It has now been over a year since President Trump signed executive orders eliminating federal diversity, equity, inclusion, and accessibility (DEIA) programs and related initiatives, reshaping policies and priorities across federal agencies, research, and education. Additionally, the Trump administration’s workforce reshaping initiatives, including reductions in force, the Deferred Resignation Program, early retirement incentives and a hiring freeze have led to major declines in the federal workforce which have reduced resources available to support efforts to address disparities. While some efforts have been halted or modified by court rulings, the Trump administration has continued to take steps to remove staff, programs, funding, data collection, and other activities tied to concepts of diversity, equity, or disparities. Together, these actions signal a significant shift in federal approaches to addressing inequities and may have broad implications for efforts to monitor and address disparities in health and health care, as well as for the diversity of the workforce, including in health care.
This brief provides an update on the status of the administration’s actions to eliminate DEI-related initiatives one year later and examines emerging impacts and implications for racial health disparities.
Reductions to Federal Agency Staff and Programs
Federal workforce reductions have led to the elimination or scaling back of programs that support data collection, research, and interventions that have historically included a focus on addressing disparities or groups at higher risk of poor health outcomes. Since January 2025, the Trump administration’s workforce reshaping initiatives have led to significant federal workforce declines, with more than 420,000 people separating from the federal workforce as of May 14, 2026. Within the Department of Health and Human Services (HHS), staffing losses have exceeded 20,000 employees since January 2025. At the Centers for Disease Control and Prevention (CDC), an estimated 15% of the workforce, or about 3,000 employees, have departed, with some reports suggesting even larger reductions. With these reductions, many programs that support research and public health interventions appear to have been terminated. Although the full scope of program cutbacks is unclear due to the lack of a comprehensive public record, staffing reductions across agencies have left key programs understaffed or unable to maintain core functions, including efforts focused on addressing health disparities and advancing health equity. For example:
- Reporting suggests that layoffs within the CDC’s Division of Reproductive Health in late March and early April reduced the workforce by about two-thirds, disrupting multiple programs focused on maternal and infant health, an area of health with longstanding disparities. These cuts included the elimination of the Pregnancy Risk Assessment Monitoring System (PRAMS), a primary source of data on health behaviors and outcomes before, during, and after pregnancy that has been widely used to study maternal mortality, including disparities, leaving its future uncertain.
- At HHS, the Office of Climate Change and Health Equity was removed from the agency’s website, and its staff were reportedly placed on administrative leave. Staffing reductions within the CDC’s Division of Environmental Health Science and Practice also led to the elimination of the Environmental Public Health Tracking Program, which monitored data on issues such as cancer clusters and weather-related illnesses. Together, these changes may limit federal capacity to monitor and address environmental and climate-related health disparities, particularly among low-income communities and communities of color that are often disproportionately exposed to environmental hazards and extreme weather events.
- The elimination of the National Survey on Drug Use and Health team halted a key federal data source on substance use and mental health trends, while CDC staff supporting the National Youth Tobacco Survey were also eliminated. Both surveys have historically been used to assess differences in behavioral health and tobacco use across populations and to help guide prevention and treatment efforts for groups disproportionately affected by these issues.
Elimination of Grants and Research Initiatives
Efforts to eliminate DEI across the federal government have reduced support for research related to disparities, including through funding cuts, changes to grant review and award processes, and the loss of leadership and infrastructure that support clinical trials and participation. Federal agencies have reduced or eliminated funding for research initiatives that included DEI-related goals or focused on specific populations, and grant review processes have been revised to flag or exclude applications containing DEI-related terms or focus areas including discrimination, diversity, equity, and race. For example, the recently formed and now defunct Department of Government Efficiency (DOGE) was tasked with auditing and canceling DEI-related federal research grants. Recent deposition hearings indicate that staff members used ChatGPT to propose cuts to roughly 1,400 grants under the National Endowment for the Humanities, including examples that were not related to DEI. In addition to the grants reviewed under DOGE, broader administrative actions led to the termination of more than 2,300 National Institute of Health (NIH) grants by late June 2025, with nearly 1,100 grants remaining terminated as of May 4, 2026. One study found that the National Institute of Minority Health and Health Disparities lost both the largest share of grants and the largest share of funding across all NIH institutes and centers. Research shows that grant terminations were more likely to impact American Indian or Alaskan Native (AIAN), Asian, Black, Hispanic or Native Hawaiian or Pacific Islander (NHPI) researchers compared to White researchers. These actions also affected 160 NIH-funded clinical trials, more than half of which (57%) included project terms related to racial and ethnic minority populations, such as Black, Latino, Indigenous, Asian, and other historically underserved groups. At the same time, the loss of research leadership and staff has disrupted the research pipeline and contributed to additional grant terminations. HIV research has been particularly impacted. Reporting indicates that at least 145 NIH-funded HIV research grants, totaling nearly $450 million, were terminated in early 2025, including studies focused on HIV prevention, access to pre-exposure prophylaxis (PrEP), and populations disproportionately affected by HIV, which include groups of color. A newly proposed rule issued by the Office of Management and Budget (OMB) would revise federal grant requirements by increasing political review of awards, requiring alignment with presidential priorities, and creating new mechanisms for modifying or terminating existing funding, with an emphasis on prohibiting federal support for programs, funding preferences, or award requirements that advance DEI efforts. If finalized, the proposal could expand federal grantmaking agencies’ authority to review and terminate awards deemed inconsistent with the administration’s interpretation of civil rights laws and federal priorities, which may affect research and programs designed to address racial, ethnic, gender, and other disparities.
Elimination of Public Information and Resources
Efforts to eliminate DEI across the federal government have also reduced the availability and integrity of public information and data, including through the suspension of national surveys, the removal of DEI-related data elements, and changes to climate data and evidence. As previously noted, several national surveys were suspended, delayed, or scaled back, limiting the availability of timely population-level data. These include the Pregnancy Risk Assessment Monitoring System (PRAMS) and the National Survey on Drug Use and Health (NSDUH). There are also reports that the National Intimate Partner and Sexual Violence Survey and the National Youth Tobacco Survey (NYTS) may have also been eliminated, however, their official status remains unclear. These surveys have historically provided data used to identify disparities and inform public health policy and interventions. In addition, key surveys and data systems removed or modified questions and data elements related to race, ethnicity, gender identity, sexual orientation, and other demographic measures, reducing the ability to measure differences across populations. Some publicly available datasets were also modified or taken offline, limiting access for researchers, policymakers, and the public, while some federal websites removed or archived reports, dashboards, and tools that previously highlighted disparities or equity-focused analyses. Climate-related data and resources were similarly removed, reframed and misrepresented, or made more difficult to access. For example, the Trump administration determined that official government websites would no longer host national climate assessments, including the most recent assessment released in 2023, which found that climate change disproportionately affects the health, livelihoods, and security of people of color, with Indigenous populations at particular risk. In addition, concerns have been raised about the scientific rigor and peer review process of the Climate Working Group report recently released under the administration.
Education and Workforce
Amid the executive orders, threats by the Trump administration to withdraw funding from schools with DEI programs, and charges from the Equal Employment Opportunity Commission (EEOC) for discrimination against White people, concerns have grown about the potential impacts on diversity among students and the future workforce. Early last year, the Department of Education issued guidance, commonly referred to as the “Dear Colleague” letter, directing schools and other entities receiving federal education funding to stop using what it described as “racial preferences” in admissions, programming, and other activities. This followed the Supreme Court’s 2023 decision ending race-conscious admissions, which led to a shift in enrollment patterns across higher education institutions, with declines in the share of students of color at highly selective universities. Research also suggests that the ruling has already contributed to declines in the number of Black, Hispanic, and AIAN students entering medical school, raising concerns about the future diversity of the physician workforce. These trends may further exacerbate existing disparities in representation. KFF analysis shows that Hispanic, Black, AIAN, and NHPI people remain underrepresented among physicians relative to their share of the population, with the largest gap among Hispanic people, who comprise 20% of the U.S. population but only 7% of the physician workforce. More broadly, the EEOC has increasingly emphasized enforcement related to alleged discrimination against White workers, which some argue could discourage workplace diversity initiatives. In addition, broader immigration restrictions and enforcement actions may further affect workforce diversity, particularly in health care and research fields that rely heavily on immigrant workers and internationally trained professionals.
Legal Challenges and Protections
In some cases, implementation of DEI-related cuts has been temporarily halted or mitigated by lawsuits and congressional action. As of April 2026, Congress has rejected many of the Trump administration’s proposed reductions to federal health programs through the FY 2026 appropriations process. For example:
- The legislation provided HHS with approximately $116 billion in funding, about $33 billion more than proposed in President Trump’s FY 2026 budget request, including increases for several public health and behavioral health programs, such as reproductive and community health programs, that support populations disproportionately affected by poor health outcomes, including people of color and lower-income groups.
- It also maintained the Substance Abuse and Mental Health Services Administration (SAMHSA) as an independent agency and increased SAMHSA funding by $65 million to approximately $7.4 billion, despite earlier proposals to reduce funding by roughly $1 billion. The legislation also included guardrails intended to ensure that SAMHSA funds are distributed as appropriated, preserving support for mental health and substance use programs that often serve low-income and underserved communities.
- Similarly, Congress maintained CDC funding at approximately $9.2 billion, rather than the nearly 50% reduction proposed in the administration’s FY 2026 budget request, and directed HHS to maintain staffing levels needed to carry out CDC programs, although the agency’s Social Determinants of Health program was eliminated.
- The legislation also preserved funding for reproductive health programs, including Title X and the Teen Pregnancy Prevention Program, and increased investments in maternal health programs across HRSA, CDC, and NIH, which have historically focused on addressing longstanding racial disparities in maternal and infant health outcomes.
- In addition, while the administration proposed substantial reductions to NIH funding, Congress ultimately approved increased funding for the agency, and several court challenges temporarily halted some funding cuts and grant terminations, which had a noted focus on DEI-related research.
Separate legal challenges have also limited implementation of some workforce and education-related actions. Federal courts and Congress blocked or delayed aspects of the Trump administration’s workforce reduction efforts, including rulings against certain reductions in force and layoffs implemented during agency restructuring efforts. Courts also blocked implementation of the Department of Education’s “Dear Colleague” guidance related to race-conscious practices in schools, and the Department later withdrew the guidance following legal challenges and court rulings. These actions suggest that the scope and long-term effects of the administration’s policies may continue to evolve as litigation and congressional oversight proceed.
