The Brooklyn Rail

In March of 2025 I wrote in these pages about the anticipated impacts on public health of the second Trump administration. Based on Trump’s first presidency in 2017–21 and what we had seen so far of the second one, the perspectives were not good. Reality has turned out to be even worse than what we expected: censorship of science based on ideology and political positions, misinformation, disregard for public health expertise, incompetence in leadership, and a radical retreat on environmental policies fundamental to protecting the health of the public. It can be argued that the public health implications of the second Trump administration pale in comparison to broader implications for freedom of speech, rule of law, and respect for human rights, and what all this means not just for the United States but globally for humanity and for our planet. This is true. But the impacts on public health offer a specific illustration of the ways in which this administration is threatening very basic aspects of our society fundamental to everyone’s health and well-being and to the health and well-being of future generations.

One area that has received significant attention in the press, and also in political discussions, is health care access and insurance. Among high-income countries the US stands out as having a system that is simultaneously expensive, inequitable, and inefficient. Health care spending in the United States (17.6 percent of GDP and 14,570 dollars per capita in 2023)¹ far exceeds spending in other wealthy nations both in terms of per capita spending and as a percentage of GDP², significant proportions of the population have no health care coverage, and high proportions of expenditures are spent on administrative costs (as high as 15–30 percent of all spending on health care).³ The fundamental systemic problem is the US’s reliance on a patchwork of private insurance linked to employment, with limited public insurance, which if well managed can improve coverage, increase efficiency, and reduce costs. Medicare, a public insurance system that covers all adults sixty-five years or over, is a notable exception and despite some limitations (including the frequent need for supplementary private coverage) has become the model that some have aspired to for the whole US, as exemplified by calls for “Medicare for all.” Medicaid, the second public insurance system in the US, covers only persons who fulfill certain requirements, primarily low income. Over time there have been multiple piecemeal attempts to reform this system, none of which addressed the fundamental structural problems. The latest major overhaul was Obamacare (or the Affordable Care Act), approved in 2010, which implemented reforms and subsidies in the existing private insurance market to incentivize the purchase of insurance by the uninsured, established minimum coverage requirements, and prohibited discrimination based on pre-existing conditions. Obamacare also included an expansion of Medicaid coverage that was taken up by some states but refused by others. Despite its limitations, Obamacare succeeded in reducing the uninsured population (adults ages nineteen to sixty-four) from about 20 percent in 2013 to 12.3 percent in 2017, and also decreased racial gaps in coverage.⁴

The second Trump administration is impacting health insurance coverage in two major ways. The first is through reductions in federal spending and other changes in Medicaid, a program that provides health insurance to about eighty million low-income adults and children. Although Medicaid is run by the states, all states must follow rules set by the federal government and the programs are supported in part by federal funds. The so-called One Big Beautiful Bill Act (OBBBA), signed into law in July 2025, includes cuts to Medicaid of the order of almost one trillion dollars over the next ten years, which will have major implications for coverage. These cuts result from making it more difficult for persons to enroll in Medicaid (e.g. through the addition of work requirements or other changes to how eligibility is determined), eliminating coverage of many lawfully present immigrants, and other changes.⁵ The second major impact on health insurance coverage is through the failure to extend the subsidies that make coverage under Obamacare affordable beyond December 31, 2025. This has already led to substantial increases in premiums (some estimates suggest a doubling on average, although the impacts can vary widely) and could result in around four million people losing insurance. Other changes making it more difficult for persons to enroll in Obamacare (even if eligible) could make this number even higher. The Congressional Budget Office has estimated that as many as seventeen million people in total could lose insurance as a result of changes to Medicaid and Obamacare.⁶ As I write this in January 2026, the impasse over extension of the Obamacare subsidies (which led to the government shutdown in October 2025) remains unresolved. In addition to the obvious impact on those who lose their insurance, these changes will likely have many other direct and indirect impacts including likely increases in the price of other health insurance (because of increases in provider costs related to covering the uninsured) as well as implications for the viability of providers who cater especially to Medicaid populations, including rural hospitals (despite the last minute addition to the OBBBA of a special “rural fund” to support rural hospitals). Tax cuts in the OBBBA could also have longer-term implications for Medicare reimbursements of community services, which are critical to promoting the health of older populations.

There is no doubt that radical changes to the US health care system are needed to increase its impact and efficiency, and there is a long history of failed attempts to reform a system that is primarily driven by market incentives and relies on private insurance and private providers. But the changes proposed by the Trump administration to the existing imperfect system will make it even worse and will undoubtedly have major adverse consequences for health conditions in which health care makes a real difference in disease development, progression, and survival.⁷ However, the effects of the current administration on public health go well beyond impacts on health care access, important as that is. This broader impact has to do with the ways in which actions and policies of the administration are impacting the fundamental social and environmental drivers of health, the generation and use of evidence relevant to promoting public health, and the ability of the government to act to protect the health of the public. Four public health initiatives of the current administration: federal policies on vaccines, environmental regulation at EPA, policies of the department of Health and Human Services (HHS) around funding for health research, and the Make America Healthy Again (MAHA) plan illustrate ways in which the administration’s strategies are already having significant impact.

 

Undermining Public Health Interventions: The Attack on Vaccination

Vaccines are a public health intervention par excellence: vaccines prevent disease and vaccination can protect the entire population, even those not vaccinated. That people understand and support vaccinations is demonstrated by high levels of vaccination coverage overall, even in the United States, where an individualistic approach to health tends to dominate. Perhaps for this reason, Robert F. Kennedy, Jr. (RFK Jr.) , known for his anti-vax views, went to great lengths to dispel any suggestions that he would threaten government support for vaccination during his confirmation hearings.⁸ Not unexpectedly, RFK Jr.’s actions have been more aligned with his past, and with an unstated agenda to undermine vaccination generally, than with his promises to senators. Since RFK Jr.’s confirmation, the anti-vax agenda has been advanced in multiple ways. It started with the complete revamping of the Centers for Disease Control (CDC) Advisory Committee on Immunization Practices (ACIP), a federal advisory committee that develops recommendations on the use of vaccines in the United States. In early June 2025, to the consternation of multiple public health and medical organizations,⁹ Kennedy removed all seventeen members of ACIP, arguing that they were not prioritizing public health and evidence-based medicine and that they functioned as a “rubber stamp for industry profit-taking agendas.” ¹⁰ They were replaced by a new set of appointees much more favorable to the new HHS vaccine-skeptical position, including several with limited experience in vaccines, and a chair known for his anti-vaccine stance. Not unsurprisingly the first meeting of the committee revealed a remarkable lack of understanding of the process these committees follow to ensure full and rigorous consideration of all the evidence, and descended into chaos.¹¹ In early December 2025, a second chaotic meeting was notable for the fact that the “experts” presenting to the committee were not experts in vaccination or in infectious disease at all but advocates or scientists with limited health expertise who had a pre-determined position against vaccination.¹² At the time of this writing, two meetings of the new ACIP have already resulted in changes to recommended vaccinations including elimination of recommendations for COVID-19 vaccinations and hepatitis B vaccination for all newborns.¹³ On January 5, 2026 by order of Kennedy, and completely circumventing established evidence review processes, the CDC Director abruptly reduced the childhood vaccinations recommended in the US from seventeen to eleven, eliminating recommended vaccinations for hepatitis A, hepatitis B, meningococcal disease, rotavirus, influenza, and respiratory syncytial virus¹⁴ (the leading cause of hospitalization in infants in the United States¹⁵). Of course, parents who want these vaccines for their children may be able to get them, although insurance coverage for these vaccines may disappear if they are not recommended, and access to care will play a big role, likely creating inequities in who does or does not get vaccinated. Most worrisome, these changes have created a climate that elevates the anti-vaccine stance with no scientific evidence. Sadly, a lot more damage to vaccination with major implications for the impacts of vaccine-preventable diseases is very likely.

In another development, apparently without input from any CDC scientists, on November 19, 2025 the CDC website on vaccines was modified to suggest that the jury was still out on whether vaccines cause autism,¹⁶ a claim that has been debunked by study after study but that is used repeatedly by the anti-vax movement to create fear and distrust of vaccines. The website now includes a long list of misleading statements about what the evidence suggests regarding vaccines (not just one type of vaccine but many) as purported causes of autism, including misrepresentations of the evidence generated by committees of experts, as noted in a subsequent statement issued by the National Academy of Medicine.¹⁷ In a bizarre twist, the statement “Vaccines do not cause autism,” remained on the site as of February 20, 2026 but had attached to it a footnote that states “The header ‘Vaccines do not cause autism’ has not been removed due to an agreement with the chair of the U.S. Senate Health, Education, Labor, and Pensions Committee that it would remain on the CDC website.”¹⁸

Needless to say this attack on vaccines is bizarre and anachronistic, given the wealth of evidence on the public health value of vaccines, and even the unquestionable success during Trump’s first administration in producing remarkably effective COVID-19 vaccines in record time, vaccines which played a key role in preventing deaths, especially in older people.¹⁹ It will take time for the adverse public health impacts to be seen, but it is likely that over time vaccination rates for many diseases including preventable childhood diseases like measles, mumps, rubella and chickenpox will eventually drop below the levels needed to provide herd immunity, which implies that even those not vaccinated are protected. This will likely result in increased incidence of these diseases with predictable consequences in many areas, including not only severe disease but even death and other consequences for newborn infants whose mothers are infected during pregnancy. We are already seeing this in the worrisome measles outbreaks emerging in various parts of the US.

The chaos around vaccines also decimated CDC’s leadership. In late August 2025, less than a month into her tenure, CDC Director Susan Monarez was fired by President Trump for refusing to pre-approve vaccine recommendations without first considering the relevant scientific data and for refusing to remove top CDC scientists.²⁰ Three CDC leaders, with a wealth of expertise, resigned in protest as a result. The agency has also been plagued by multiple rounds of terminations,²¹ uncertainty, and a feeling of lack of security, further heightened by the mass shooting incident on August 8, 2025, by a shooter who believed he had been harmed by vaccines. In a remarkable acknowledgement of the leadership vacuum, chaos, and lack of trust in public health leadership from the federal government, groups of states have begun to create separate public health alliances to fill in the gap.²² In yet another alarming development and further consolidating of the administration’s anti-vax stance and ideological control over CDC, Ralph Abraham, a former surgeon general of Louisiana who discouraged COVID vaccination and supported ineffective treatments for COVID (like hydroxychloroquine and ivermectin) was appointed Principal Deputy Director of the CDC. The dismantling of the CDC, and not just in the vaccine area, is truly shocking as the CDC was formerly recognized as one of the top—if not the top—public health agencies worldwide. The effects of this dismantling on public health in the US will be large and the CDC’s reputation will take many years to rebuild.

 

Rolling Back Environmental Regulation

Along with vaccination, environmental regulation has been a big success story for public health, one that is less acknowledged despite its huge impact. The US Environmental Protection Agency (EPA) has been an international leader in evidence-based regulation designed to protect the health of all people, including those most vulnerable. Through a sophisticated and science-driven review process, the agency has regulated a variety of toxins in the environment, including contaminants in the air, soil, and water. These efforts have had a significant impact on the level of contaminants and their health consequences. Air pollution is a case in point: thanks to environmental regulation, the quality of the air US residents breathe has improved dramatically since the passage of the Clean Air Act (which established a regulatory process for many air contaminants) with major health benefits.²³

Consistent with its strategy during the first Trump administration, the second Trump administration has pretty much dismantled the EPA and is in the process of weakening or even completely rolling back significant environmental regulation. In March 2025, the Trump administration announced the “biggest deregulatory action in US history,” purportedly to “power the great American comeback,” but with dire consequences for public health long into the future.²⁴ Since then this threat has materialized via a strategy that has included delaying implementation of previously approved standards, revoking existing standards, modifying the regulatory framework, and undermining the science that is used to establish regulations. For example, Trump’s EPA has recently extended several compliance deadlines in the Clean Air Act (CAA) rules for the oil and gas industry,²⁵ with implications for a number of contaminants known to be harmful to health. In another development, the EPA pulled back from defending the most recent standard for fine particles in the air (referred to as PM2.5 or the “soot” standard) which was reduced from twelve to nine micrograms per cubic meter.²⁶ The revised standard had been put forth after an extensive science-based review conducted by the EPA with input from dozens of experts, which demonstrated substantial health benefits, including preventing thousands of premature deaths as well as many other adverse health outcomes. Of note: the reduced standard was of special importance to vulnerable groups, including older people, children, and persons with pre-existing chronic conditions. EPA has also proposed changes to the regulation of harmful chemicals in our environment, like formaldehyde,²⁷ a known carcinogen. Even MAHA activists (the “MAHA Moms”) are concerned about the deregulation of chemicals.²⁸ To be fair, the EPA has so far chosen to uphold a rule requiring polluters to be accountable for the clean-up of PFAS (the so-called forever chemicals) for which there is growing evidence of adverse health effects (this may be related to the EPA Administrator’s history as a congressman from Long Island New York, where PFAS contamination has been a major issue).

In another recent development, the Trump administration is proposing to rescind the “Endangerment Finding”, a 2009 EPA finding that carbon dioxide, methane, nitrous oxide and other greenhouse gases threaten public health and welfare, which allows the EPA to regulate emissions from cars, trucks, power plants and oil and gas operations under the Clean Air Act. Reputable scientific reports, including a September 2025 report from the National Academy of Sciences, have documented that the health and other risks from these pollutants have only been increasing over time.²⁹ These efforts at deregulation have been accompanied by a dismantling of the EPA’s science office.³⁰ The agency is also rife with conflicts of interest. For example, the EPA office that regulates chemical safety is led by two former executives of the American Chemistry Council,³¹ which has long advocated for less regulation of chemicals in our environment. The top official for pesticide policy was formerly a lobbyist for the soybean industry, where he advocated for controversial pesticides.³² The major retreat from health-protecting environmental regulations will have many health consequences long into the future.

 

Defunding and Censoring Public Health Research

Public health research conducted by universities, hospitals, non-governmental organizations of various types, and government agencies is heavily dependent on funding delivered through HHS, primarily the National Institutes of Health (NIH) and the CDC. Public health research has been significantly impacted by federal funding cuts and by redirection of funding away from certain areas based on what are primarily ideological considerations, which target many public health research topics. On one hand federal funding cuts have been weaponized in the administration’s attack on universities. This has had an especially strong impact on schools and programs in public health because of their heavy dependence on external funding. In addition, certain areas of public health research, including research on vaccines (and infectious disease generally), environmental research (including research linking climate change to health), research on the impact of gender identity on health and the health of LGBTQ+ persons, and research on health equity have been targeted for elimination.

The attack on health equity research has been especially virulent. Health inequities are differences in health across social groups (such as class, race, ethnicity, gender identity, geography etc.)³³ that are rooted in social and economic conditions operating through living conditions, environmental exposures, and behavioral processes, all of which ultimately impact biology in distinct and measurable ways. A large body of work in public health research has focused on characterizing and understanding the causes of large and pervasive health inequities and on identifying interventions and policies that can be used to reduce them. In addition, over the past years, government agencies, NGOs, and health care providers have prioritized strategies to reduce health inequities in their work.³⁴ But anything with the term “health equity” in it has now become suspect, and labelled as ideological and unscientific by the Trump administration.

Throughout 2025, the NIH abruptly and chaotically cancelled hundreds of grants that focused on a range of health equity-related topics. Rumors (often based on internal NIH documents and conversations) began to circulate noting that certain words such as “equity”, “racism”, “underserved”, “gender identity”, even “race” needed to be avoided in NIH grants. Researchers were advised to avoid these terms in new submissions and to revise the aims and summaries of existing grants to eliminate these terms. Reflecting ignorance and confusion (as well a strong ideological position), the language in the termination letters conflated health equity research with diversity, equity, and inclusion (DEI) initiatives (which health equity research is not).³⁵ The entire field was delegitimized with accusations of being unscientific as reflected in the boiler plate language used in many of the termination notices (I received several myself):

This award no longer effectuates agency priorities. Research programs based primarily on artificial and non-scientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry, do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness.

The bizarre language speaks for itself.

Lawsuits were filed arguing that these terminations were “arbitrary and capricious,” and although some are still making their way through the courts, they have succeeded in getting at least some terminated grants reinstated. In two recent agreements between the plaintiffs and the NIH, the NIH has committed to evaluating applications that were frozen, denied, or withdrawn earlier this year “in good faith” (many are skeptical this is possible given the intense politicization of the NIH over the past few months).³⁶ In addition, according to the statements of NIH Director Jay Bhattacharya, the NIH reserves the right not to continue these grants if they are no longer aligned with the NIH mission, thus allowing for the possibility that these grants could be reinstated but not renewed when the grant year ends (traditionally grants are funded for multiple years).³⁷

Taking this censorship even a step further, and in response to the lawsuits arguing that terminations had been “arbitrary and capricious,” in mid-December 2025 the NIH issued guidance to NIH staff on reviewing grants for “priority alignment.”³⁸ The guidance requires the use of a “computational text analysis tool” to identify suspect terms that identify grants (new or renewals) that would be flagged for additional review (yes, truly Orwellian). Of course, all these grants have been through expert review by a panel of scientists. The guidance goes on to indicate that the NIH will not fund grants that refer to “poorly defined, non-scientific or subjective terms.” “Health equity” and “structural racism” are provided as examples. All these terms have precise definitions in the scientific literature, definitions that are of course debatable as part of scientific inquiry, and the implications of these concepts for health are subject to empirical inquiry. The claim that research projects that include these terms are unscientific reflects either blatant ignorance, or worse (but sadly more likely), an effort to censor certain kinds of research on purely ideological grounds.

Notably, in the new guidelines, health disparities research, which is essentially synonymous with health equity research but lacks the dangerous word, is considered acceptable by the NIH as long as “the interventions or potential interventions relate to areas that can be directly influenced by healthcare or biomedical science.” This rules out any research linking upstream factors like poverty, employment, or even housing as a focus of NIH funded research—a bizarre exclusion. Regardless of the confusing language, reinstatements, and declarations by the NIH Director that health disparities research remains an NIH priority, the result has been censorship—outright by the NIH or anticipatory by researchers themselves—of research aimed at reducing health inequities. Most worrisome, through the new guidelines, the censorship is also targeting any research that aims to identify ways to improve population health that go beyond traditional medical interventions. Recent resignations by NIH scientists and administrators concerned about the ideological bent of current NIH priorities further illustrate the impact that this is having on the federal agency itself.³⁹

 

The MAHA Plan: Contradictions and Vacuous Statements 

Before and during his confirmation hearings, RFK Jr. articulated a vision to improve health in the United States centered on the prevention of chronic diseases. Chronic diseases, especially cardiovascular diseases, are a major cause of morbidity and mortality in the United States, appear to be fundamental drivers of the US health disadvantage compared to other high-income nations, and seem to explain a significant portion of the stalling in the decline of mortality (or even increasing mortality) in many US population groups (although it should be noted that gun, drug, and car deaths contribute significantly to the US health disadvantage).⁴⁰ Cardiovascular and related diseases also show strong health inequities by race and class, which are linked to social, economic and environmental conditions. A focus on reducing the burden of chronic disease is therefore a reasonable public health priority, which is why RFK Jr.’s purported focus on the topic was initially received with cautious optimism by many in the public health field hoping to find a silver lining in the otherwise dismal public health actions of the administration.

Under normal circumstances, establishing a commission to guide a broad-based approach to improve health in the United States, including preventing chronic diseases, would be celebrated by public health experts everywhere. But the MAHA Commission and the so-called MAHA program have been characterized by a mixture of misunderstanding and ignorance of the scientific evidence, promotion of unsubstantiated claims (even quack science), acquiescence to special interests, a retreat from using the power of government to take the actions really needed, and an overall ideological, as opposed to fact-based, approach to public health. Launched by executive order in February 2025, the MAHA Commission, composed primarily of political appointees from various government agencies as well as special appointees like Stephen Miller (but no public health experts), has produced two reports.⁴¹ The first report issued May 2025,“The MAHA Report,” focused on childhood health. An earlier version of this report included a number of fake citations, indicating that AI was likely used to generate it.⁴² The report identified childhood chronic diseases as a priority and correctly pointed to the role of diet, physical activity, and environmental exposures, including multiple co-occurring exposures, as important factors that need to be addressed. It highlighted the role of advertising, corporate influences, and excessive medicalization. All of these things are true. But on the downside, without any evidence, the report also dedicated considerable space to suggesting that vaccines administered to children could be unsafe. A second report issued in September 2025, “The MAHA Strategy,” listed a number of strategies to “end the childhood chronic disease crisis.” In characteristic fashion, the proposed strategies were a mixture of sensible recommendations that have been made by public health experts for years (like working with schools to promote physical activity and improve nutrition options) mixed with fringe and scientifically unsupported opinions that advance the beliefs and ideological agenda of members of the current administration, like suggesting the urgent need to study vaccine injuries or arguing that fluoride in water at the levels used in water fluoridation represents a health risk.

Despite a lot of talk about a new approach, many of the recommendations in the “MAHA Strategy” report align with traditional health education and health promotion strategies that have been advocated for years. However, no concrete or new regulatory actions were proposed to reduce pesticides in food or reduce consumption of unhealthy foods (e.g. through taxation or other regulation of the food industry), and the language around reducing environmental contaminants flies in the face of the actions taken in other areas of the executive branch of the government, like the EPA, which has been swiftly moving towards retreating from regulations that have been shown to be especially important to children. The recently issued updated nutritional guidelines⁴³ follow a similar pattern to the “MAHA Strategy,” combining sensible and important recommendations that public experts have been promoting for years (like reductions in the consumption of processed foods and added sugars) with rather bizarre elements apparently reflecting Kennedy’s personal beliefs, like promoting the consumption of red meat and the use of beef tallow. Most importantly, they do not include any proposed concrete actions (like regulation) that would be needed to make these recommendations more than mere statements. Contradictions and vacuous talk abound. See for example the piece in Nature magazine⁴⁴ on the MAHA Summit held in November 2025 entitled “Psychedelics and immortality: Nature went to a health summit starring RFK and JD Vance,” which reports on how the summit included sessions on psychedelics, brain implants, and anti-aging. So much for evidence based public health and the “gold standard” science advocated for by the administration.

 

Where Does All This Leave Us? 

As is the case for everything going on in our world, it is hard to be optimistic. The four areas discussed in this piece do not encompass all the public health areas that have been severely impacted or are under threat. Impacts also include the defunding of many public health activities, including the dismantling of the US government’s engagement in global health which has resulted in draconian cuts to health programs across the world. The impact of this administration on public health in the US and globally is impossible to fully assess at this time. Most importantly, many other actions in the economic and social spheres (e.g. persecution, incarceration, and deportation of immigrants; threats to human rights in the US and abroad; promotion of war; among others) will necessarily have major consequences for public health.

It is easy to be paralyzed and despondent. Despite the many challenges with public health in the United States, many of us found in this country public health institutions (including academic and governmental) that advocated for, supported, and advanced a public health agenda that was solidly grounded in science and that was committed to protecting the health of everyone. It is therefore shocking to see it all fall apart like a house of cards. It is even more shocking to see how some of the language (and even ideology) of the current administration has been internalized, with institutions and individuals tacitly accepting that certain words should just not be used and certain topics should not be pursued. But in this, public health has been no different from what we are seeing in other aspects of society in the United States and increasingly globally.

Some have argued that this is an opportunity for us to reconsider what the public health community (researchers and practitioners) has done right and what it has done wrong, implying that the attack on the public health professions (and public health evidence) is at least in part justified by the past failures of the public health community. The pandemic experience is frequently raised as an example of the failure of the public health approach—without regard for the facts and forgetting what little evidence we had at the time. Of course, we must learn from past experiences, including what we have done, right and wrong, with evidence and honesty. But this is impossible to do in the context of the authoritarianism and censorship that we are living through today. The pandemic experience is manipulated to demonize the fundamental strategy in public health, which is based on collective approaches to protecting the population as a whole. By definition, this collective approach, which also includes attention to inequities, is a threat to a worldview based on individualism at all cost. A similar argument, defending individual “choice,” is increasingly used to demonize vaccination. This ideological critique of public health has been accompanied by posturing around the need for “Gold Standard Science.” But arguments made by the current administration in support of so-called “Gold Standard Science” are hard to take seriously given the ideological appropriation of terms like “rigorous” and “scientific” to exclude certain concepts altogether from scientific inquiry, and the outright censorship of entire areas of legitimate public health research. But this should be no surprise as the ideological manipulation of facts has always gone hand in hand with authoritarian governments.

Ultimately the fate of public health is closely entwined with the fate of human rights; the promotion of equity and social justice; respect for freedom of speech; open and rigorous science, social, political, and economic systems that support people and protect our environment; and, of course, world peace. It is also fundamentally linked to our ability to act collectively to protect our community and our environment. Today, all of this is under threat. But as I finish writing this, I see in the news a small glimmer of hope. I see this in the protests in Minneapolis, in the news stories and in the videos, which often show tragic and violent outcomes, but also show just regular people standing up to protect each other and their neighbors. I see people taking care of each other, people looking out for others who they do not know and who do not always look like them or speak their language. I see people standing up for the rights of others to have full and healthy lives, working together to create a world where everyone can reach their full potential. And this is after all what public health is really about.