread use since about the 1950s and, as well as being used for home cooking, are also in many ultra-processed foods. They include rapeseed (known as canola in the US and generally labelled as vegetable oil in the UK), sunflower, soya bean, corn, grapeseed, rice bran, sesame and safflower. While you can buy cold-pressed seed oils, the most common production method involves using a solvent (normally hexane) to extract the oil from the plant. It is correct that hexane is a toxic substance, but it is almost entirely removed from the final product by the refining process – the EU allows a maximum residual limit of 1mg per kilo.The refining process includes bleaching and deodorising, both of which critics have jumped on to claim that seed oil is “unnatural” and therefore “bad”.Tom Sanders, emeritus professor of nutrition and dietetics at King’s College London, who has spent his career researching dietary fat and health, explains: “The processing actually takes out potentially toxic material.”Sarah Berry, professor of nutritional sciences at King’s, agrees: “The end product, in my opinion, is very safe to eat.”The next allegation against seed oils is that they are “inflammatory”. This assumption is based on a fundamental misunderstanding of the science, says Berry.View image in fullscreenSeed oil critics claim that the type of omega-6 fatty acid present in them (called linoleic acid) can be inflammatory, whereas omega-3 – the other essential polyunsaturated fatty acid, found in foodstuffs such as oily fish, flaxseed and chia seeds – can reduce inflammation.“Because the enzymes used to convert omega-3 into anti-inflammatory chemicals are the same ones used to convert omega- 6, their argument is that having too much seed oil will mean the enzymes are stolen away from the omega-3,” says Berry.“This isn’t true. It’s true from a theoretical biochemical pathway. It’s true in mice upon unrealistic stimuli. But it is absolutely not true in humans.” In fact, randomised, controlled trials show that linoleic acid has either a neutral or, in most studies, an anti-inflammatory effect in humans.“The idea that linoleic acid is some sort of toxic thing is absolute nonsense,” says Sanders. “It’s an essential nutrient. Of the essential fatty acids it’s the most important one. If you’re deficient, it impairs immune function and platelet function doesn’t work.”It also has a potent cholesterol-lowering effect, says Berry, who is chief scientist at nutrition company Zoe. “It has been shown to reduce blood cholesterol significantly. Because of this and based on the current evidence I would say that not only are seed oils not bad for us, they are a healthy part of our diet.”Sanders attributes much of the decline in cardiovascular disease we’ve seen in the past 50 years to our increased consumption of seed oils. A few weeks ago, a study that followed 200,000 adults over 33 years found that those who replaced a tablespoon of butter a day with the same amount of plant-based oil such as soya bean or rapeseed had a 17% reduction in risk of death from all causes. The study, which was published in JAMA Internal Medicine also found a 17% reduction in risk of death from cancer.“Our study found that higher butter intake was associated with increased deaths from all causes and cancer, while higher intake of plant-based oils was associated with lower deaths from all causes, cancer and cardiovascular disease,” said lead study author Yu Zhang, a graduate student at Harvard TH Chan School of Public Health.Priya Tew, from Dietitian UK, says some of the confusion might have come from a 1960s study: “It showed men with heart disease had a higher intake of seed oils. But this was through margarines that also contain trans fats, which we know increase the risk of heart disease.”A similar logic applies to the argument that, as our intake of seed oils has risen – which it has more than 200-fold over the past 50 to 70 years – so too have our rates of chronic disease.“Association does not mean causality,” says Berry. “Think what else has changed; our food landscape is almost unrecognisable compared with 70 years ago. It’s estimated 60% of the seed oils we consume come from ultra-processed food which has many other chemicals that are unhealthy for us and processes that affect the healthfulness of the food.”In other words, it’s not the seed oil that’s the problem.Berry’s recent statements about seed oils have landed her in hot water. After appearing on a podcast explaining that seed oils are healthy, she received relentless hate mail, including being told she’s “the most hated scientist in America”.“It nearly got to the point where I was going to stop speaking out on the topic so I didn’t have to be subjected to such horrible comments and meanness. But then I thought, that’s exactly what they want. They want to shut down the real evidence, so it just galvanised me to speak out about it even more.”As always, with nutrition, it’s better to consider overall diet than to hyper-fixate on one ingredient. But these kind of messages don’t tend to get as much traction. “Human nature is such that we are more susceptible to risk and scare headlines,” Berry says. “They’re going to get more clicks than a balanced, boring nutrition scientist like myself saying seed oils are fine as part of a balanced diet.”Sanders says you don’t have to ditch your seed oils and you shouldn’t swap them for butter or lard. “The seed oil scare is all just gossip. It’s not based on any good science at all.” More

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    My child has autism. Trump and RFK Jr linking it to vaccines scares parents like me

    It was a moment when Donald Trump’s larger-than-life presence on the global stage became unexpectedly personal.Near the end of his one-hour, 40-minute speech to a joint session of Congress on 4 March, the US president diverted from his favoured themes of a new golden age of American greatness and grievances against his adversaries to address a more unlikely topic: autism.The president drew his audience’s attention to Robert F Kennedy Jr, his controversial, newly confirmed choice as health secretary, and charged him with one overarching responsibility.“Not long ago, you can’t even believe these numbers – one in 10,000 children had autism,” Trump intoned. “Now it’s one in 36. There’s something wrong. One in 36 think of that. So we’re going to find out what it is. And there’s nobody better than Bobby.“Good luck. It’s a very important job.”It was not the first time that Trump had waded into the controversy swirling around autism – a neurodivergent condition affecting an estimated 75 million people worldwide. Nor was it the first occasion that he had touted Kennedy’s credentials as being able to tackle it.But the high symbolism of the setting brought home to me, a watching journalist, with sobering clarity that a life-changing decision, taken for the most pressing of family reasons, had taken on unforeseen contours.Just over two years ago, my wife and I had moved to the United States so that we could better address the needs of our son, who had been diagnosed with autism just before his third birthday. We had gradually despaired of finding a practical solution in the Czech capital of Prague, where we previously lived, and where state-of-the-art therapeutic remedies were still fledgling works in progress.America, by contrast, seemed to be a land of possibility and innovative approaches and to offer a more amenable environment to our circumstances – and had the added attraction that we all held US citizenship.In the period since our arrival, we found progress uneven, but engaged an outstanding therapist who made up for our difficulties navigating the Maryland state education system. I shifted my career from one centered in Europe, to covering US politics – and the second Trump administration.Now here – in the highest shrine of US democracy – was the graphically vivid figure of Trump digressing from his usual weaving script to elevate the very topic that had brought us to America’s shores to a national priority.It was not, to put it mildly, exactly what we had envisioned.The uptick in the autism trend Trump cited was exaggerated; while the most recent US autism statistics, recorded in 2020, did indeed record one in 36 children in the US having received a diagnosis of autism, the jump was less dramatic than he described – comparing with a rate of one in 150 in 2000, according to the Centers for Disease Control and Prevention (CDC).Nevertheless, the undoubted spike in instances of the condition meant that his proclaimed zeal to find a cause resonated with many, us included.The catch lay in his choice of Kennedy, who has declared that autism is caused by vaccines – a scientifically baseless theory which Trump himself has previously indulged – as the lead figure in a national crusade to discover a cause.I spoke with other parents of children with autism, who used a range of pejorative adjectives to deride this conviction; among them “dangerous”, “scary”, “batshit crazy”, “despicable” and “disgusting”.Kennedy’s views carry weight which, experts fear, will be lent still greater authority by his new health portfolio. The CDC is reportedly now planning a large study into potential connections between vaccines and autism.“Were I the father of a child with autism, I would be really angry at the anti-vaccine community for taking this story hostage and for diverting resources and attention away from the real cause, or causes, of autism,” said Paul Offit, a pediatrician specialising in immunology and author of the 2008 book Autism’s False Prophets, which rebutted the alleged links between the condition and vaccines.“There’s financial or emotional burdens that make it hard enough for parents, but to have this offered as a reason for why a child has autism is just spurious and in some ways malicious, because I think it puts the burden on the parent.”Belief in the alleged connection between vaccinations and autism gained traction after a 1998 study conducted by a British physician, Andrew Wakefield, and published in the Lancet asserted a causal link with the measles, mumps and rubella (MMR) vaccine. The paper ignited a firestorm of controversy in Britain, with the then prime minister, Tony Blair, pressured to say whether his baby son had been administered the MMR shot.But research underpinning the finding was later debunked as fraudulent, leading to the Lancet retracting the paper and Wakefield being struck off the UK medical register. Multiple subsequent studies have found no connection between the vaccine and autism.Despite the countervailing evidence, suspicions persisted – fuelled in no small part by Kennedy himself, who has shown himself unmoved in the face of challenge.My personal interest in Kennedy and his views on vaccines was piqued after hearing a 2023 podcast interview with the New Yorker. He was adamant under questioning from the magazine’s editor-in-chief, David Remnick, who – disclosing himself as the parent of a child with “quite severe” autism – asked if he had second thoughts about “slinging around theories … that don’t have any great credibility among scientists”.“I’ve read the science on autism and I can tell you … If it didn’t come from the vaccines, then where is it coming from?” Kennedy responded.Scientists say there are multiple potential answers to that question, including genetics, drugs taken during pregnancy, age of conception – albeit none giving a definitive explanation.skip past newsletter promotionafter newsletter promotion“When you hear about autism and its causes, the first thing people think is vaccines, which is the one thing you can say it’s not,” Offit said.Caught in the crossfire of this conflict between science and dogma are parents struggling to cope with a condition whose manifestations can be maddening, challenging and bewildering.Autism is a wide spectrum condition and children with it come in a surprising variety of types. Some – like my son – are functional, verbal and teachable, with aspects of high intelligence; others are non-verbal and may have severe intellectual disabilities; many others may fall somewhere in between.“If you’ve met one child with autism, you’ve met one child with autism,” goes the refrain among many specialists.Common to all, however, are atypical behaviours that for the parents, are life-changing and force them to make painful adaptations, sometimes at high financial cost.A complaint frequently heard about Kennedy’s views is that they heap stigmatisation on their children and unwarranted blame on the parents.“It puts a stigma on our children that their parents did something wrong when they were pregnant with them, and thus it’s the parents fault,” said Davina Kleid, 38, an executive assistant in a real estate development company in Maryland, whose nine-year-old daughter has autism.Kleid feared Kennedy’s views have the potential to unleash an eventual crackdown conjuring scenes resembling The Handmaid’s Tale, Margaret Atwood’s novel dystopian novel depicting a bleak patriarchal future and female subjugation.“Who knows? Maybe I could be arrested for having a child on the spectrum, because they’re going to say that I did something to purposely cause her to have this condition,” she said. “There’s nothing wrong with my child. It’s how she was born. I’m not ashamed of it, and I don’t think anyone should be ashamed of it.”Madeline, a publisher from Maryland who requested that her real name not be disclosed, said Kennedy’s views amounted to a disparagement of her 24-year-old son, who was born at the height of the MMR controversy arising from the Wakefield paper but who showed signs of developmental delay before being vaccinated.“It is just insulting that people would think that it would be better to get measles or mumps or pertussis or whooping cough than to have autism,” she said. “And RFK Jr has said as much. It’s like this is worse than getting these terrible, life-threatening diseases.”Lux Blakthorne, 33, a professional gardener living in Chester county, Pennsylvania, said fears for the future over her non-verbal, nine-year-old autistic son, Kai, had prompted her to make plans to emigrate to Germany, the country of her ex-husband’s birth and where she said provisions for autism had made great strides.The breaking point, she said, would be cuts to Medicaid, the public healthcare system that Kennedy oversees and which pays for Kai’s daily needs including education at a special private facility.An added factor is a recent White House executive order banning puberty blocking medication for those under 18, a measure aimed at stymying gender-affirming care for transgender youth but which, Blakthorne says, would prevent her trying to mitigate harmful autism-related behaviour that is likely to be exacerbated by the onset of puberty.“I think RFK sees disabilities as a problem that needs to be fixed,” said Blakthorne. “He has a dangerous belief system, and it’s not science- or fact-based.”Yet amid the negativity, the Autism Science Foundation, a research group, says Kennedy has a unique opportunity to discover its causes.“Many of us in the autism community give RFK credit for wanting to study the causes of autism,” said Alison Singer, the foundation’s president and the mother of a daughter with autism.“What would be very positive is if as health secretary, he can declare profound autism as a national public health emergency,” she said.“That would open up a variety of actions he could take, like making additional grants, entering into new contracts [and] really focusing funding on investigating the causes of autism, treatments and prevention.” More

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    Schools in Puerto Rico are bracing for Trump cuts after gains made during the Biden years

    Maraida Caraballo Martínez has been an educator in Puerto Rico for 28 years and the principal of the elementary school Escuela de la Comunidad Jaime C Rodriguez for the past seven. She never knows how much money her school in Yabucoa will receive from the government each year because it isn’t based on the number of children enrolled. One year she got $36,000; another year, it was $12,000.But during the Biden administration, Caraballo noticed a big change. Due to an infusion of federal dollars into the island’s education system, Caraballo received a $250,000 grant, an unprecedented amount of money. She used it to buy books and computers for the library, whiteboards and printers for classrooms, to beef up a robotics program and build a multipurpose sports court for her students. “It meant a huge difference for the school,” Caraballo said.Yabucoa, a small town in south-east Puerto Rico, was hard-hit by Hurricane Maria in 2017. And this school community, like hundreds of others in Puerto Rico, has experienced near-constant disruption since then. A series of natural disasters, including hurricanes, earthquakes, floods and landslides, followed by the pandemic, has pounded the island and interrupted learning. There has also been constant churn of local education secretaries – seven in the past eight years. The Puerto Rican education system – the seventh-largest school district in the United States – has been made more vulnerable by the island’s overwhelming debt, mass emigration and a compromised power grid.Under Joe Biden, there were tentative gains, buttressed by billions of dollars and sustained personal attention from top federal education officials, many experts and educators on the island said. Now they worry that it will all be dismantled with the change in the White House and Donald Trump’s plan to eliminate the US Department of Education. Trump has made no secret of his disdain for the US territory, having reportedly said that it was “dirty and the people were poor”. During his first term, he withheld billions of dollars in federal aid after Hurricane Maria and has suggested selling the island or swapping it for Greenland.View image in fullscreenA recent executive order to make English the official language has worried people on the island, where only one in five people speak fluent English, and Spanish is the medium of instruction in schools.Trump has already made massive cuts to the US Department of Education and its staff, which will have widespread implications across the island. Even if federal funds – which last year made up more than two-thirds of funding for the Puerto Rican department of education (PRDE) – were transferred directly to the local government, it would probably lead to worse outcomes for the most vulnerable children, say educators and policymakers. The PRDE has historically been plagued by political interference, widespread bureaucracy and a lack of transparency.And the local education department is not as technologically advanced as other state education departments, nor as able to disseminate best practices. For example, Puerto Rico does not have a “per pupil formula”, a calculation commonly used on the mainland to determine the amount of money each student receives for their education. Robert Mujica is the executive director of the Puerto Rico Financial Oversight and Management Board, first convened under Barack Obama in 2016 to deal with the island’s financial morass. Mujica said Puerto Rico’s current allocation of education funds was opaque. “How the funds are distributed is perceived as a political process,” he said. “There’s no transparency, and there’s no clarity.”In 2021, Miguel Cardona, Biden’s secretary of education, promised “a new day” for Puerto Rico. “For too long, Puerto Rico’s students and educators were abandoned,” he said. During his tenure, Cardona signed off on almost $6bn in federal dollars for the island’s educational system, leading to historic teacher pay increases, funding for after-school tutoring programs, the hiring of hundreds of school mental health professionals and a pilot program to decentralize the PRDE.Cardona also designated a senior adviser, Chris Soto, to be his point person for the island’s education system to underscore the federal commitment. During nearly four years in office, Soto made more than 50 trips to the island. Carlos Rodríguez Silvestre, the executive director of the Flamboyan Foundation, a non-profit that has led children’s literacy efforts on the island, said the level of respect and sustained interest felt like a partnership, not a top-down mandate. “I’ve never seen that kind of attention to education in Puerto Rico,” he said. “Soto practically lived on the island.”Soto also worked closely with Victor Manuel Bonilla Sánchez, the president of the teachers union, Asociación de Maestros de Puerto Rico, or AMPR, which resulted in a deal in which educators received $1,000 more a month than their base salary, a nearly 30% increase for the average teacher. “It was the largest salary increase in the history of teachers in Puerto Rico,” Bonilla said, though even with the increase, teachers here still make far less money than their mainland counterparts.One of the biggest complaints Soto said he heard was how rigid and bureaucratic the Puerto Rico department of education was, despite a 2018 education reform law that allows for more local control. The education agency – the largest unit of government on the island, with the most employees and the biggest budget – was set up so that the central office had to sign off on everything. So Soto created and oversaw a pilot program in Ponce, a region on the island’s southern coast, focusing on decentralization.For the first time, the local community elected an advisory board of education, and superintendent candidates had to apply rather than be appointed, Soto said. The superintendent was given the authority to sign off on budget requests directly rather than sending them through officials in San Juan, as well as the flexibility to spend money in the region based on individual schools’ needs. The pilot project also focused on increasing efficiency. For example, children with disabilities are now evaluated at their schools rather than having to visit a special center.But already there are plans to undo Cardona’s signature effort in Ponce. The island’s newly elected governor, Jenniffer González Colón, is a Republican and a Trump supporter. The popular secretary of education, Eliezer Ramos Parés, returned earlier this year to head the department after leading it from April 2021 to July 2023 when the governor unexpectedly asked him to resign – not an unusual occurrence within the island’s government, where political appointments can end suddenly and with little public debate. He said that the program would not continue in its current form.“The pilot isn’t really effective,” Ramos said, noting that politics can influence spending decisions not only at the central level but at the regional level as well. “We want to have some controls.” He also said expanding the effort across the island would cost tens of millions of dollars. Instead, Ramos said, he was looking at more limited approaches to decentralization, around some human resource and procurement functions. He said he was also exploring a per-pupil funding formula for Puerto Rico and looking at lessons from other large school districts such as New York City and Hawaii.While education has been the largest budget item on the island for years, Puerto Rico still spends far less than any of the 50 states on each student: $9,500 per student, compared with an average of $18,600 in the states.The US Department of Education, which supplements local and state funding for students in poverty and with disabilities, plays an outsized role in Puerto Rico schools. On the island, 55% of children live below the poverty line and 35% of students are in special education. In total, during fiscal year 2024, more than 68% of the education budget on the island came from federal funding, compared with 11% in US states. The department also administers Pell grants for low-income students; about 72% of Puerto Rican students apply.Linda McMahon, Trump’s new education secretary, has reportedly said that the government will continue to meet its “statutory obligations” to students even as the department shuts down or transfers some operations and lays off staff. The US Department of Education did not respond to requests for comment.Some say the Biden administration’s pouring billions of dollars into a troubled education system with little accountability has created unrealistic expectations and there’s no plan for what happens after money is spent. Mujica, the executive director of the oversight board, said the infusion of funds postponed tough decisions by the Puerto Rican government. “When you have so much money, it papers over a lot of problems. You didn’t have to deal with some of the challenges that are fundamental to the system.” And, he said, there was little discussion of what happens when that money runs out. “How are you going to bridge that gap? Either those programs go away, or we’re going to have to find the funding for them,” Mujica said.Puerto Rico is one of the most educationally impoverished regions, with academic outcomes well below the mainland’s. On the math portion of the National Assessment of Educational Progress, or NAEP, a test that US students take, just 2% of fourth-graders in Puerto Rico were proficient, and 0% of eighth-graders were. Puerto Rican students don’t take the NAEP for reading because they learn in Spanish, not English, though results shared by Ramos at a press conference in 2022 showed only 1% of third-graders were reading at grade level.There are some encouraging efforts. Flamboyan Foundation, the non-profit in Puerto Rico, has been leading an islandwide coalition of 70 partners to improve literacy from kindergarten through the third grade (K-3), including through professional development. Teacher training through the territory’s education department has often been spotty or optional.The organization now works closely with the University of Puerto Rico and, as part of that effort, oversees spending of $3m in literacy training. Approximately 1,500 or a third of Puerto Rico’s K-5 teachers have undergone the rigorous training. That effort will continue, according to Ramos, who called it “very effective”.A new reading test for first- through third-graders the non-profit helped design showed that between the 2023 and 2024 school years, most children were below grade level but made growth in every grade. “But we still have a long way to go so that this data can get to teachers in a timely manner and in a way that they can actually act on it,” Silvestre said.Kristin Ehrgood, Flamboyan Foundation’s CEO, said it was too soon to see dramatic gains. “It’s really hard to see a ton of positive outcomes in such a short period of time with significant distrust that has been built over years,” she said. She said they weren’t sure how the Trump administration may work with or fund Puerto Rico’s education system but that the Biden administration had built a lot of goodwill. “There is a lot of opportunity that could be built on, if a new administration chooses to do that,” she said.Another hopeful sign is that the oversight board, which was widely protested against when it was formed, has cut the island’s debt from $73bn to $31bn. And last year board members increased education spending by 3%. Mujica said the board was focused on making sure that any investment translates into improved outcomes for students: “Our view is resources have to go into the classroom,” he said.Ramos said he met McMahon, the new US secretary of education, in Washington DC, and that they had a “pleasant conversation”. “She knows about Puerto Rico, she’s concerned about Puerto Rico, and she demonstrated full support in the Puerto Rico mission,” he said. He said McMahon wanted PRDE to offer more bilingual classes, to expose more students to English. Whether there will be changes in funding or anything else remains to be seen. “We have to look at what happens in the next few weeks and months and how that vision and policy could affect Puerto Rico,” Ramos said.Ramos was well-liked by educators during his first stint as education secretary. He will also have a lot of decisions to make, including whether to expand public charter schools and close down traditional public schools as the island’s public school enrollment continues to decline precipitously. In the past, both those issues led to fierce and widespread protests.Soto says he’s realistic about the incoming administration having “different views, both ideologically and policy-wise”, but he’s hopeful the people of Puerto Rico won’t want to go back to the old way of doing things. “Somebody said: ‘You guys took the genie out of the bottle and it’s going to be hard to put that back’ as it relates to a student-centered school system,” Soto said.Principal Caraballo’s small school of 150 students and 14 teachers has been slated for closure three times already, though each time it has been spared, partly thanks to community support. She’s hopeful that Ramos, with whom she’s worked previously, will turn things around. “He knows the education system,” she said. “He’s a brilliant person, open to listen.”But the long hours of the past several years have taken a toll on her. She is routinely in school from 6.30am to 6.30pm. “You come in when it’s dark and you leave when it’s dark,” she said.She wants to retire but can’t afford to. After pension plans were frozen, Caraballo will receive only 50% of her salary at retirement, $2,195 a month. She is entitled to social security benefits, but it isn’t enough to make up for the lost pension. “Who can live with $2,000 in one month? Nobody. It’s too hard. And my house still needs 12 years more to pay,” she said.This story was produced by Guardian partner the Hechinger Report, a non-profit, independent news organization focused on inequality and innovation in education More

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    ‘There was no place for me in American society’: an ex-Black Panther cub speaks out

    Hello and welcome to The Long Wave. This week, Guardian Documentaries has released a short film about the life and legacy of the Black Panthers with a focus on the group’s children. It was released alongside a Long Read by Ed Pilkington in the US on the wider group. I spoke to one of those cubs in the film, Ericka Abram, about her childhood within the activist community in the 1970s, and how her life was shaped by the experience. But first, the weekly roundup.‘I lived in a protected Panther bubble’View image in fullscreenThe first thing I notice about Ericka is that she is deliberate in her articulation and her responses are meticulously considered. She is also warm and quick-witted, with a flair for a killer line. She will not argue with people online about Donald Trump, she says, because it’s a waste of time to engage with a “bot, a baby or a bigot”.Ericka is the daughter of Elaine Brown, a former chair of the Black Panther party, and Raymond Hewitt, one of its leaders. She spent her early years in Oakland, California, and the Black Panther party she grew up in was not only a political organisation, but also a social one. The cubs lived in dormitories and had their own school. At weekends, they could return to a home where adult members of the party lived together and played an equal role in their care – “comrade moms” is how she describes the women she lived with.Ericka had no idea her childhood was anything out of the ordinary. Even though reporters showed up at their schools, and she had seen her mother and Huey Newton, the co-founder of the Black Panthers, on television, she did not have a sense of how outsiders perceived the party. I ask her if she was aware of the risks involved for her family and the wider network. “It just felt like family,” she says. Despite this, she shares a chilling story about her mother’s bodyguard stopping a seven-year-old Ericka from opening the door of their house and rebuking her, because he was the first person who should walk out, in case someone shoots.The full picture did not start to become clear until she was in high school, years after her mother left the party and took Ericka with her. She recalls someone once telling her: “Your mother is the only woman in US history to lead a paramilitary organisation.” Ericka says it was “strange” to hear her mum being described like that.She recalls a community that was deeply activist but also, perhaps counterintuitively, apolitical. Ericka tells me it often shocks people that she not only had no insights on the internal politics of the Black Panthers, but she had almost no idea what the party actually was. “The Black Panther party and the reasons it existed were unknown to me. [This is] because I wasn’t suffering racism or sexism; I lived in a protected Panther bubble.” The group participated in boycotts with farmworkers, who successfully secured better working conditions and union rights, and Ericka “hated” that party members couldn’t eat grapes and things she thought were delicious. But the boycotts were explained to her in such a way that she grasped that there were overlords who needed to be forced to play fair. She says from an early age she understood capitalism as synonymous with greed.View image in fullscreenLeaving that bubble was a sharp adjustment. When Ericka was eight her mother left the party and moved to Los Angeles, and the experience of attending a non-Black Panther school for the first time was full of conflict. “I had fights frequently – arguments with my teachers – most of it was about injustice. One teacher put me out of class because I said Australia was founded by prisoners and bigots or something like that. I was in seventh grade.” Another time she was ejected from class for sitting quietly during the pledge of allegiance. “I might not have understood the values that were raising me, but as soon as I was removed from them I needed them most,” she says.I ask how she adjusted to living in the mainstream. Her answer is unequivocal: “There was no place for me in American society.” That might have led to her finding refuge in drugs, says Ericka, who started using cocaine when she was 15. “I was trying to medicate a pain I didn’t understand. And living a life I hadn’t any intention of living.” As a child, she had assumed she would one day become a Black Panther. When that life did not come to pass, a profound sense of effacement took hold. “I developed this idea that unless I die for the people, my life was worthless,” she says. Growing up in an organisation with such a clear purpose raised the hurdle so high that one may as well not try to scale it. That’s what comes “from being raised by people who knew what they were willing to die for”, she says.I suggest that she is describing a sort of nihilism and erasure. Well, yes, is her answer. Ericka has always believed that individuals do not matter. “We were raised to believe we were precious – but we were precious for a purpose. I went to school with a kid called Bullet. I mean, there’s no pressure there.” Ericka says at times she felt she did not live up to expectations. As a teenager “I felt I had failed my mother,” she admits casually. I stop her. Why? “Because when we left [the Black Panther party] there was nothing to protect us from America. I thought I could protect her but I didn’t understand what that meant.”skip past newsletter promotionafter newsletter promotionWith such a legacy, I wonder if she harbours any resentment towards her mother, or indeed that generation of Black Panther parents, for not preparing their children for life outside the party? “No,” she says, before I finish the question. “I didn’t feel resentment. But I remember I was about to start my sophomore year when Huey Newton was killed. I felt so alone. And I realised that I wasn’t mourning his death but that, even at the age of 19, some part of me thought that as long as he was alive, someone would still come and tell me what to do.” As she holds back tears, there is such plaintiveness and loss in her voice. For a moment, she is again that 19-year-old faced with figuring life out on her own.And it feels as if she has. Ericka’s sense of failure has been replaced by an understanding that what the Black Panthers signed up to was something exceptional. She refuses to call herself a cub, because a cub grows up to be a Panther. And she is not that. “They really did promise their lives to an ideal,” she says.The values she grew up with are serving her well during a tumultuous time in US political history. “I know that I see the world in a unique way,” Ericka says when I ask how the Black Panthers shaped her life. She understands now that the difference between “activists and revolutionaries is what you are willing to risk” – and that without solidarity, nothing can be achieved. The Black Panthers were not just seeking racial equality but interconnection between all who are suffering the depredations of state and capital. There is in Ericka a clear understanding that what it takes to stabilise politics in a country roiled by a second Trump administration is a combination of empathy but also resolve – action guided by love.The Black Panther Cubs: When the Revolution Doesn’t Come is out now. For more on this story read Ed Pilkington’s in-depth essay, here. And for an exclusive behind-the-scenes look at the Guardian’s latest films as they release, sign up here to the Guardian Documentaries newsletter.To receive the complete version of The Long Wave in your inbox every Wednesday, please subscribe here. More