Confusion rules in one corner of the Centers for Disease Control and Prevention, where the purpose is the pursuit of certainty.
The National Center for Health Statistics plans and disseminates research informing public health policies on everything from food to oral health to environmental exposures. It may be best known for reports that rely on the National Health and Nutrition Examination Survey, though its future is now a question mark after the people who make it happen were among the roughly 1,300 who received layoff notices on Oct. 10. Nearly 600 of those reductions in force were reversed, but the small corps of planners in that division were not among them.
Or so it appears. They have not been able to access their work email accounts, and not just because of the federal government shutdown, sources told STAT.
“The hardship that the RIF folks have to go through — these are real people with families — and then there is the hardship on the rest of NCHS staff who have to pick up the responsibilities that are left undone,” Denys Lau, formerly the director of a division that tracks the nation’s health care provision and utilization, told STAT. “It will take two to three generations to rebuild the damage done.”
An HHS spokesperson had previously said those planning jobs were not eliminated, but sources have repeatedly told STAT that the people in those roles received layoff notices. STAT has reviewed emails from people confirming they’ve lost their jobs.
On Friday, Richard Danker, a spokesperson at the Department of Health and Human Services, said “because of a recent court order, HHS is not currently taking actions to implement or administer its reduction-in-force notices.” He did not answer questions about how many RIFs or rescissions were previously made in NCHS and how affected employees might find out about rescissions that HHS has said were made to correct coding errors.
Former leaders of the planning branch and other NCHS divisions estimate about 100 jobs were terminated: the director and deputy director of the division on vital statistics (birth and death data) and one Epidemic Intelligence Service officer (part of a postdoctoral training program) in the division behind NHANES, plus all 15 staff in the planning and operation branch of the division on health care statistics, which tracks health care provider and hospitalization data. A minority were called back.
What does NCHS do?
People in the planning branch behind NHANES are part of a larger effort but are essentially the ones who make the survey run. Other planners across the agency also handle budgets, contracts, IT and data security, privacy protection for survey participants, outreach, communication, methods development and implementation, technical inquiries, as well as the numerous administrative tasks that all organizations require.
“NCHS is a lot more than NHANES,” said Jennifer Schoendorf, former NCHS director of research and methodology, who is now senior deputy editor at the American Journal of Public Health. “With the loss of the critical staff in these behind-the-scenes programs that intersect with the data collection pipeline along the way, I fear there may be too many barriers to overcome.”
In addition to planners in a branch of the NHANES division, RIFs to date have hit:
All of the people in the Office of Planning, Budget, and Legislation, which talks to Congress, tracking policies and ensuring funding is sustained.
People working in research units in the division of research and methodology, including the mathematical statisticians and the behavioral scientists who evaluate survey questions to make sure survey designs are valid and can produce reliable, accurate data.
Planning branches in the division that runs health care surveys.
The administrative and management group, which does timesheets, travel, and administrative HR support.
Why does it matter, and why now?
The government shutdown and related furloughs may mask the immediate impact of job cuts, Schoendorf said.
“If the government were open, the impact of these RIFs would be debilitating. In addition to the time spent trying to figure out what is going on, adjusting to the gaps at best would take a lot of time,” she said. “This time means that the health data needed to make informed decisions and assessments of the administration’s health priorities would not be available. Even if the planning groups for the two survey programs are reinstated, the gaps in the administration, management, IT, publications, budget, and research will hobble the programs.”
Keeping data under umbrella of objectivity
NCHS is federally mandated to keep its reports nonpartisan because it is part of the umbrella statistical system that also includes the Census Bureau, Bureau of Labor Statistics, and the Bureau of Justice Statistics. Lau, who is now editor in chief of the American Journal of Public Health, said that if that data process moves out from under that umbrella of objectivity, it might be harder to guarantee that any NCHS findings are scientifically valid, clear and free of political bias.
Lau was baffled by layoffs of people working at the small statistical agency.
“They are critical in providing answers on what the effects are as a result of the federal policy changes that this administration is implementing,” he said. “Don’t they want to know if their changes are making America healthy again? Without objective, nonpartisan data from NCHS, they cannot do that.”
A judge in San Francisco has issued a temporary restraining order barring further RIFs during the federal government shutdown, now in its third week.
RIFs and rescissions may also seem temporary. Some people who were laid off on Feb. 14 soon had their RIFs overturned. But then they were laid off again on Oct. 10, only to have their RIFs rescinded again.
“It’s dizzying and demoralizing thinking that you can be let go anytime,” Lau said.
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.