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Inside the High-Stakes Corporate Fight Over Feeding Preterm Babies

David Hilzenrath — Mon, 30 Mar 2026 09:00:00 +0000

In 2013, a scientist at Abbott Laboratories saw study results with potentially big implications for the company’s profits and the lives of some of the world’s most fragile people: preterm infants.

The upshot, : Babies fed rival Mead Johnson Nutrition’s acidified liquid human milk fortifier — a nutritional supplement used in neonatal intensive care units — developed certain complications at higher rates than those given an Abbott fortifier, a researcher at the University of Nebraska had found.

At least one of those complications .

The Abbott scientist, Bridget Barrett-Reis, described the results in the email to colleagues, using two exclamation points. Then she proposed that Abbott test the Mead Johnson fortifier, acidified for sterilization, against another Abbott product.

The clinical trial among preterm infants that Abbott subsequently sponsored, , is a case study of corporate warfare in the high-stakes business of infant nutrition, wherein preemies have been coveted like commodities; their anxious, vulnerable parents have been — whether they know it or not — targets of calculated commercial pursuit; and scientific research has been used as a marketing tool.

In hospitals around the country, dozens of babies born an average of 11 weeks early were fed Mead Johnson’s fortifier. Dozens of others were fed an Abbott fortifier that wasn’t acidified.

The clinical trial became a boon for Abbott, which to wrest market share from Mead Johnson. But for some of the babies enrolled, it didn’t turn out so well, a �鶹Ů�� Health News investigation found.

Far more infants given Mead Johnson’s product developed a buildup of acid in the blood called metabolic acidosis than those fed Abbott’s product — 19 versus four, according to results published in the journal .

Two outside doctors monitoring infants in the study became so alarmed that they refused to enroll any more babies, according to an April 2016 email one of them sent to Abbott.

In a related email to Abbott, neonatologist Robert White of Memorial Hospital in South Bend, Indiana, and Pediatrix Medical Group — an investigator in the study — .

“We had another SAE” — serious adverse event — “today in which a child developed profound metabolic acidosis while on the study fortifier,” White wrote. The severity was “unlike what we would see in most children with these issues.”

A manager at Abbott replied that the company was “taking your concerns very seriously.”

The study continued for almost a year.

At least some of the consent forms used to inform parents about risks did not mention metabolic acidosis or the often-fatal necrotizing enterocolitis, another condition identified in the 2013 email that led to the study.

In a November response to questions for this article, Abbott spokesperson Scott Stoffel said the clinical trial “was safe and ethical” and that the fortifiers it compared were “on the market and widely used.”

The study was “led by 20 non-Abbott investigators,” Stoffel said.

According to a federal website, chaired the study.

Stoffel added that the study was approved “by 14 independent safety review boards at hospitals” and “published in a leading peer-reviewed scientific journal.”

“It is reckless and not credible to suggest that these doctors and institutions conducted and then published the results of an unsafe or unethical study,” Stoffel said.

A spokesperson for Mead Johnson, Jennifer O’Neill, did not comment on Abbott’s clinical trial but said in a November statement to �鶹Ů�� Health News that existing studies “cannot responsibly support” any connection between the acidified fortifier and conditions such as necrotizing enterocolitis or metabolic acidosis.

Mead Johnson executive Cindy Hasseberg argued in a deposition that Abbott waged a “smear campaign” against the acidified fortifier that was “very hard to come back from.”

In 2024, Mead Johnson discontinued the product.

Winning the ‘Hospital War’

Behind their warm-and-fuzzy marketing, industry giants Abbott, maker of Similac products, and Mead Johnson, maker of the Enfamil line, have turned neonatal intensive care units into arenas of brutal competition.

This article quotes from and is based largely on records from three lawsuits against formula manufacturers that went to trial in 2024 and are now on appeal. The cases are , , and The records include emails, internal presentations, and other company documents used as exhibits in litigation, as well as court transcripts and witness testimony from depositions.

The records provide an inside view of the business of infant formula and fortifier, a nutritional supplement added to a mother’s milk. For example, a Mead Johnson slide deck for a 2020 national sales meeting — later used in the Whitfield trial — outlined a plan for “Branding NICU Babies.”

Urging employees to win more sales from neonatal intensive care units, the document said: “’”

In internal documents and other material from litigation reviewed by �鶹Ů�� Health News, formula makers described hospitals as gateways to the much larger retail market because parents are likely to stick with the brand their babies started on. Products used in the NICU help win hospital contracts, and hospital contracts help establish brand loyalty, according to court records.

Manufacturers vie for contracts that can be “exclusive” or nearly so, according to records from the litigation, including company documents and testimony by people who have worked in management for the companies.

An undated Abbott presentation used in the Gill case, apparently referring to inroads with hospitals in its rivalry with Mead Johnson, boasted of “MJ Strongholds Broken!”

It saluted two employees who “Own 27K Babies Exclusively,” and said another “Stole 600 formula feeders from MJ.”

Still others were praised for “Playing in Mom’s mailbox” or “kicking … and ‘taking names.’”

In July 2024, Abbott CEO Robert Ford said in a conference call for investors that formula and fortifier for preterm infants generated total annual revenue of about $9 million — a small portion of Abbott’s total sales of $42 billion in 2024 and its $2.2 billion of sales in the United States from pediatric nutritional products.

Industry documents cited in litigation provide a different perspective.

“‘,” stated an Abbott training presentation from about a decade ago used in the Gill and Whitfield trials.

That described a baby’s first formula feeding in the hospital, the document said. Over 74% of the time, an infant fed formula in the hospital stays on that brand at home, the document said.

Abbott’s goal was that the first-bottle-fed strategy , the document showed. A staff training slide displayed during the Whitfield trial showed how that momentum could pay off in bonuses for Abbott sales representatives, leading to a “Happy Rep.”

Mead Johnson has espoused a similar strategy.

The company rolled out a with cash rewards for flipping hospitals from Abbott, according to a 2019 document marked for internal use by Mead Johnson and its parent company, England-based Reckitt Benckiser Group, and admitted into evidence in the Watson case.

“ is critical to contract gains and acquisition,” stated a company plan for 2022 that was cited in the Whitfield case.

One Abbott document shown in the Whitfield trial said more than half of first feedings happen at night, adding, “.”

A “Mead Johnson University” training document described a scenario in which a sales rep overhears patient information in a NICU and encouraged the rep to promote the company’s products. The document, titled “,” was admitted as evidence in the Watson case.

“[Y]ou are walking back into your most important NICU,” it said. “You overhear the HCP’s” — health care providers, apparently — “stating all of the notes,” it said. “There may be some information that may help you to position your products as a resource for this patient and to handle any objections that the HCP may present you with.”

To win parents’ business, companies have supplied formula to hospitals free or at a loss, court records show. That has resulted in such curiosities as a Mead Johnson “purchasing agreement” cited in the Watson case, listing the price for product after product as “no charge.”

In a 2017 strategy document prepared for Mead Johnson, a consulting firm laid out a plan “to win hospital war.”

Why focus on hospitals? “,” it explained.

The document was displayed in the Whitfield case.

In the market for preterm nutrition, Abbott and Mead Johnson compete with each other, not against the use of human milk, the companies told �鶹Ů�� Health News.

“Thus, references in documents about wanting to ‘win’ or ‘own’ the NICU refer to out-performing Mead Johnson by offering the highest-quality products,” Abbott’s Stoffel said in February.

Asked specific questions about business strategies and internal documents, Mead Johnson’s O’Neill said the company was “concerned that you are presenting a misleading and incomplete picture.”

Mead Johnson’s products “are safe, effective, and recommended by neonatologists when clinically appropriate,” O’Neill added.

On the Defensive

In courthouses around the country, Abbott and Mead Johnson are on the defensive — and have been for years.

In hundreds of lawsuits, parents of sickened or deceased preterm infants have alleged that formula designed for preemies has caused necrotizing enterocolitis, or NEC, a devastating condition in which immature intestinal tissue can become infected and die, spreading infection through the body.

Lawsuits also accuse the manufacturers of failing to warn parents of the risk.

One of the cases on which this article is based, , resulted in a against Mead Johnson. , Gill v. Abbott Laboratories, et al., resulted in a against Abbott. , Whitfield v. St. Louis Children’s Hospital, et al., resulted in a , but the judge found errors and misconduct on the part of defense counsel, faulted his own performance, and .

The cases have involved children like Robynn Davis, who was born at 26 weeks, lost 75% to 80% of her intestine to NEC, suffered brain damage — and, at almost 3 years old, couldn’t walk, couldn’t really talk, and was eating through a tube, as Jacob Plattenberger, an attorney representing her, in 2024.

An attorney for Abbott, James Hurst, that Robynn suffered a catastrophic brain injury at birth, 10 days before she received any Abbott formula, and that her NEC resulted not from formula but from many health problems.

In at least three cases, a federal judge has in favor of Abbott — ruling for the company before the lawsuits even reached trial.

The formula makers have repeatedly denied fault.

Addressing stock analysts in 2024, as “without merit or scientific support” the theory that preterm infant formula or milk fortifier caused NEC.

In a issued in 2024, the FDA, the Centers for Disease Control and Prevention, and the National Institutes of Health said there was “no conclusive evidence that preterm infant formula causes NEC.”

Mead Johnson’s O’Neill said the scientific consensus is that there is no established causal link between the use of specialized preterm hospital nutrition products and NEC.

Neonatologists use the products routinely, O’Neill said.

O’Neill cited a statement by the saying the causes of NEC “are multifaceted and not completely understood.”

In a legal brief filed with an Illinois appeals court in the Watson case, the company said “the NEC-related risks” of a formula for preterm infants “are the subject of medical debate,” adding that trial evidence “demonstrated, at a minimum, uncertainty as to the magnitude of the risk, as well as the causal role of various feeding options in the development of NEC.”

Manufacturers say formula is needed when mother’s milk or human donor milk isn’t an option. Fortifier, a product tailored to preemies, is meant to augment mother’s milk when babies are born prematurely and a mother’s milk alone doesn’t deliver enough nutrition. The Mead Johnson fortifier used in the head-to-head clinical trial sponsored by Abbott was acidified to prevent bacterial contamination.

In March 2025, Health and Human Services Secretary Robert F. Kennedy Jr. announced that his department, which encompasses the FDA, was undertaking a review of infant formula, dubbed “Operation Stork Speed.” It includes and increasing testing for heavy metals and other contaminants, HHS said.

However, is limited. The agency doesn’t approve the products or their labeling. Whether to report adverse events — illnesses or deaths potentially related to the products — to the FDA is largely at manufacturers’ discretion.

The business of infant formula further spotlights a central contradiction in the Trump administration’s health policies. When it comes to food and medical products, the administration has criticized industry-funded research as unworthy of trust. Yet under Kennedy, it has disrupted, defunded, or sought to cut government-funded research, which could leave industry-funded research with a larger and more influential role.

It “is entirely appropriate for the Department to scrutinize research design, conflicts of interest, and funding sources, particularly when research is used to inform public policy,” HHS spokesperson Andrew Nixon said.

‘At the Table’

Company emails cited in litigation shed light on the industry’s approach to research.

In a 2015 email, when Mead Johnson was considering supplying some of its formula to a researcher for a study, a company neonatologist expressed concern that the results could be spun to make the preemie product look unsafe.

“However, we are more likely to have control over final language if we provide the small support and are ‘at the table’ with him,” Mead Johnson’s Timothy Cooper added in the email, which was cited in the Watson trial.

In 2017, Abbott with researchers at Johns Hopkins University about a study on how the composition of infant formula might affect NEC in mice. The email thread became an exhibit in the Whitfield case.

Abbott was both funding and collaborating on the work, shows.

Forwarding a draft of the resulting paper to Abbott, David Hackam, chief of pediatric surgery at the Johns Hopkins University School of Medicine, said in one of the emails, “We hope you like it.” He also requested help from Abbott in filling in information.

“The manuscript looks great!” Abbott’s Tapas Das , after a back-and-forth.

But Abbott had some changes, the email thread shows.

“We (VM & DT) made some edits in the text especially to soften a bit with the statement ‘infant formula seems responsible for developing NEC,’” Das wrote.

“Instead, we thought if we could state as ‘infant formula is linked to severity of NEC’. So we made changes throughout the text emphasizing on severity of NEC by infant formula rather than development of NEC by infant formula,” Das wrote.

Das wrote that “other factors are involved for NEC development as described in the text.”

Hackam did not respond to questions �鶹Ů�� Health News sent by email.

Efforts to reach Das and Cooper — including by phoning numbers and sending letters to addresses that appeared to be associated with them — were unsuccessful.

When Mead Johnson provided support to scientific researchers, the company would want to make sure they reported the results “in an honest way,” Cooper said in a deposition played in the Watson trial.

The Abbott co-authors “proposed routine edits to the article for scientific accuracy and for the consideration of the other authors, some of the most well-respected NEC researchers in the world,” Abbott’s Stoffel said.

“Abbott regularly collaborates with and publishes studies with leading NEC scientists for the benefit of both premature infants and the entire scientific community,” Stoffel said.

“The research studies Mead Johnson supports are conducted independently and appropriately, with full transparency,” said O’Neill, the Mead Johnson spokesperson.

‘In the Wrong Direction’

Transparency can be subjective.

More than a decade ago, Mead Johnson sponsored a clinical trial testing what was then a new acidified liquid fortifier against a powdered fortifier already on the market.

In the study, which enrolled 150 babies, 5% of infants fed the acidified liquid developed NEC compared with 1% of infants fed the powder, according to deposition testimony and a record of the clinical trial used in the Watson case.

That information was not included in a 2012 that reported the study results.

The article, in the journal Pediatrics, whose authors included two Mead Johnson employees, concluded it was safe to use the new liquid fortifier instead of the powdered one. The article also said that, comparing babies fed the liquid with those fed the powder, the study observed no difference in the incidence of NEC.

The unpublished finding of 5% to 1% represented so few babies that it was not statistically significant.

Nonetheless, retired neonatologist Victor Herson, who ran a NICU in Connecticut and has studied fortifiers, said in an interview he would have wanted to see those numbers.

“The trend was in the wrong direction,” Herson said, “and would have, I think, alerted the typical neonatologist that, well, maybe not to rush in and adopt” the new fortifier.

It’s common for study publications to include tables showing complications even if they aren’t statistically significant so that readers can draw their own conclusions, Herson said.

Neonatologist Fernando Moya, a co-author of the Pediatrics article, had a different perspective.

“You may not be very familiar with medical literature but when there are no ‘statistically significant’ differences, we do not comment on whether something was increased or decreased,” Moya said by email. He referred questions to Mead Johnson.

Mead Johnson’s O’Neill gave several reasons why “the data you cite was not included in the publication.” She said the study was designed to examine infant nutrition and growth, NEC was a “secondary outcome,” the NEC numbers weren’t statistically significant, and the size of the study, “while appropriate, was not powered to draw any conclusions with respect to any potential differences in NEC.”

In a deposition used in the Watson trial, Carol Lynn Berseth — a co-author of the paper and Mead Johnson’s director of medical affairs for North America when the study was completed — testified that the article was peer-reviewed and that no reviewer asked for additional data.

“Had they asked for it, we would have shown it,” Berseth testified.

Berseth did not respond to a phone message or to an email or letter sent to addresses apparently associated with her.

‘It Should Not Be in a NICU’

The Abbott scientist who flagged research on Mead Johnson’s acidified fortifier in 2013, Bridget Barrett-Reis, was later of AL16, the follow-up clinical trial Abbott sponsored, and of .

In a deposition, she was asked why she conducted the study.

“I conducted that study because I thought [the acidified fortifier] could be dangerous,” she said, “and I thought it would be a good idea to find out if it really was because nobody was doing anything about it.”

Elaborating on the thinking behind the study, she testified: “It should not be in a NICU in the United States. That product should not be anywhere for preterm infants.”

In her 2013 email recommending that Abbott conduct a study, Barrett-Reis cited findings by “an independent investigator,” Ann Anderson-Berry, that showed, compared with preterm infants fed an Abbott powder, those on Mead Johnson’s acidified liquid “had slower growth, higher incidence of metabolic acidosis and NEC!!”

Asked about the exclamation points, Barrett-Reis testified in a January 2024 deposition used in the Gill case that she wasn’t excited about the findings. “I am known to put exclamation points instead of question marks and everything anywhere, so I have no idea at the time what those meant,” she testified.

The research that caught her eye in 2013 reviewed patient records from the Nebraska Medical Center. The institution had switched to the acidified fortifier with high hopes but stopped using it after four months because it was concerned about patient outcomes, Anderson-Berry and Nebraska co-authors .

In an interview, Anderson-Berry said she set out to analyze why, during those four months, babies’ growth “fell apart in our hands.”

Abbott was “very pleased” with Anderson-Berry’s findings and paid her to go around the country discussing them, she said.

Metabolic acidosis can be fatal, Anderson-Berry said. But typically it can be managed, she said, adding that she didn’t know of deaths from metabolic acidosis caused by the acidified fortifier.

Research has found that metabolic acidosis “is associated with poor developmental and neurologic outcomes in very low birth weight infants,” according to . In addition, it is “a risk factor for neonatal necrotizing enterocolitis,” the paper said.

Barrett-Reis did not respond to inquiries for this article, including a message sent via LinkedIn and a letter sent to an address that appeared to be associated with her.

In court, Abbott representative Robyn Spilker testified that metabolic acidosis and that nobody should knowingly put kids at risk for getting NEC in an effort to make money.

Before infants were enrolled in the AL16 study, their parents or guardians had to sign consent forms disclosing, among other things, the risks that clinical trial subjects would face.

International ethical principles for medical research on humans, known as the , say each participant must be adequately informed of the “potential risks.”

Questioning Abbott’s Spilker in litigation, plaintiff’s attorney Timothy Cronin said, “Ma’am, despite the hypothesis going in, are you aware Abbott on the informed consent form given to parents that signed their kids up for that study?” Spilker, who identified herself in court as a senior brand manager, said she didn’t know what was on the consent forms.

Through a request under a Kentucky open-records law, �鶹Ů�� Health News obtained an informed consent form for the AL16 study used at a public institution, the University of Louisville. The form mentioned risks such as diarrhea, constipation, gas, and fussiness. It did not mention metabolic acidosis or NEC.

�鶹Ů�� Health News also reviewed an informed consent form for the AL16 study used at Memorial Hospital of South Bend. It was largely identical to the one used in Louisville and did not mention metabolic acidosis or NEC.

Cronin, the plaintiff’s attorney, said in an interview that Abbott showed disregard for the health and safety of premature babies participating in the AL16 clinical trial.

“I think it’s unethical to do a study if you know you are subjecting participants in the study to an increased risk of a potentially deadly disease and you don’t at least tell them that,” Cronin said.

Anderson-Berry told �鶹Ů�� Health News that Abbott was “ethically well positioned” to conduct the AL16 clinical trial because her paper was not definitive.

Yet she said she was unwilling to enroll any of her patients in the Abbott clinical trial because she didn’t want to take the chance that they would be given the acidified liquid.

White, the neonatologist who stopped enrolling patients in the study, defended the decision to conduct it. In an interview, he said it was appropriate to conduct a large, properly controlled clinical trial to see whether concerns raised in earlier research were borne out. The two babies whose serious adverse events he reported to Abbott ended up doing fine, he said.

But White, who went on to be listed as a co-author of the study, told �鶹Ů�� Health News that parents should have been informed that the risks included metabolic acidosis and NEC.

“In retrospect, obviously, that is something that we, I think, should have informed parents of,” he said.

Abbott did not directly answer questions about the consent forms.

The results of AL16 were in 2018. The conclusion: Infants fed the acidified product — in other words, the Mead Johnson fortifier — had higher rates of metabolic acidosis and poorer feeding tolerance. Plus, poorer “initial weight gain.”

The title of the article trumpeted “Improved Outcomes in Preterm Infants Fed a Nonacidified Liquid Human Milk Fortifier” — in other words, the Abbott product.

Eight of the 78 infants receiving the Mead Johnson fortifier were treated for metabolic acidosis, compared with none of the 82 receiving the Abbott product, the article said. Four infants on Mead Johnson’s product experienced serious adverse events, compared with one on the Abbott product, the article reported.

One infant receiving the Mead Johnson product died — from sepsis, the article said. One had a case of NEC, and infants on Mead Johnson’s fortifier “had significantly more vomiting,” the article said.

However, in a pair of letters to the editor published in the Journal of Pediatrics, the article as hyped. Writers said the article emphasized findings that were .

In its business battle with Mead Johnson, Abbott deployed the study. It produced an annotated copy for its sales force, which was shown in the Whitfield trial.

Abbott’s use of AL16 as a marketing tool worked.

In 2019, when Barrett-Reis applied for a promotion at Abbott, she wrote that the results of the study had been “leveraged to secure whole hospital contracts which have increased hospital share to > 70%.”

Her letter was displayed in a deposition video filed in the Gill litigation.

Internally, Mead Johnson conceded it had been beaten in the fight over fortifiers. In the slide deck for a 2020 national sales meeting, the company said, “Abbott won the narrative.”

Share your story with us: Do you have experience with infant formula or any insights about it that you’d like to share? We’d like to hear from you. Click here to contact our reporting team.

New Work Requirement Adds Red Tape to Missouri’s Snarled Food Aid System

Samantha Liss — Mon, 01 Dec 2025 10:00:00 +0000

WARRENTON, Mo. — Distributing food stamps soon could get even harder for Missouri’s food aid system, which a federal judge has already called “broken and inaccessible.”

States depend heavily on federal funds to operate their food stamp programs, which help feed about 42 million people nationwide. But a new federal law has restructured the nation’s food assistance, requiring more people to work to qualify for aid and shifting more of the program’s cost onto states over the next decade. Meanwhile, many Americans are struggling to afford groceries, and state governments are straining to help them.

More than a year ago, for example, a federal judge ruled that Missouri’s food aid system was “overwhelmed,” had wrongly denied assistance to applicants, and had caused many to go hungry as a “direct result of the system’s inadequacy.” The judge, Douglas Harpool, ordered the state to fix the problems.

Despite the court order, not much has changed, according to a �鶹Ů�� Health News analysis of state performance metrics.

Missouri’s ongoing problems foreshadow the trouble that lies ahead for state food aid programs nationwide. Food assistance advocates have said Missouri is just one example of a nationwide problem in which strained state systems struggle to deliver timely aid. For example, low-income people in Alaska have while the state has spent years trying to fix the problem.

Last year, then-U.S. Agriculture Secretary Tom Vilsack sent letters to 44 governors urging swifter application processing and greater accuracy in determining benefits.

The administrative snarls come on top of concerns about funding during the recent federal government shutdown. The Trump administration refused to use emergency funds to keep the food aid program running, and food benefits lapsed for millions of people, including in Missouri, on Nov. 1 as the shutdown dragged into its fifth week. Two federal judges ordered the Trump administration to tap emergency funds for the program.

The shutdown ended Nov. 12, and Missouri said its SNAP recipients began receiving their full benefits three days later. Meanwhile, as Thanksgiving approached, were still being reported in some states.

Even after the shutdown, states will have to do more with fewer resources. Republicans’ One Big Beautiful Bill Act slashes billions in federal funding to the food aid program and pushes more of the administrative and financial burden to states.

The bill President Donald Trump signed in July axes $187 billion over the next decade from the Supplemental Nutrition Assistance Program, commonly referred to as food stamps, or SNAP. That represents a 20% cut, according to the Congressional Budget Office.

One of the most significant and immediate changes requires more people to work to qualify for aid. The change will cause at least 2.4 million Americans to lose aid, according to from the bipartisan Congressional Research Service. The analysis predicts many people will lose their benefits because the work requirements will make applying more difficult.

Expanding work requirements will harm some of the nation’s most vulnerable people, said , who leads food aid strategies at the left-leaning Center on Budget and Policy Priorities.

But the conservative , a group that has worked to advance similar policies in states, says the requirement is necessary to preserve assistance for the “truly needy.”

‘Undisputed’ Strains in Missouri

Some Missourians were already struggling before Trump signed the bill.

Kelly Thweatt, 64, said she received a notice in the mail that her food benefits had been cut back. She didn’t understand why, because her income hadn’t changed, she said recently outside a SNAP office 60 miles west of St. Louis.

After she pays for her spot at a mobile home park in Warrenton, she said, she’s left with about $300 each month from Social Security. The roughly $300 in SNAP benefits she had received every month kept her afloat.

Thweatt will be subject to the new federal work requirement because she’s not yet 65.

More than are at risk of losing some amount of food aid because of the new work requirement, which went into effect Nov. 1.

For Thweatt, finding a job may prove difficult. She’s been out of the workforce for nearly 20 years.

Food aid provides a lifeline to more than 650,000 Missourians — that’s more than eight sold-out crowds at Arrowhead Stadium in Kansas City, where the NFL’s Chiefs play. The program helps feed 20% of Missouri’s children every month, according to the Missouri Foundation for Health, a nonprofit philanthropic organization. (The foundation provides financial support to �鶹Ů�� Health News.)

The recent federal changes will require more seniors, parents, veterans, homeless people, and former foster care youths to clear additional administrative hurdles to get food aid, .

Patrick McKelvey, executive director of the Gateway Food Pantry in Arnold, Missouri, unloads a recent grocery delivery. (Samantha Liss/�鶹Ů�� Health News)

For years, thousands of Missourians have struggled to tap into food assistance, largely because applicants must complete an interview, over the phone or in person. But many Missourians can’t get through to a state staffer.

Applicants have spent hours waiting on hold or in line outside state offices, according to a lawsuit filed in 2022 in federal court. At times, so many people have been waiting on hold that the phone system started hanging up on people, the lawsuit says.

Some Missouri SNAP offices are staffed by only a single employee, according to Harpool’s May 2024 order, adding to the strain.

In a statement provided to �鶹Ů�� Health News, the Missouri Department of Social Services said that because demand varies by location, it may be appropriate to have a single staffer in some places.

In Warrenton, makeshift phone booths line the walls of the food aid office. People sit at a cubicle with a desk and use a phone to complete interviews with officials elsewhere. A sign sitting on the floor asks applicants to “please be patient with our progress” as the state works on technology improvements.

According to Harpool’s order, the “evidence is undisputed” that Missouri’s food aid system has “unacceptable wait times” and that thousands of calls “cannot be completed.” These problems put Missourians at risk of losing aid “each and every time” they apply for food benefits, the judge wrote. To stay in the program, most households need to periodically submit documents and complete interviews.

A �鶹Ů�� Health News analysis of Missouri SNAP reports showed the same problems persist more than a year later. In the 16 months after the judge’s order, nearly half of all the applications that were denied were rejected at least partly because no interview was completed, according to data the state submitted to the court as part of the order. That indicates the state’s system is failing the most vulnerable, the judge has said.

In an order released in May of this year, Harpool found that Missouri failed to show significant improvement and that its performance deteriorated by some measures. The state hadn’t documented adding a single staffer or investing any additional resources to process applications faster, Harpool wrote.

Missouri’s Department of Social Services said the state legislature has provided money to hire temporary workers in other areas, freeing up staff to process SNAP applications.

To complete the required interviews for food aid, the agency said, it makes multiple attempts to reach applicants once an application is received.

, an attorney with National Center for Law and Economic Justice who represented Missourians in the case, said, “These are your neighbors, these are your kids’ classmates who are going hungry when the system doesn’t work.”

Trouble Ahead

Roughly 68% of the state’s food aid recipients are children, adults over 60, or people with a disability, according to the Missouri Foundation for Health. Many who can work already do.

, the food security policy manager with Empower Missouri, an organization working to eradicate poverty in the state, said Missouri lacks the money and the will to fix its food aid system.

Woody and other advocates fear the federal changes will erode the nation’s most powerful defense against hunger.

“For a state like Missouri that is already struggling to operate the program, these new rules couldn’t come at a worse time,” said Bolen, of the Center on Budget and Policy Priorities.

Nelson Berra, senior manager at the Gateway Food Pantry in Arnold, Missouri, organizes a recent grocery delivery. (Samantha Liss/�鶹Ů�� Health News)

Missouri foreshadows the trouble that lies ahead for other states, he said. Like Missouri, many states are reluctant to fund their food aid programs. And now they’ll be forced to use state dollars to fill the gaps left by the federal cuts, which “sets states up to fail,” Bolen said.

Supporters of the changes see it differently. U.S. House Speaker Mike Johnson previously described the cost shift to states as “modest” and said it’s necessary to reduce fraud. States “don’t have enough skin in the game,” ahead of the budget bill’s passage.

Still, if states do not come up with the money to fill the gap, Bolen said, they’ll be left with two options: Make it harder for people to qualify for SNAP, or end the program entirely.

For Thweatt, the change comes at a particularly hard moment. A few months ago, she lost her life partner of three decades, leaving her reeling and struggling to afford the basics. She does not turn 65 until April, which means she’s subject to the expanded work requirement until then and may have to show she has a job to maintain the $220 in monthly food benefits she has left. The state will apply the work rules to her case when she’s up for renewal, state officials said. Thweatt’s car needs repairs and its license plates are set to expire, she said. She doesn’t have the money to address either problem.

She’s selling everything that she can, including an antique bedroom set, to afford necessities, she said.

“I can satisfy myself with a bag of chips per day,” Thweatt said. “So if that’s what I need to do, that’s what I need to do.”

�鶹Ů�� Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at �鶹Ů��—an independent source of health policy research, polling, and journalism. Learn more about .

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The Nation’s Largest Food Aid Program Is About To See Cuts. Here’s What You Should Know.

Katheryn Houghton and Samantha Liss and Renuka Rayasam — Fri, 31 Oct 2025 19:29:14 +0000

The Trump administration’s overhaul of the nation’s largest food assistance program will cause millions of people to lose benefits, strain state budgets, and pressure the nation’s food supply chain, all while likely hindering the goals of the administration’s “Make America Healthy Again” platform, according to researchers and former federal officials.

Permanent changes to the Supplemental Nutrition Assistance Program are coming regardless of the outcome of at least two federal lawsuits that seek to prevent the government from cutting off November SNAP benefits. The lawsuits challenge the Trump administration’s refusal to release emergency funds to keep the program operating during the government shutdown.

A federal judge in Rhode Island ordered the government to use those funds to keep SNAP going. A Massachusetts judge in a separate lawsuit also said the government must use its food aid contingency funds to pay for SNAP, but gave the Trump administration until Nov. 3 to come up with a plan.

Amid that uncertainty, food banks across the U.S. braced for a surge in demand, with the possibility that millions of people will be cut off from the food program that helps them buy groceries.

On Oct. 28, a vanload of SpaghettiOs, tuna, and other groceries arrived at Gateway Food Pantry in Arnold, Missouri. It may be Gateway’s last shipment for a while. The food pantry south of St. Louis largely serves families with school-age children, but it has already exhausted its yearly food budget because of the surge in demand, said Executive Director Patrick McKelvey.

New Disabled South, a Georgia-based nonprofit that advocates for people with disabilities, announced that it was offering one-time payments of $100 to $250 to individuals and families who were expected to lose SNAP benefits in the 14 states it serves.

Less than 48 hours later, the nonprofit had received more than 16,000 requests totaling $3.6 million, largely from families, far more than the organization had funding for.

“It’s unreal,” co-founder Dom Kelly said.

The threat of a SNAP funding lapse is a preview of what’s to come when changes to the program that were included in the One Big Beautiful Bill Act that President Donald Trump signed in July take effect.

The domestic tax-and-spending law cuts $187 billion within the next decade from SNAP. That’s a nearly 20% decrease from current funding levels, according to the Congressional Budget Office.

The new rules shift many food and administrative costs to states, which may lead some to consider withdrawing from the program, which helped about 42 million people buy groceries last year. Separate from the new law, the administration is also pushing states to limit SNAP purchases by barring such things as candy and soda.

All that “puts us in uncharted territory for SNAP,” said Cindy Long, a former deputy undersecretary at the Department of Agriculture who is now a national adviser at the law firm Manatt, Phelps & Phillips.

The country’s first food stamps were issued at the end of the Great Depression, when the poverty-stricken population couldn’t afford farmers’ products. Today, instead of stamps, recipients use debit cards. But the program still buoys farmers and food retailers and prevents hunger during economic downturns.

The CBO estimates that will lose food assistance as a result of in the budget law, including applying work requirements to more people and shifting more costs to states. Trump administration leaders have backed the changes as a way to limit waste, to , and to .

This is the biggest cut to SNAP in its history, and it is coming against the backdrop of rising food prices and a fragile labor market.

The exact toll of the cuts will be difficult to measure, because the Trump administration that measures food insecurity.

Here are five big changes that are coming to SNAP and what they mean for Americans’ health:

1. Want food benefits? They will be harder to get.

Under the new law, people will have to file more paperwork to access SNAP benefits.

Many recipients are already required to work, volunteer, or participate in other eligible activities for 80 hours a month to get money on their benefit cards. The new law to previously exempted groups, including homeless people, veterans, and young people who were in foster care when they turned 18. The expanded work requirements also apply to parents with children 14 or older and adults ages 55 to 64.

, if recipients fail to document each month that they meet the requirements, they will be limited to three months of SNAP benefits in a .

“That is draconian,” said Elaine Waxman, a senior fellow at the Urban Institute, a nonprofit research group. About 1 in 8 adults reported having lost SNAP benefits because they had problems filing their paperwork, according to .

Certain refugees, asylum-seekers, and other lawful immigrants are cut out of SNAP entirely under the new law.

2. States will have to chip in more money and resources.

The federal law drastically increases what each state will have to pay to keep the program.

Until now, states have needed to pay for only half the administrative costs and none of the food costs, with the rest covered by the federal government.

Under the new law, states are on the hook for 75% of the administrative costs and must cover a portion of the food costs. That amounts to an estimated median cost increase for states of more than 200%, according to by the Georgetown Center on Poverty and Inequality.

A �鶹Ů�� Health News analysis shows that a single funding shift related to the cost of food could put states on the hook for an additional $11 billion.

All states participate in the SNAP program, but they could opt out. In June, nearly wrote to congressional leaders warning that some states wouldn’t be able to come up with the money to continue the program.

“If states are forced to end their SNAP programs, hunger and poverty will increase, children and adults will get sicker, grocery stores in rural areas will struggle to stay open, people in agriculture and the food industry will lose jobs, and state and local economies will suffer,” the governors wrote.

3. Will the changes lead to more healthy eating?

The Trump administration, through its “Make America Healthy Again” platform, has made healthy eating a priority.

Health and Human Services Secretary Robert F. Kennedy Jr. has championed the restrictions on soda and candy purchases within the food aid program. To date, to limit what people can buy with SNAP dollars.

Federal officials previously blocked such restrictions, because they were difficult for states and stores to implement and they boost stigma around SNAP, according to . In 2018, the first Trump administration to ban sugar-sweetened drinks and candy.

A store may decide that hassle isn’t worth participating in the program and drop out of it, leaving SNAP recipients fewer places to shop.

People who receive SNAP are no more likely to buy sweets or salty snacks than people who shop without the benefits, . Research shows that encouraging healthy food choices is than regulating purchases.

When people have less money to spend on food, they often resort to cheaper, unhealthier alternatives that keep them sated longer rather than paying for more expensive food that is healthy and fresh but quick to perish.

4. How will SNAP cuts affect health?

Advocacy organizations working to end hunger in the nation say the cuts will have long-term health effects.

Research has found that kids in households with limited access to food to have a mental disorder. Similarly, food insecurity is linked to .

Working-age people with food insecurity to experience chronic disease. That high blood pressure, arthritis, diabetes, asthma, and chronic obstructive pulmonary disease.

Those health issues come with costs for individuals. Low-income adults who aren’t on SNAP more a year on health care than those who are.

lived in households with limited or uncertain access to food in 2023.

5. What does this mean for the nation’s food supply chain?

SNAP spending directly boosts grocery stores, their suppliers, and the transportation and farming industries. Additionally, when low-income households have help accessing food, they’re more likely to spend money on other needs, such as prescriptions or car repairs. All that means that every dollar spent through SNAP generates at least $1.50 in economic activity, .

A report by associations representing convenience stores, grocers, and the food industry estimated it to comply with the new SNAP restrictions.

Advocates warn stores may pass the costs on to shoppers, or they may close.

Ticks Are Migrating, Raising Disease Risks if They Can’t Be Tracked Quickly Enough

Aaron Bolton, MTPR — Thu, 18 Sep 2025 09:00:00 +0000

Biologist came to this small meadow in the mountains outside Condon, Montana, to look for ticks. A hiking path crossed the expanse of long grasses and berry bushes.

As Hokit walked the path, he carried a handmade tool made of plastic pipes taped together to hold a large rectangle of white flannel cloth.

He poked fun at this “sophisticated” device, but the scientific survey was quite serious: He was sweeping the cloth over the shrubs and grass, hoping that “questing” ticks would latch on.

Along the summer trail, ticks dangle from blades of grass, sticking their legs out and waiting for a passing mammal.

“We got one,” Hokit said.

“So that came off of this sedge grass right here,” he said. “Simply pick them off with our fingers. We’ve got a vial that we pop them in.”

Any captured ticks would go back to Hokit’s lab in Helena for identification. Most of them would probably be identified as Rocky Mountain wood ticks.

But Hokit also wanted to find out whether new species are making their way into the state.

As human-driven climate change makes winters shorter, ticks are spending less time hibernating and have more active months when they can hitch rides on animals and people. Sometimes the ticks carry themselves — — to new parts of the country.

Hokit found in northeastern Montana earlier this year. Deer ticks are infamous for transmitting Lyme disease and can infect people with .

Knowing a new species like the deer tick has arrived in Montana or other states is important for doctors.

is an infectious disease specialist at the Billings Clinic in eastern Montana. He said most patients don’t come in right after they get bitten by a tick. They usually show up later, when they start feeling sick from a tick-borne illness.

“Fever, some chills, they may just feel bad, similar to many infections we may encounter throughout the year,” he said.

It’s rare that patients connect a tick bite to those symptoms, and even more rare that they capture and keep the tick that bit them. Sorting out whether someone might have a tick-borne illness can be complicated.

Knowing what kinds of ticks are in the region will help doctors know that they might start encountering patients infected with new diseases after a tick bite, Ku said.

That’s partially why the state is on the hunt for new tick species.

“The more we know about what’s in Montana, the better we can inform our physicians, the better care you can receive,” said , a zoonotic illness and vector-borne disease epidemiologist with the Montana Department of Public Health and Human Services.

Cozart collects and tests the ticks from field surveys in Montana to see whether they are carrying any pathogens.

Hokit drags a white cloth through brush outside Condon looking for ticks. These surveys help public health officials understand where ticks are in Montana and detect new species that have migrated on large mammals like deer. Hokit found deer ticks, which are known to carry Lyme disease, earlier this year in northeastern Montana. (Aaron Bolton/Montana Public Radio)

Whether a tick can get a human sick depends on the species, but the kind of mammal it feeds on also plays a role.

“Usually it’s a rodent that might be carrying, for example, Rocky Mountain spotted fever,” she said. “So, the tick will feed on that rodent, then will get the pathogen as well.”

Because the prevalence of a particular disease can vary in mammal populations, ticks in one part of the state could be more or less likely to get you sick. That’s also important information for medical providers, Cozart said.

This kind of surveillance and testing isn’t happening in every county or state. A of nearly 500 health departments throughout the country found that roughly a quarter do some kind of tick surveillance.

Not all are equal, said , director of environmental health at the National Association of City and County Health Officials.

Field surveys can be expensive. For numerous local and state health departments, tick surveillance relies on a less expensive, more passive approach: Concerned patients, veterinarians, and doctors must collect and send in ticks for identification.

“It does provide a little information about what ticks are actually interacting with people and animals, but it doesn’t get into the weeds of how common ticks are in that area and how often do those ticks carry pathogens,” Gridley-Smith said.

She said more health departments want to start tick surveillance, but getting funding is hard — and might get harder as federal public health grants from agencies like the Centers for Disease Control and Prevention dry up.

Montana receives about $60,000 from a federal grant annually, but the bulk of that funding goes toward mosquito surveillance, which is more intensive and costly. What’s left funds trips into the field to look for ticks.

Hokit said he doesn’t have enough funding for his small team to survey everywhere he would like to in a state as large as Montana. That means he’s unable to monitor emerging populations of deer ticks as closely as he would like.

He found those new deer ticks in two Montana counties, but he doesn’t have enough data to determine whether they have begun reproducing there, establishing a local population.

In the meantime, Hokit uses data on climate and vegetation to make predictions about where deer ticks might thrive in the state. He has his eye on particular areas of western Montana, like the Flathead Valley.

He said that will help him and his team narrow down where to look next so they can let the public know when deer ticks — and the diseases they can carry — arrive.

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Millions of Americans Are Expected To Drop Their Affordable Care Act Plans. They’re Looking for a Plan B.

Blake Farmer, Nashville Public Radio — Mon, 12 Jan 2026 10:00:00 +0000

Robert Sory feeds a treat to a blind, albino raccoon named Cricket. Russian foxes, African porcupines, emus, bobcats, and goats are also part of his menagerie. (Blake Farmer/WPLN)

It’s feeding time for the animals on this property outside Nashville, Tennessee. An albino raccoon named Cricket reaches through the wires of its cage to grab an animal cracker, an appetizer treat right before the evening meal.

“Cricket is blind,” said Robert Sory, who is trying to open a nonprofit animal sanctuary along with his wife, Emily. “A lot of our animals come to us with issues.”

The menagerie in Thompson’s Station includes Russian foxes, African porcupines, emus, bobcats, and some well-fed goats.

The Sorys are passionate about their pets and seem to put the animals’ needs before their own.

Both Robert and Emily started 2026 without health insurance.

Robert had been covered through a marketplace plan subsidized through the Affordable Care Act. His share of the monthly premiums was $0. When he looked up the rates for 2026, he saw that a barebones “bronze”-level plan would cost him at least $70 a month. He decided to forgo coverage altogether.

“When you don’t have any income coming in, it doesn’t matter how cheap it is,” he said. “It’s not affordable.”

Emily and Robert Sory are trying to open a nonprofit animal sanctuary at their home in Thompson’s Station, Tennessee. They have forgone health insurance this year and are looking for ways to pay for their care without coverage. (Blake Farmer/WPLN)

Dumping Coverage

Marketplace plans from the Affordable Care Act no longer feel very affordable to many people, because Congress did not extend a package of enhanced subsidies that expired at the end of 2025. Last week, the House did pass legislation to extend the expired subsidies, and negotiations have moved to the Senate. Without a deal, an estimated will go without coverage this year.

But even without a health plan, people will still need medical care. Many, like the Sorys, have been thinking through their plan B to maintain their health.

The Sorys both lost jobs in November, within days of each other. Robert worked as a farmhand. Emily worked at a staffing firm and lost her insurance along with her position.

“It’s a horrible, horrible market right now. Really tough,” she said.

The first time she had to pay out-of-pocket for her three monthly prescriptions, the cost was $184.

“To equate that to kind of how we think about it, you’re talking about 350 pounds of food for these animals,” Robert said. He pointed to his bobcats, who eat only meat.

A bobcat waits for a meaty meal served by Robert Sory. (Blake Farmer/WPLN)

Workarounds for the Newly Uninsured

To keep kibble in the food bowls, the Sorys are prepping for an uninsured future. They see the same psychiatrist and met with him to make a plan. He was willing to work with them by charging $125 per visit. They’ll have to go every three months to keep their prescriptions current.

And if other medical problems emerge? They’re hoping for the best.

“I’m not somebody who gets sick super often, thank God,” Robert said. “And if I do, generally I go to an emergency room where they’re going to bill me later.” Robert said he would arrange a repayment plan for bills like that.

Emily has costly health conditions and has already taken on substantial medical debt. “It’s just sitting there, and I’ve racked up money,” she said. “But I’ve had to go to the doctor.”

Donated Drugs and Sliding Scales

Hospitals and clinics are of newly uninsured patients. They’re also concerned that people won’t know about alternative ways to get medical care.

“We don’t have marketing dollars, so you’re not going to see big billboards or radio ads,” said , CEO of in Nashville. It’s one of the country’s 1,400 federally qualified health centers, also called FQHCs.

FQHCs are by the federal government. Although they do not usually offer free care, their fees tend to be lower or on a sliding scale.

Uninsured people who get care receive a bill, Beard said, “but the bill will be based on their ability to pay.”

FQHCs often have on-site pharmacies, and some offer prescription medications free of charge through a partnership with the , a Nashville-based nonprofit.

Many hospital pharmacies also partner with the nonprofit, which has donated by pharmaceutical companies to 277 sites in 38 states. must make the medicine available free of charge to people without insurance who have annual incomes below 300% of the federal poverty limit.

The organization primarily sources medications for chronic conditions such as high blood pressure, diabetes, and mental health. Demand is expected to outstrip supply in the new year, according to .

“We’re projecting and engaging with our manufacturers and asking them, ‘Are you willing to help support, for this future status that we are anticipating?’” he said. “By and large,” he said, pharmaceutical companies have said they’re willing to step up.

“It’s a continuous conversation that we’re having,” Cornwell said.

Emily Sory readies the foxes’ supper. (Blake Farmer/WPLN)

A Medicaid ‘Gap’ in 10 States

Hospitals will also have to find a way to care for more patients who cannot pay. Industry groups such as the have been vocal about the threat to hospitals’ financial health and have urged Congress to extend the enhanced subsidies, which take the form of tax credits.

The impact might be most acute in states like Tennessee that have not expanded Medicaid to cover people who work but do not have job-based insurance and cannot afford it on their own.

Ten states have chosen not to expand Medicaid to uninsured, low-income adults — an optional provision of the ACA that is mainly paid for by federal funds.

This Medicaid “gap” is , at the high end of the spectrum, by as much as 65% in Mississippi and by 50% in South Carolina, according to the Urban Institute.

As Emily Sory pets a Russian fox, she admits she is keenly aware that she will soon become part of this growing population. After all, her last job involved health care staffing. Her mother is a nurse.

“I understand the system. And I get it’s people like me that don’t pay their bill are why it suffers. And I feel bad,” she said. “But at the same time, I don’t have the money to pay it.”

This article is from a partnership that includes ,��, and �鶹Ů�� Health News.

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Under Kennedy, America’s Health Department Is in the Business of Promoting Kennedy

Darius Tahir — Thu, 04 Dec 2025 10:00:00 +0000

As health and human services secretary, Robert F. Kennedy Jr. wields one of the louder megaphones the federal government has. Yet he insists he doesn’t want to impose his opinions on Americans.

“I don’t think people should be taking medical advice from me,” Kennedy Democratic congressman in May.

Kennedy once expressed different views — for example, about the need to proselytize about exercise. As he , he wants to use the “bully pulpit” to “obliterate the delicacy” with which Americans discuss fitness and explain that “suffering” is virtuous.

“We need to establish an ethic that you’re not a good parent unless your kids are doing some kind of physical activity,” Kennedy told the podcaster in September 2024.

The Department of Health and Human Services is tasked with communicating information to protect and improve the health and well-being of every American. It provides reminders about vaccinations and screenings; alerts about which food is unsafe; and useful, everyday tips about subjects such as sunscreen and, yes, exercise.

Under Kennedy’s watch, though, HHS has compromised once-fruitful campaigns promoting immunizations and other preventive health measures. On Instagram, the agency often emphasizes Kennedy’s personal causes, his pet projects, or even the secretary himself. Former agency employees say communications have a more political edge, with “Make America Healthy Again” frequently featured in press releases.

Interviews with over 20 former and current agency employees provide a look inside a health department where personality and politics steer what is said to the public. �鶹Ů�� Health News granted many of these people anonymity because they fear retribution.

One sign of change is what is no longer, or soon will not be, amplified — for instance, acclaimed anti-smoking campaigns making a dent in one of Kennedy’s priorities, chronic disease.

Another sign is what gets celebrated. On the official HHS Instagram account this year, out were posts saluting Juneteenth and Father’s Day. In, under Kennedy, were posts and .

Commenting on such changes, HHS spokesperson Andrew Nixon said in an email that “DEI is gone, thanks to the Trump administration.”

Some elected officials are pointedly not promoting Kennedy as a source of health care information. Regarding the secretary’s announcement citing unproven links between Tylenol and autism, Senate Majority Leader John Thune told MSNBC that, “if I were a woman, I’d be talking to my doctor and not taking, you know, advice from RFK or any other government bureaucrat, for that matter.” (Thune’s office did not respond to a request for comment.)

At since January show trust in Kennedy as a medical adviser is low. , from The Economist and YouGov, barely over a quarter of respondents said they trusted Kennedy “a lot” or “somewhat.”

The department’s online messaging looks “a lot more like propaganda than it does public health,” said Kevin Griffis, who worked in communications at the CDC under President Joe Biden .

Transition to a New Administration

The new administration inaugurated dramatic changes. Upon arrival, political appointees froze the health agency’s outside communications on a broader scale than in previous changeovers, halting everything from routine webpage updates to meetings with grant recipients. The pause created logistical snafus: For example, one CDC employee described being forced to cancel, and later rebook, advertising campaigns — at greater cost to taxpayers.

Even before the gag order was lifted in the spring, the tone and direction of HHS’ public communications had shifted.

According to data shared by iSpot.tv, a market research firm that tracks television advertising, at least four HHS ads about vaccines ended within two weeks of Trump’s inauguration.

“Flu campaigns were halted,” during a season in which a died from influenza, Deb Houry, who had resigned as the CDC’s chief medical officer, said in a Sept. 17 congressional hearing.

Instead of urging people to get vaccinated, HHS officials contemplated more-ambivalent messaging, said Griffis, then the CDC’s director of communications. According to Griffis, other former agency employees, and communications reviewed by �鶹Ů�� Health News, Nixon contemplated a campaign that would put more emphasis on vaccine risks. It would “be promoting, quote-unquote, ‘informed choice,’” Griffis said.

Nixon called the claim “categorically false.” Still, the department continues to push anti-vaccine messaging. In November, the CDC to assert the false claim that vaccines may cause autism.

Messaging related to tobacco control has been pulled back, according to Brian King, an executive at the Campaign for Tobacco-Free Kids, as well as multiple current and former CDC employees. Layoffs, administrative leaves, and funding turmoil have drained offices at the CDC and the FDA focused on educating people about the risks of smoking and vaping, King said.

Four current and former CDC employees told �鶹Ů�� Health News that “Tips From Former Smokers,” a campaign credited with helping approximately a million people quit smoking, is in danger. Ordinarily, a contract for the next year’s campaign would have been signed by now. But, as of Nov. 21, there was no contractor, the current and former employees said.

Nixon did not respond to a question from �鶹Ů�� Health News regarding plans for the program.

“We’re currently in an apocalypse for national tobacco education campaigns in this country,” King said.

Kennedy’s HHS has a different focus for its education campaigns, including the “Take Back Your Health” campaign, for which the department this year to produce “viral” and “edgy” content to urge Americans to exercise.

An earlier version of the campaign’s solicitation asked for partners to boost wearables, such as gadgets that track steps or glucose levels — reflecting a for every American to be wearing such a device within four years.

The source of funds for the exercise campaign? In the spring, leadership of multiple agencies discussed using funding for the CDC’s Tips From Former Smokers campaign, employees from those agencies said. By the fall, the smoking program hadn’t spent all its funds, the current and former CDC employees said.

Nixon did not respond to questions about the source of funding for the exercise campaign.

Food Fight

At the FDA, former employees said they noticed new types of political interference as Trump officials took the reins, sometimes making subtle tweaks to public communications, sometimes changing wholesale what messages went out. The interventions into messaging — what was said, but also what went unsaid — proved problematic, they said.

Early this year, multiple employees told �鶹Ů�� Health News, Nixon gave agency employees a quick deadline to gather a list of all policy initiatives underway on infant formula. That was then branded “,” as if it were a new push by a new administration.

Marianna Naum, a former acting director of external communications and consumer education at the FDA, said she supports parts of the Trump administration’s agenda. But she said she disagreed with how it handled Operation Stork Speed. “It felt like they were trying to put out information so they can say: ‘Look at the great work. Look how fast we did it,’” she said.

Nixon called the account “false” without elaborating. �鶹Ů�� Health News spoke with three other employees with the same recollections of the origins of Operation Stork Speed.

“Things that didn’t fit within their agenda, they were downplayed,” Naum said.

For example, she said, Trump political appointees resisted a proposed press release noting agency approval of cell-cultured pork — that is, pork grown in a lab. Similar products have raised the ire of ranchers and farmers working in typically GOP-friendly industries. States such as Florida have .

The agency ultimately issued . But a review of the agency’s archives showed it hasn’t put out press releases about two later approvals of cell-cultured meat.

Wide-ranging layoffs have also hit the FDA’s food office hard, leaving fewer people to make sure news gets distributed properly and promptly. Former employees say notices about recalled foods aren’t circulated as widely as they used to be, meaning fewer eyeballs on alerts about contaminated , , and the like.

Nixon did not respond to questions about changes in food recalls. Overall, Nixon answered nine of 53 questions posed by �鶹Ů�� Health News.

Pushing Politics

Televised HHS public service campaigns earned nearly 7.3 billion fewer impressions in the first half of 2025 versus the same period in 2022, according to iSpot data, with the drop being concentrated in pro-vaccine messaging. Other types of ads, such as those covering substance use and mental health, also fell. Data from the marketing intelligence firm Sensor Tower shows similar drops in HHS ad spending online.

With many of the longtime professionals laid off and new political appointees in place atop the hierarchy, a new communications strategy — bearing the hallmarks of Kennedy’s personality — is being built, said the current and former HHS employees, plus public health officials interviewed by �鶹Ů�� Health News.

Whereas in 2024, the agency would mostly post public health resources such as the 988 suicide hotline on its Instagram page, its feed in 2025 features more of the health secretary himself. Through the end of August, according to a �鶹Ů�� Health News review, 77 of its 101 posts featured Kennedy — often fishing, biking, or doing pullups, as well as pitching his policies.

By contrast, only 146 of the agency’s 754 posts last year, or about 20%, featured Xavier Becerra, Kennedy’s predecessor.

In 2024, on Instagram, the agency promoted Medicare and individual insurance open enrollment; in 2025, the agency has not.

In 2024, the agency’s Instagram feed included some politicking as Biden ran for reelection, but the posts were less frequent and often indirect — for instance, touting a policy enacted under Biden’s signature legislation, the Inflation Reduction Act, but without mentioning the name of the bill or its connection to the president.

In 2025, sloganeering is a frequent feature of the agency’s Kennedy-era Instagram. Through the end of August, “Make America Healthy Again” or variants of the catchphrase featured in at least 48% of posts.

Amid the layoffs, the agency made a notable addition to its team. It hired a state legislative spokesperson as a “rapid response” coordinator, a role that employees from previous administrations couldn’t recall previously existing at HHS.

“Like other Trump administration agencies, HHS is continuously rebutting fake news for the benefit of the public,” Nixon said when asked about the role.

On the day Houry and Susan Monarez, the CDC leader ousted in late August, testified before senators about Kennedy’s leadership, the agency’s X feed posted clips belittling the former officials. The department also derisively rebuts unfavorable news coverage.

“It’s very interesting to watch the memeification of the United States and critical global health infrastructure,” said McKenzie Wilson, an HHS spokesperson under Biden. “The entire purpose of this agency is to inform the public about safety, emergencies as they happen.”

‘Clear, Powerful Messages From Bobby’

Kennedy’s , released in September, proposes public awareness campaigns on subjects such as illegal vaping and fluoride levels in water, while reassuring Americans that the regulatory system for pesticides is “robust.”

Those priorities reflect — and are amplified by — cadres of activists outside government. Since the summer, HHS officials have appeared on Zoom calls with aligned advocacy groups, trying to drum up support for Kennedy’s agenda.

— on which, according to host Tony Lyons, activists “representing over 250 million followers on social media” were registered — famous names such as motivational speaker Tony Robbins gave pep talks about how to influence elected officials and the public.

“Each week, you’re gonna get clear, powerful messages from Bobby, from HHS, from their team,” Robbins said. “And your mission is to amplify it, to make it your own, to speak from your soul, to be bold, to be relentless, to be loving, to be loud, you know, because this is how we make the change.”

The communications strategy captivates the public, but it also confuses it.

Anne Zink, formerly the chief medical officer for Alaska, said she thought Kennedy’s messaging was some of the catchiest of any HHS director.

But, she said, in her work as an emergency physician, she’s seen the consequences of his health department’s policies on her puzzled patients. Patients question vaccines. Children show up with gastrointestinal symptoms Zink says she suspects are related to raw milk consumption.

“I increasingly see people say, ‘I just don’t know what to trust, because I just hear all sorts of things out there,’” she said.

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New Orleans Brings Back the House Call, Sending Nurses To Visit Newborns and Moms

Rosemary Westwood, WWNO — Mon, 23 Feb 2026 10:00:00 +0000

When Lisa Bonfield gave birth to daughter Adele in late November, she was thrust into the new world of parenting, and faced an onslaught of challenges and skills to learn: breastfeeding, diapering, sleep routines, colic, crying, and all the little warning signs that something could be wrong with the baby.

But unlike parents in most of the U.S., she had extra help that was once much more common: house calls.

Adele was only a few weeks old when a registered nurse showed up at Bonfield’s door on Dec. 10 to check on them and offer hands-on help and advice.

As a city resident who had recently given birth, she was eligible for up to three home visits from , a program of the city health department.

She didn’t need to feed and change the baby before packing everything up for a car trip to the pediatrician or a clinic. It was a relief; Bonfield was exhausted and was still trying to figure out how to use the infant car seat.

“Everything is so abstract before you have a baby,” Bonfield said. “You are going to have questions you never even thought about.”

Louisiana is among the worst-performing states in maternal and infant health outcomes. So New Orleans is trying to catch health issues early — and get families off to an easier start — by adding health visits during the crucial first months of life.

The hope is that health outcomes can be improved by returning to the old-fashioned medical practice of house calls.

The Family Connects model has been tried in communities . It began in Durham, North Carolina, in 2008, as a partnership with Duke University. In 2023, New Orleans’ health director, , helped launch a local version of the program.

Avegno was concerned by Louisiana’s particularly grim statistics for maternal and infant health.

The state has some of the highest rates of preterm births, unnecessary cesarean sections, and maternal and infant deaths, according to the . A from the United Health Foundation found that Louisiana was the “least healthy” state for women and children.

“We got to do some real things real differently, unless you like being No. 50 all the time,” Avegno said.

The home visits are free and available to anyone who has just given birth in a New Orleans hospital, no matter their insurance status or income level.

Avegno describes the home visits as going “back to the future,” replicating a practice that was far more common a hundred years ago.

“There is no more critical time and vulnerable time than right at birth and in the few weeks to months following birth,” Avegno said.

The nurses arrive with diaper bags filled with newborn essentials, from diapers to nipple cream. They weigh, measure, and examine the babies, and check in with the mothers about their health and well-being. They offer referrals to other programs across the city.

They ask if the family has enough food, and whether there are guns in the house and how they’re stored, Avegno said.

In Bonfield’s case, the nurse stayed for over two hours. Bonfield especially liked their conversation about how to safely store breastmilk.

“I’ve never felt so well taken care of and listened to,” she said.

Broad Support

Louisiana has struggled a long time with poor maternal and infant health outcomes, but the problem has been complicated by the .

The 2022 law led to risky medical delays and in obstetrical care, and confusion among doctors about what’s allowed in ending dangerous pregnancies or .

Avegno opposes the state’s abortion policies, believing they are harmful to women’s health. But she says that Family Connects offers other ways to preserve and expand care for women. For example, the visiting nurse can check in with the mother about whether she needs help with birth control.

“We can’t give them abortion access,” she said. “That’s not the goal of this program, and that wouldn’t be possible anyway. But we can make sure they’re healthy and understand what their options are for reproductive health care.”

Abortion politics aside, the postpartum home visits seem to have bipartisan support in Louisiana, and state lawmakers want to expand their availability.

Last year, the Republican-dominated legislature requiring private insurance plans to cover the visits.

The new law is another way that Louisiana officials can be “pro-life,” said state , who, as a Republican and an abortion opponent, sponsored the legislation.

“One of the slings used against advocates against abortion is that we’re pro-birth, and not truly pro-life,” Bayham said. “And this bill is proof that we care about the overall well-being of our mothers and our newborns.”

Improving Health and Help for Postpartum Depression

Two years in, there are already promising signs that the program is improving health.

Early data analyzed by researchers at Tulane University showed that families who got the visits were more likely to stick to the recommended schedule of pediatric and postpartum checkups. Moms and babies were also less likely to need hospitalization, and overall health care spending was down among families insured by Medicaid.

Research on Family Connects programs elsewhere has found similar results. In North Carolina, one study showed that three to seven home visits in the year before a baby turned 1.

But the statistic that most excited Avegno related to the program’s role in screening mothers for postpartum depression.

The visiting nurses are helping spot more cases of postpartum depression — earlier — so that new moms can get treatment. About 10% of moms participating in the New Orleans program were eventually diagnosed with postpartum depression, compared with 6% of moms who did not get the visits.

Timely diagnosis is important to prevent depression symptoms from worsening, or leading to more , such as suicidal thoughts, thoughts of harming the baby, or problems bonding with their newborn.

Lizzie Frederick was one of the New Orleans mothers whose postpartum symptoms were caught early by a visiting nurse.

When she was pregnant, she and her husband took all the childbirth and newborn classes they could. They hired a doula to help with the birth. But Frederick still wasn’t prepared for the stresses of the postpartum period, she said.

“I don’t think there are enough classes out there to prepare you for all the different scenarios,” Frederick said.

When her son, James, was born in May, he had trouble breastfeeding. He was sleeping for only 90-minute stretches at night.

When the nurse arrived for the first visit a few weeks later, Frederick was busy trying to feed James. But the nurse reassured her that there was no rush. She could wait.

“I am here to support you and take care of you,” Frederick recalled the nurse saying.

The nurse weighed James, and Frederick was relieved to learn he was gaining weight. But for most of the visit, the nurse focused on Frederick’s needs. She was exhausted, anxious, and had started hearing what she called phantom cries.

The nurse walked her through a mental health questionnaire. Then she recommended that Frederick see a counselor and consider attending group therapy sessions for perinatal women.

Frederick followed up on these suggestions and was eventually diagnosed with postpartum depression.

“I think that I would have felt a lot more alone if I hadn’t had this visit, and struggled in other ways without the resources that the nurse provided,” Frederick said.

Home Visits Save Money

, an assistant professor at Tulane’s School of Public Health, helped interview over 90 families participating in the Family Connects New Orleans program.

“It was overwhelmingly positive experiences,” she said. “This is like a gold-standard public health project, in my opinion.”

To operate, Family Connects costs the city about $1.5 million a year, or $700 per birth, according to Avegno. But the program also has the potential to save money: Research on North Carolina’s program in the program saved $3.17 in health care billing before the child turned 2.

That’s another reason to require the visits statewide, according to state Rep. Bayham.

“The nurses and medical practitioners will be able to monitor potential problems on the front end, so that they could be handled without a trip to the emergency room or something even more drastic,” he said.

Avegno is advocating that the program be included in Louisiana’s Medicaid program, since more than in the state are covered by Medicaid. A recent made the same recommendation.

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Even as SNAP Resumes, New Work Rules Threaten Access for Years To Come

Renuka Rayasam and Katheryn Houghton and Samantha Liss — Wed, 03 Dec 2025 10:00:00 +0000

Alejandro Santillan-Garcia is worried he’s going to lose the aid that helps him buy food. The 20-year-old Austin resident qualified for federal food benefits last year because he aged out of the Texas foster care system, which he entered as an infant.

The Supplemental Nutrition Assistance Program — commonly referred to as food stamps, or SNAP — helps feed 42 million low-income people in the United States. Now, because of changes included in the One Big Beautiful Bill Act, to keep his food benefits Santillan-Garcia might soon have to prove to officials that he’s working.

He said he lost his last job for taking time off to go to the doctor for recurrent stomach infections. He doesn’t have a car and said he has applied to a grocery store, Walmart, Dollar General, “any place you can think of” that he could walk or ride his bike to.

“No job has hired me.”

Under the new federal budget law, to be eligible for SNAP benefits, more people are required to show that they are working, volunteering, or studying. Those who don’t file paperwork in time risk losing food aid for up to three years. States were initially instructed to start counting strikes against participants on Nov. 1, the same day that millions of people saw their SNAP benefits dry up because of the Trump administration’s refusal to fund the program during the government shutdown. But federal officials backtracked partway through the month, instead giving states until December to enforce the new rules.

The new law further limits when states and counties with high unemployment can waive recipients from requirements. But a legal battle over that provision means that the deadline for people to comply with the new rules varies depending on where recipients live, even within a state in some cases.

The U.S. Department of Agriculture did not respond to a detailed list of questions about how the new rules around SNAP will be implemented, and the White House did not respond to a request for comment about whether the rules could kick off people who rely on the program. The law did extend exemptions to many Native Americans.

Still, states must comply with new rules or accrue penalties that could force them to pay a bigger share of the program’s cost, which was about $100 billion last year.

Santillan-Garcia is worried that he will lose his federal food benefits because of new rules under Republicans’ One Big Beautiful Bill Act that make it harder for former foster care youths to qualify. (Callie Richmond for �鶹Ů�� Health News)

President Donald Trump signed the massive budget bill, along with the new SNAP rules, into law on July 4. States initially predicted they would need at least 12 months to implement such significant changes, said Chloe Green, an assistant director at the American Public Human Services Association who advises states on federal programs.

Under the law, “able-bodied” people subject to work requirements can lose access to benefits for three years if they go three months without documenting working hours.

Depending on when states implement the rules, many people could start being dropped from SNAP early next year, said Lauren Bauer, a fellow in economic studies at the Brookings Institution, a policy think tank. The changes are expected to knock at least 2.4 million people off SNAP within the next decade, according .

“It’s really hard to work if you are hungry,” Bauer said.

Many adult SNAP recipients under 55 already needed to meet work requirements before the One Big Beautiful Bill Act became law. Now, for the first time, adults ages 55 to 64 and parents whose children are all 14 or older must document 80 hours of work or other qualifying activities per month. The new law also removes exemptions for veterans, homeless people, and former foster care youths, like Santillan-Garcia, that had been in place since 2023.

Republican policymakers said the new rules are part of a broader effort to eliminate waste, fraud, and abuse in public assistance programs.

Agriculture Secretary Brooke Rollins said in November that in addition to the law, she will require millions to reapply for benefits to curb fraud, though she did not provide more details. Rollins she wants to ensure that SNAP benefits are going only to those who “are vulnerable” and “can’t survive without it.”

States are required to notify people that they are subject to changes to their SNAP benefits before they’re cut off, Green said. Some states have announced the changes on websites or by mailing recipients, but many aren’t giving enrollees much time to comply.

Anti-hunger advocates fear the changes, and confusion about them, will increase the number of people in the U.S. experiencing hunger. Food pantries have reported record numbers of people seeking help this year.

Even when adhering to the work rules, people often report challenges uploading documents and getting their benefits processed by overwhelmed state systems. In a survey of SNAP participants, about 1 in 8 adults reported having lost food benefits because they had problems filing their paperwork, according to . Some enrollees have been dropped from aid as a result of state errors and staffing shortfalls.

Pat Scott, a community health worker for the Beaverhead Resource Assistance Center in rural Dillon, Montana, is the only person within at least an hour’s drive who is helping people access public assistance, including seniors without reliable transportation. But the center is open only once a week, and Scott says she has seen people lose coverage because of problems with the state’s online portal.

Jon Ebelt, a spokesperson with the Montana health department, said the state is always working to improve its programs. He added that while some of the rules have changed, a system is already in place for reporting work requirements.

In Missoula, Montana, Jill Bonny, head of the Poverello Center, said the homeless shelter’s clients already struggle to apply for aid, because they often lose documentation amid the daily challenge of carrying everything they own. She said she’s also worried the federal changes could push more older people into homelessness if they lose SNAP benefits and are forced to pick between paying rent or buying food.

In the U.S., are the fastest-growing group experiencing homelessness, according to federal data.

Sharon Cornu is the executive director at St. Mary’s Center, which helps support homeless seniors in Oakland, California. She said the rule changes are sowing distrust. “This is not normal. We are not playing by the regular rules,” Cornu said, referring to the federal changes. “This is punitive and mean-spirited.”

In early November, a federal judge in Rhode Island ordered the Trump administration to deliver full SNAP payments during the government shutdown, which ended Nov. 12. That same judge sought to buffer some of the incoming work requirements. He ordered the government to respect existing agreements that waive work requirements in some states and counties until each agreement is set to end. In total, and the District of Columbia had such exemptions, with different end dates.

Adding to the confusion, some states, including New Mexico, have waivers that mean people in different counties will be subject to the rules at different times.

If states don’t accurately document SNAP enrollees’ work status, they will be forced to pay later on, Green said. Under the new law, states must cover a portion of the food costs for the first time — and the amount depends on how accurately they calculate benefits.

During the government shutdown, when no one received SNAP benefits, Santillan-Garcia and his girlfriend relied on grocery gift cards they received from a nonprofit to prioritize feeding his girlfriend’s baby. They went to a food pantry for themselves, even though many foods, including dairy, make Santillan-Garcia sick.

He’s worried that he’ll be in that position again in February when he must renew his benefits — without the exemption for former foster care youths. Texas officials have yet to inform him about what he will need to do to stay on SNAP.

Santillan-Garcia said he’s praying that, if he is unable to find a job, he can figure out another way to ensure he qualifies for SNAP long-term.

“They’ll probably take it away from me,” he said.

Because of new rules included in the One Big Beautiful Bill Act, to keep his food benefits, Santillan-Garcia might soon have to prove to officials that he’s working. (Callie Richmond for �鶹Ů�� Health News)

What You Should Know

Changes to SNAP removed work-requirement exemptions for:

People ages 55 to 64.
Caretakers of dependent children 14 or older
Veterans
People without housing
People 24 or younger who aged out of foster care

What SNAP Participants Should Do:

Check with public assistance organizations to find out when the new rules go into effect in your region. Your benefits may be checked at recertification, but you may be required to meet the monthly work reporting rules long before that.
Let your state know if you’re responsible for a dependent child younger than 14 who lives in your home; pregnant; a student at least half the time; attending a drug or alcohol treatment program; physically or mentally unable to work; a Native American; or a caretaker of an incapacitated household member. If so, you may still be exempt.

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Federal Cuts Gut Food Banks as They Face Record Demand

Jazmin Orozco Rodriguez — Thu, 01 May 2025 09:00:00 +0000

Food bank shortages caused by high demand and cuts to federal aid programs have some residents of a small community that straddles Idaho and Nevada growing their own food to get by.

For those living in Duck Valley, a reservation of about 1,000 people that is , there’s just one grocery store where prices are too high for many to afford, said Brandy Bull Chief, local director of a federal food distribution program for tribes. The next-closest grocery stores are more than 100 miles away in Mountain Home, Idaho, and Elko, Nevada. And the local food bank’s troubles are mirrored by many nationwide, squeezed between growing need and shrinking aid.

Reggie Premo, a community outreach specialist at the University of Nevada-Reno Extension, grew up cattle ranching and farming alfalfa in Duck Valley. He runs workshops to teach residents to grow produce. Premo said he has seen increased interest from tribal leaders in the state worried about high costs while living in food deserts.

“We’re just trying to bring back how it used to be in the old days,” Premo said, “when families used to grow gardens.”

Reggie Premo and a small team from the University of Nevada-Reno Extension host workshops on gardening and creating hoop houses, similar to greenhouses, to help tribes statewide increase food security. (Jazmin Orozco Rodriguez/�鶹Ů�� Health News)

Food bank managers across the country say their supplies have been strained by rising demand since the covid pandemic-era emergency Supplemental Nutrition Assistance Program benefits ended two years ago and steepening food prices. Now, they say, demand is compounded by recent cuts in federal funding to food distribution programs that supply staple food items to pantries nationwide.

In March, the U.S. Department of Agriculture cut $500 million from the Emergency Food Assistance Program, which buys food from domestic producers and sends it to pantries nationwide. The program has supplied more than 20% of the distributions by Feeding America, a nonprofit that serves a network of over 200 food banks and 60,000 meal programs.

The collision between rising demand and falling support is especially problematic for rural communities, where the federal program might cover 50% or more of food supplied to those in need, said Vince Hall, chief government relations officer of Feeding America. Deepening the challenge for local food aid organizations is an additional $500 million the Trump administration slashed from the USDA Local Food Purchase Assistance Cooperative Agreement Program, which helped state, tribal, and territorial governments buy fresh food from nearby producers.

“The urgency of this crisis cannot be overstated,” Hall said, adding that the Emergency Food Assistance Program is “rural America’s hunger lifeline.”

Farmers who benefited from the USDA programs that distributed their products to food banks and schools will also be affected. Bill Green is executive director for the Southeast region of Common Market, a nonprofit that connects farmers with organizations in the Mid-Atlantic, the Southeast, Texas, and the Great Lakes. Green said his organization won’t be able to fill the gap left by the federal cuts, but he hopes some schools and other institutions will continue buying from those farmers even after the federal support dries up.

“I think that that food access challenge has only been aggravated, and I think we just found the tip of the iceberg on that,” he said.

Food Bank for the Heartland in Omaha, Nebraska, for example, is experiencing four times the demand this year than in 2018, according to Stephanie Sullivan, its assistant director of marketing and communications. The organization expects to provide food to 580,000 households across the 93 counties it serves in Nebraska and western Iowa this fiscal year, the highest number in its history, she said.

“These numbers should be a wake-up call for all of us,” Sullivan said.

The South Plains Food Bank in Texas projects it will distribute approximately 121,000 food boxes this year to people in need across the 19 counties it serves, compared with an average 90,000 annually before the pandemic. CEO Dina Jeffries said the organization now is serving about 25% more people, while shouldering the burden of decreased funding and food products.

In Nevada, the food bank that helps serve communities in the northern part of the state, including the Shoshone-Paiute Tribes of the Duck Valley Reservation, provides food to an average of 160,000 people per month. That’s a 76% increase over its clientele before the pandemic, and the need continues to rise, said Jocelyn Lantrip, director of marketing and communications for the Food Bank of Northern Nevada.

Lantrip said one of the most troubling things for the food bank is that the USDA commodities shipped for local distribution often are foods that donations don’t usually cover — things like eggs, dairy, and meat.

“That’s really valuable food to our neighbors,” she said. “Protein is very difficult to replace.”

Forty percent of people who sought assistance from food banks during the pandemic did so for the first time, Hall said. “Many of those families have come to see their neighborhood food bank not as a temporary resource for emergency help but an essential component of their monthly budget equation.”

About 47 million people lived in food-insecure households in 2023, available.

Bull Chief, who also runs a small food pantry on the Duck Valley Reservation, said workers drive to Elko to pick up food distributed by the Food Bank of Northern Nevada. But sometimes there’s not much to choose from. In March, the food pantry cut down its operation to just two weeks a month. She said sometimes they must weigh whether it’s worth spending money on gas to pick up a small amount of food.

When the food pantry opened in 2020, Bull Chief said, it helped 10 to 20 households a month. That number is 60 or more now, made up of a broad range of community members — teens fresh out of high school and living on their own, elders, and people who don’t have permanent housing or jobs. She said providing even small amounts of food can help households make ends meet between paychecks or SNAP benefit deposits.

“Whatever they need to get to survive for the month,” Bull Chief said.

The Food Bank of Northern Nevada’s Produce on Wheels program delivers fresh food to seniors across the region, including those in rural communities. (Aramelle Wheeler)

Pinched food banks, elevated need, and federal cuts mean there’s very little resiliency in the system, Hall said. Additional challenges, like an economic slowdown, policy changes to SNAP or other federal nutrition programs, or natural disasters could render food banks unable to meet needs “because they are stretched to the breaking point right now.”

A proposed budget resolution passed by the U.S. House of Representatives in April would require $1.7 trillion in net funding cuts, and anti-hunger advocates fear SNAP could be a target. More people living in rural parts of the country than people in urban areas because of higher poverty rates, so they would be disproportionately affected.

An extension of the federal 2018 Farm Bill, which lasts until Sept. 30, included for the Emergency Food Assistance Program for this year. But the funding that remains doesn’t offset the cuts, Hall said. He hopes lawmakers pass a new farm bill this year with enough money to do so.

“We don’t have a food shortage,” he said. “We have a shortage of political will.”

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House Cats With Bird Flu Could Pose a Risk to Public Health

Sarah Boden — Mon, 10 Feb 2025 10:00:00 +0000

More than , among many other types of mammals, have been confirmed to have had bird flu since 2022 — generally barn cats that , as well as feral cats and and likely caught it by hunting diseased rodents or wild birds.

Now, a small but growing number of house cats have gotten sick from H5N1, the bird flu strain driving the current U.S. outbreak, after eating raw food or drinking unpasteurized milk. Some of those cats died.

The strain of bird flu currently circulating has to efficiently spread among people. And there have been no known cases of cat-to-human transmission during the current outbreak of H5N1.

Still, there’s , which are arguably , could bring home a disease from a midnight prowl.

“Companion animals, and especially cats, are 100% a public health risk in terms of the risk of zoonotic transmission to people,” said virologist , who studies disease progression in emerging viruses at the University of Saskatchewan’s .

This is because we snuggle with and sleep in bed with our cats. When we’re not looking, cats drink from our water glasses and walk on kitchen counters. So, cat owners should be aware of the ongoing spread of bird flu. “By reducing the risk to your cats, you reduce the risk to yourself,” Rasmussen said.

Rasmussen doesn’t think pet owners should be afraid their cats will give them bird flu but said taking precautions is good for pets, and for public health.

Signs of bird flu in cats include runny nose and discharge around the eyes, explained president-elect of the .

H5N1 also causes neurological problems like dizziness and seizures, which are symptoms of rabies, too. Rabies is almost always fatal, and it poses a threat to human health, so any animal suspected of having the viral disease must be euthanized. Bailey encourages people to ensure pets are up-to-date on their vaccinations.

Veterinarian , who specializes in infectious diseases in cats and dogs at the University of California-Davis School of Veterinary Medicine, said people should not assume it’s bird flu if their cat is sick — even if their animal spends time outdoors or eats a raw diet. Upper-respiratory illnesses are common in cats, while H5N1 is “still pretty rare.”

Sykes gives her indoor cat, Freckles, regular kibble exclusively. She told NPR and �鶹Ů�� Health News she has no concerns about Freckles getting H5N1 because the heating process of making dry or canned pet food kills viruses.

More Cases in Cats, More Risk to Humans

Some people feed their pets raw meat or unpasteurized milk because they think it’s a more nutritious or natural diet. The American Veterinary Medical Association’s website like salmonella and listeria, and now the .

By keeping pets healthy, veterinarians play an essential role in protecting humans from zoonotic diseases. The American Veterinary Medical Association says the risk of H5N1 spilling over from a pet to a person is “considered extremely low, but not zero.”

State and local public health agencies, including those in and , have issued similar warnings against raw food diets for pets.

Concerns for human health are partly why the FDA it is now requiring cat and dog food companies to update their safety plans to protect against bird flu.

This came after the Oregon Department of Agriculture discovered a cat that was had contracted H5N1 and died after consuming a frozen turkey product made by the raw pet food brand . It stated that “tests confirmed a genetic match between the virus in the raw and frozen pet food and the infected cat.”

Northwest Naturals voluntarily recalled that batch of its frozen turkey-based product. The company told �鶹Ů�� Health News and NPR that the recall involved “a small product run” and that it has concerns about the accuracy of the Oregon Agriculture Department’s testing.

Los Angeles County’s public health department said five cats from two households tested positive for bird flu after drinking unpasteurized raw milk from the Raw Farm dairy in California’s Central Valley.

Raw Farm its milk and cream after retail products tested positive for H5N1, but it , calling the concern “a political issue.”

Veterinarians also warn pet owners not to allow cats unsupervised time outside as there’s the risk of them getting H5N1 by interacting with other animals that might carry the disease.

“This is a very scary virus, given that it can infect so many different host species,” said , director of Cornell University’s Feline Health Center.

At least one instance of a cat infecting a person with bird flu occurred in 2016. As , a veterinarian in New York City caught the virus after having close contact with infected cats. The vet experienced mild symptoms and quickly recovered.

In that case, the strain of bird flu was H7N2, not the H5N1 that is now circulating in the U.S.

H7N2 is a very different type of virus, Sykes explained. But she said it shows that cat-to-human transmission of avian influenza is theoretically possible.

There isn’t a lot of research on transmission of bird flu from companion animals like cats or dogs to humans, though Rasmussen agreed it’s definitely a concern: The more infections you have in animals, “the more your luck is potentially going to run out.”

Most people who have caught H5N1 are agricultural workers who had direct contact with infected poultry or cattle. Of at least human cases of H5N1 in the U.S., there’s been one fatality in an immunocompromised person who had contact with birds.

In general, zoonotic disease researchers want more in companion animals of all types. Even if the human death toll of H5N1 remains relatively low, it remains a public health risk.

Chances for Mutation

Part of the concern with this H5N1 outbreak is that bird flu viruses change. Just a few mutations could make this strain adept at spreading between people. And the more people who catch H5N1, the more likely it would adapt to be more efficient, said , a virologist at the University of Pittsburgh School of Public Health, where he researches zoonotic diseases. H5N1 in cats.

Another concern is . If an animal or person is infected with two viruses at once, the viruses can trade genetic material, creating something new. This is common in influenza, so virologists are on the lookout for a case in which the bird flu reassorts to make a virus that’s far more contagious, and potentially more virulent.

Virologist Rasmussen is way more worried about this happening in pigs. Human respiratory physiology is more like that of swines than felines. So far, the current outbreak of H5N1 has not reached commercial hog operations. Rasmussen hopes it stays that way.

Kuchipudi said that reassortments are relatively rare events, but the outcome is completely unpredictable. Sometimes the results are benign, though it was likely a reassortment that involved an avian virus that led to the 1918 flu pandemic, which killed an . In the century since, virologists have established a global surveillance network to monitor influenza viruses. Scientists say to preparing for and hopefully preventing another pandemic.

Winter is “reassortment season” because of all the influenza viruses circulating, Rasmussen said. A reassortment in cats could technically be possible since these pets , but it’s highly unlikely. Rather, Rasmussen said, it’s more likely that a cat would pass H5N1 to a human who already has seasonal flu, and then a reassortment happens in the sick person. While the risk isn’t zero, Rasmussen doubts this will happen. It would depend on how ill the human was, and how much virus they’re exposed to from their cat.

“Unless the cat is really shedding a ton of virus, and you’re kind of making out with the cat, I think it would be hard,” she said.

Rasmussen and Kuchipudi caution there isn’t enough research to know for sure how much virus cats shed, or even how they shed the virus.

The Centers for Disease Control and Prevention was poised to release a new study about H5N1 in cats, but that was delayed when the Trump administration paused the Morbidity and Mortality Weekly Report. That investigation, revealed through emails obtained by �鶹Ů�� Health News in a public records request, found that house cats likely got bird flu from dairy workers.

Scientists and public health agencies should question previously held assumptions about bird flu, Kuchipudi urged. He noted that 20 years ago nobody would have predicted that bird flu would infect dairy cattle the way it is now.

Dogs Seem To Fare Better

The other domesticated animals, including dogs, can get bird flu infections. There are no confirmed cases of H5N1 among dogs in the U.S., though in other countries they have died from the virus.

There’s some disagreement and an overall lack of research on whether cat biology makes them more susceptible to H5N1 than other mammals, including humans, pigs, or dogs.

But cat behaviors, such as their love of dairy and predation of wild birds, put them at higher risk, Kuchipudi said. Also, living in groups might play a role as there are more feral cat colonies in the U.S. than packs of stray dogs.

There’s very little people can do about the H5N1 circulating in wild birds. As Rasmussen explained, “It’s flying around in the skies. It’s migrating north and south with the seasons.”

But she said there’s a lot people can do to keep the virus out of their homes.

That includes limiting a pet’s exposure to H5N1 by not feeding them raw food or unpasteurized milk, and trying to keep them from interacting with animals like rodents and wild birds that could be infected with the virus.

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