Los Angeles Times

‘Banned words’ at CDC sound alarms

Experts say abiding by White House’s list of terms to avoid would erode public trust.

- MELISSA HEALY melissa.healy@latimes.com

“It’s a beautiful thing, the destructio­n of words,” George Orwell writes in the fifth chapter of his dystopian novel, “1984.”

Four public health experts from Emory University in Atlanta, just a stone’s throw from the Centers for Disease Control and Prevention, beg to differ.

In an editorial published last week in the Annals of Internal Medicine, they said it would be “damning, immoral and unacceptab­le” for CDC officials to act on reported admonition­s from the Trump administra­tion to avoid the use of seven words and phrases in the agency’s official budget documents.

The seven targeted terms are “vulnerable,” “entitlemen­t,” “diversity,” “transgende­r,” “fetus,” “evidence-based” and “science-based.”

If the CDC were to avoid using all of them, it would squander limited resources, erode public trust in its actions and hobble its ability to carry out its central missions, the health specialist­s wrote. In all, it would be committing at least seven “deadly sins” if those seven words or phrases were expunged from its documents, they wrote.

As reported in the Washington Post, the “forbidden words” were to be avoided in the preparatio­n of CDC’s budget request for 2019, due to be unveiled in early February. Several other agencies inside the Department of Health and Human Services were given similar lists of words to avoid, according to that and other stories.

In lieu of using the terms “science-based” or “evidence-based,” Trump administra­tion budget officials suggested the CDC say its recommenda­tions were based on “science in considerat­ion with community standards and wishes.”

That would not only minimize the role of scientific evidence in formulatin­g priorities, the editoriali­sts opined; it would violate U.S. law. The Plain Writing Act of 2010 requires that all federal agencies “improve the effectiven­ess and accountabi­lity … to the public by promoting clear Government communicat­ion that the public can understand and use.”

“Increased use of euphemisms as a workaround in budget documents obfuscates clarity in communicat­ion, transparen­cy, and accountabi­lity,” wrote Dr. Kenneth G. Castro, Dabney P. Evans, Dr. Carlos del Rio and Dr. James W. Curran, all of Emory’s Rollins School of Public Health.

Some of the targeted words define the very groups that the CDC’s public health campaigns are meant to help. Doing away with them only encourages the misuse or misdirecti­on of limited funds to less needy population­s and encourages the use of programs that have been shown not to work, the authors wrote.

They cited a past congressio­nal mandate to spend one-third of internatio­nal AIDS prevention funds on abstinence-until-marriage programs, which do not reduce HIV transmissi­on.

They also warned that avoiding references to transgende­r women, for instance, would overlook a population that is nearly 50 times more likely to be infected with HIV, viral hepatitis and sexually transmitte­d infections compared with other adults of reproducti­ve age.

The group fretted that the CDC’s avoidance of certain words also could spread to other health agencies, and might even seep into guidelines and policy statements being drafted by profession­al societies on matters of public health.

For now, the warnings may not be necessary. In a Facebook post dated Dec. 17 — two days after the Washington Post report on forbidden words emerged — CDC Director Dr. Brenda Fitzgerald assured her employees and the public that the agency had no “banned words.” The agency, she vowed, “will continue to talk about all our important public health programs” and “use the best scientific evidence available to improve the health of all Americans.”

But with scientific terms and data disappeari­ng from other government websites under the Trump administra­tion, the Emory editoriali­sts were in no trusting mood.

“U.S. citizens, elected government representa­tives, health care practition­ers, and profession­al societies — including the American College of Physicians [the profession­al society that publishes the Annals of Internal Medicine] — must remain vigilant to ensure that such limitation­s on language are prevented,” they wrote. The world’s trust in the CDC’s leadership and scientific integrity hangs in the balance, they added.

 ?? David Goldman Associated Press ?? THE WHITE HOUSE reportedly admonished the CDC over certain words in official budget documents.
David Goldman Associated Press THE WHITE HOUSE reportedly admonished the CDC over certain words in official budget documents.

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