Consider This from NPR - Trump is changing public health guidance. What's it mean for you?

Episode Date: September 24, 2025

The federal government’s approach to public health has changed more in the last eight months than it has in decades.  Since President Trump returned to office, he and members of his administration have challenged the safety of the covid vaccine, the overall childhood vaccine schedule, and the causes of autism.This has upended public health guidance that doctors and patients have relied on for years. Jen Brull, the President of the American Academy of Family Physicians talks about how doctors and patients are navigating this moment.For sponsor-free episodes of Consider This, sign up for Consider This+ via Apple Podcasts or at plus.npr.org. Email us at [e-mail] episode was produced by Elena Burnett, Brianna Scott, and Megan Lim, with audio engineering by Hannah Gluvna.It was edited by Courtney Dorning.Our executive producer is Sami Yenigun.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

For generations, the U.S. government has worked to protect the health of its citizens. It hasn't always succeeded, but it has taken major steps to do so, like this one in 1964. Out of its long and exhaustive deliberations, the committee has reached the overall judgment that cigarette smoking is a health hazard. That's then U.S. Surgeon General Luther Terry during a press conference where he laid out the findings of the report he and his committee prepared on the dangers of cigarette smoking. It is a judgment of the committee that cigarette smoking contributes substantially to mortality from certain specific diseases and to the overall death rate. It would take decades for the majority of Americans to quit smoking and for the tobacco companies to be held accountable.

But the public health initiatives and guidance that began with that report contributed to a drastic drop in smoking. Members of the Senate, members of the House, ladies and gentlemen, we are here today for the purpose of signing the Cancer Act of 1971. Seven years after, the Surgeon General warned about the dangers of smoking, President Richard Nixon focused the power of the federal government on beating cancer. We can say this, that for those who have cancer and who are looking for success in this field, they at least can have the assurance that everything that can't,

be done by government. Everything that can be done by voluntary agencies in this great, powerful, rich country now will be done. That was Nixon the day he signed the Cancer Act of 1971 into law. By the year 2021, the National Cancer Institute's annual budget had increased 25-fold. Prevention, early detection, and treatment all improved, and cancer mortality has dropped. Since 2021, overall spending on cancer research has not decreased in the Trump administration. Some cancer research grants have been terminated, and fewer cancer research grants are being funded. The federal government has also led the way on vaccines. CBS News presents a special report.

The SOC polio vaccine is a success. The vaccine works. That's a CBS News radio report from April 12, 1955, announcing that after decades of illness, there was finally a way to prevent polio. The federal government licensed the vaccine the same day and led the way for distribution. By 1979, polio was eliminated in the United States. Fifteen years later, it was completely eliminated across the Americas. Fast forward to 2025, and the president of the United States pointed to vaccines as a cause of autism. And they pump so much stuff into those beautiful little babies.

It's a disgrace. That's President Donald Trump earlier this week. I think it's very bad. They're pumping, it looks like they're pumping into a horse. You have a little child, a little fragile child, and you get a vat of 80 different vaccines, I guess, 80 different blends, and they pump it in. He made those remarks along with Health and Human Services Secretary Robert F. Kennedy, Jr.

at a press conference linking autism to the use of Tylenol in pregnancy, a finding for which there is no definitive proof. The skepticism around vaccines and Tylenol are just two areas of science the Trump administration has called into question. Consider this. The federal government has spent generations building a robust public health system. The Trump administration is scaling it back. How are doctors navigating the change and what does it mean for their patients?

From NPR, I'm Ari Shapiro. Pss, did y'all hear? Code Switch is one of Tom Magazine's top 100 podcast of all time, baby. Mm-hmm. They called our show, quote, a kind of cultural compass, never preachy, always curious, about the roots of inequality in people's lived experiences. Mm-hmm. I mean, I'm biased, but we couldn't have put it better ourselves.

And we are digging into all this every week. So make sure you catch the next episode of Code Switch on the NPR app or wherever you get your podcasts. It's Consider This from NPR. The federal government's approach to public health has changed more in the last eight months than it has in decades. Since President Trump returned to office, he and members of his administration have challenged the safety of the COVID vaccine, the overall childhood vaccine schedule, and the causes of autism. This has upended public health guidance that doctors and patients have relied on for years. Jen Brule is president of the American Academy of Family Physicians. She is with us from Fort Collins, Colorado, to talk about how doctors and patients are navigating this moment.

Welcome. Thank you. I'm so glad to be here. Before we get to the broad picture of how the federal government has changed its role in public health over the last several months, what were you thinking as you watched President Trump and Health Secretary Robert F. Kennedy Jr. the other day talking about the causes of autism. I think this is where it's important to separate headlines from science. What I know is that the best science we have today shows no credible link between acetaminopin use in pregnancy and autism. family physicians have been advising pregnant people for decades to be thoughtful about any medication use, whether it's Tylenol or anything else. And the guidance has always been, use it when you need it at the lowest effective dose, and only for as long as necessary. And so when I think about the

government releasing a report that changes that credible evidence, it can feel frustrating. And I imagine that it feels frustrating to family physicians everywhere and to parents everywhere. You say it's frustrating when you have the loudest and most powerful voices in the government giving guidance that does not conform to the best science. Is frustrating really the word? I think what worries me most is how these claims land with all sorts of people. Imagine a parent who used Tylenol during their pregnancy and now has a child with autism or an adult with autism who's hearing speculation about its cause messages like these can create guilt doubt or a stigma where none is deserved people with autism and the families who love them deserve compassion and respect

not blame they need our support our resources and our continued research that advances real understanding, not speculation that adds to their burden. And while the science today is clear that there is no credible link, the AAFP will thoroughly evaluate any data shared by federal health agencies. Well, a high-profile televised event is one thing. Broadly speaking, though, what role does the federal government typically play in educating patients and physicians about how best to take care of their health? Typically, the federal government is involved in doing that evaluation of evidence with incredible physicians, scientists and other scientists who look at all available evidence, much like the studies that have

been done to date about the COVID vaccine, about the pediatric vaccination schedule, and about medications used in pregnancy and their safety profiles. They have an incredible, powerful think tank that is able to process a large amount of data in a pool of experts and put forth a recommendation that helps physicians, patients, communities make the best decisions about their health. Can you think of a case or a patient you've dealt with where guidance from the federal government made a tangible difference in how you dealt with the case? Oh, absolutely. So in 20 years of taking care of patients in a small community in Kansas, Plainville, Kansas. I used federal guidance all the time when it came to FDA guidance, when it came to

the immunization schedule and what made the most sense and got the best results for children who needed an immunization series, the fewest number of shots with the largest positive impact and the lowest risk of side effects. Those were conversations I had with patients every day in the practice of medicine. There have always been doctors who practice what can generously be called alternative medicine. And during the COVID-19 pandemic, a lot of unproven cures and treatments flourished on social media. And the government played a key role in saying, here's what works, here's what's verified, here's what you can trust, here's what you can't. Now that you find yourself on the outside saying what the federal government is saying is not proven by science,

Is it a kind of Alice in Wonderland through the looking glass moment where you're saying don't trust NIH, the CDC, the White House, trust your doctor instead? I wouldn't say that I'm saying don't trust those sources. There are many recommendations that come from those organizations where there are still incredible scientists and physician scientists who are working hard to ensure that we have access to the best information. information. My comment instead is if you hear something, wherever that source is, whether it's the television, TikTok, or a headline, and you have a question about it, that's the time to have a conversation with the person who knows your health best. A lot of times what we hear through all different sorts of news channels and social media isn't the whole story. And having that conversation is part of understanding the whole story.

We are not yet a quarter of the way through President Trump's time and office. And as I said, we have seen more dramatic change than in decades when it comes to public health. How are you thinking about the next three years? The American Academy of Family Physicians has made a conscious choice to continue to engage in the ways that we are able with all of the federal agencies that work on. health, social determinants of health, and all the pieces that work to ensure that patients across the United States have access to health care and good health care. So we will continue to do what we have done for the last 10 months, which is provide statements that are publicly available about what we see in the evidence, provide guidance to family

physicians and others and patients across the United States on what we see in science-based, evidence-based care, and be clear in that message. Having changes in Washington doesn't mean it's a reason to step back. It is still important that the work that is happening there is informed by those who understand the needs of the population in the United States best. and that is primary care physicians. Dr. Jen Bruill is president of the American Academy of Family Physicians. Thank you so much for speaking with us. Thank you.

This episode was produced by Elena Burnett, Brianna Scott, and Megan Lim, with audio engineering by Hannah Glovena. It was edited by Courtney Dorney. Our executive producer is Sammy Yenigat. It's Consider This from NPR. I'm Ari Shapiro. Want to hear this podcast without sponsor breaks? Amazon Prime members can listen to Consider this sponsor-free through Amazon music. Or you can also support NPR's vital journalism and get Consider This Plus at plus.npr.org.

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