Navigating New York public health cuts
What sudden changes mean for our communities and how to take action
It has been another rough week for public health. I wish I were coming here to bring you some positive news, but once again, federal budget cuts are making it extremely difficult for local public health to continue doing its job: keeping us safe and healthy. But there are things we can do to take action.
Now is the time to show up, speak out, and (try) to stay educated on all of these changes.
A short (more uplifting) note before we dive in: Tickets are now on sale for *anyone* who wants to attend our upcoming live community event with my friend and colleague Dr. Katelyn Jetelina, public health podcaster (and Jon Stewart's senior producer) Brinda Adhikari, and comedian Casey Balsham. Grab your ticket today—we're almost sold out! (And don't forget paid subscribers get in free; your access code is at the bottom of this email.)
Alright, let’s dive in.
Hundreds of millions cut from New York public health budgets
Last week, the U.S. Department of Health and Human Services (HHS) cut $100 million from New York City and another $367 million from New York state’s public health budgets. The state cuts include:
$27M from the state Office of Mental Health
$40M for the Office of Addiction Services and Supports
$300M for the state Department of Health
The cuts reduce the New York City budget by 5% and likely a higher percentage for the state. (The state percentage is harder to calculate due to different office budgets.) For New York City, it doesn’t seem too big in the grand scheme of things. This is good, because it means that NYC isn’t as dependent on federal funds as other communities. But there’s a whole lot more behind this 5%...
There are three major concerns I see with these cuts:
#1: Going back to pre-pandemic times because of the loss of infrastructural gains.
Public health learned a lot of hard lessons during the pandemic, and New Yorkers felt the brunt of it, including how fractured and outdated our public health systems were. While federal officials are calling these cuts a “downscaling” of COVID-19 programs that are no longer needed following the pandemic, the reality is that these dollars are for the public health infrastructure, and eliminating them now sets us back.
For New Yorkers, these cuts will affect a variety of interconnected health efforts:
Updating tracking mechanisms for infectious diseases like measles, bird flu, mpox, and tuberculosis (not just COVID-19)
Continued education for infection prevention in nursing homes and hospitals
Updated systems for your immunization records
Monitoring and providing support for long-covid patients
Vaccination education and outreach
Setting up new public health preparedness and surveillance systems, like wastewater monitoring
Transitional housing for those in addiction treatment programs
Expansion of outpatient clinics for addiction treatment services
Improving and expanding mobile crisis response and 9-8-8 crisis call centers
Crisis Stabilization and Crisis Residence Programs to provide urgent treatment to individuals experiencing an acute mental health and/or substance use crisis
Already, Governor Hochul announced that these cuts would eliminate the CDC COVID-19 Health Disparities Grant, which funded 135 organizations to support community-based work addressing health disparities in New York, such as mental health, maternal and infant health, and food security.
#2: The abruptness and lack of transition.
This money was supposed to end in 2026/2027. This cut happened with 24 hours’ notice. This pulled the rug out from under many, leaving numerous people jobless overnight and halting infrastructure projects at midpoints, unable to be finished, effectively wasting progress. Public health operations cannot be expected to stop on a dime because disease threats do not stop.
#3: The negative impacts on the health of our communities.
Cutting programs and resources will mean more preventable diseases slip through the cracks in New York. Public health will need to “do more with less,” and further cuts will impact core services. Public health employees are also community members, and many are now faced with losing their jobs.
Why it matters: These cuts force state and local leaders to look elsewhere to fund their staff and programs. This will likely mean pulling money from other programs, cancelling programs altogether, and many layoffs. North Carolina, for example, similarly lost $100M in funding and announced it was laying off 80 public health staff. Last week, HHS announced it was laying off 10,000 federal employees.
NIH funds canceled in New York
In New York, funding from the National Institutes of Health—the research hub of the U.S., which sent $3.6 billion to New York in 2024—supports more than 29,000 jobs and almost $8 billion in economic activity across the state. But now, thousands of those grants are getting canceled.
At Columbia University alone, $400 million in scientific and medical research funding was canceled (a 31% reduction from the $1.3B in federal funding they received in 2024). The Presidential administration has withheld this research funding to pressure the university to make changes: revising Columbia’s policies on student protests, adopting new definitions of antisemitism, and adding oversight to the school’s Middle Eastern studies programs. Although the university agreed to make these changes, the funding still hasn’t been restored.
CUNY, SUNY, the University of Rochester, Hunter College, Mount Sinai, and other research centers across the state also lost NIH grants. These grants supported studies on topics like:
Alzheimer’s (Alzheimer's Disease Genetic Risk and Microglial Innate Immune Memory Study)
HIV (A Multi-site Multi-Setting RCT of Integrated HIV Prevention and HCV Care for PWID R01 Study)
Cervical cancer (Assessing Cervical Cancer Healthcare Inequities in Diverse Populations: The ACHIEVE R01 Study)
Water contaminants (Public Drinking Water Contaminants and Infant Health: Advancing Environmental Justice Study)
They also funded training programs to prepare the next generation of clinicians in pediatric infectious diseases, child psychiatry, and heart disease.
What comes next? It’s up to universities to figure out how to support the existing faculty and staff. Some may be able to accomplish this by freezing the hiring process and waiting out the storm, some may stop accepting new students to save money, and others may be able to depend on their endowments. Overall, this will have the most impact on smaller universities and those without huge donors. This could lead to many layoffs, which would have significant impacts on our local economies.
So, what do we do?
Don’t panic. Don’t look away. Buckle up. Katelyn put it best in her recent post: “In a democracy, an educated public is the primary means to correct government errors.” Navigating these choppy waters will feel rough and overwhelming, but continuing to engage, listen, and talk to each other is our best bet to maintain a strong health system.
Contact your representatives and show up. Call your senators and congressional representatives to advocate for the issues that matter to you. (Find their contact information here.) Some apps provide representative info as well as scripts for specific topics. You can attend City Council or Town Hall meetings; find the New York City schedule here or check your local City Council schedules.
Share your stories with your community, YLE through comments (comment below!), your representatives, or via social media. Federal policy may feel distant, but personal stories from neighbors, friends, or colleagues bring its impact to life. Putting human faces to policy changes helps build awareness and keeps our legislators accountable.
Support one another. With so many changes, people may be worried about losing essential health services, facing layoffs, or feeling overwhelmed by the news. We need each other’s support and empathy right now.
Bottom line
These cuts risk unraveling years of hard-fought progress, leaving our communities more vulnerable and our public health workforce disheartened. But we’re not powerless, and we can’t panic. We have the tools to support public health—let’s use them! Now more than ever, community support is critical.
Love,
Your New York Epi
A side note:
New Jersey is reporting two unrelated measles cases, one of which visited New York City. Anyone who visited the following locations during the specified times may have been exposed and should contact a healthcare provider to discuss potential exposure and risk of developing illness.
Amtrak Northeast Regional Train 175 traveling Southbound from New York Penn Station to Washington, D.C. on March 19, 2025, between 7:30 PM and 1:30 AM (March 20). Potentially exposed individuals, if infected, could develop symptoms as late as April 10, 2025.
Capital Health Medical Center—Hopewell, Emergency Department, Pennington, NJ on March 22, 2025, between 5:15 PM and 1:30 AM (March 23). Potentially exposed individuals, if infected, could develop symptoms as late as April 12, 2025.
Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health advocate. She specializes in infectious diseases, outbreak response, and emerging health threats. She has led multiple outbreak investigations at the California Department of Public Health and served as an Epidemic Intelligence Service Officer at the CDC. Dr. Donnelly is also an epidemiologist at Biobot Analytics, where she works at the forefront of wastewater-based disease surveillance.
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