A weekly roundup of public health news
The deadly risk of high-deductible health plans
High-deductible health insurance plans can be deadly for people who’ve had cancer, a new study finds.
Cancer survivors enrolled in high-deductible plans — which require patients to pay a significant amount of money before receiving care — are much more likely to die than those with other types of coverage, according to the Jan. 29 research in JAMA Network Open.
The study focused on nearly 10,000 cancer survivors, finding those with high-deductible plans had a 46% higher risk of death from any cause and a 34% higher risk of dying from cancer compared with survivors in other plans.
High-deductible health plans typically offer lower monthly premiums but require patients to pay out of pocket upfront. Deductibles in the plans can be as high as $8,500 a year for an individual or $17,000 for a family, according to the IRS.
Cancer survivors with high-deductible plans were more likely to delay or skip medical visits because of cost, cut back on prescribed medications and persistently worry about medical bills, the study found.
The harmful associations were seen even among cancer survivors with higher incomes and college educations, groups often assumed to be better positioned to manage large deductibles.
People with cancer typically require frequent medical visits, ongoing treatment and long-term monitoring, adding to costs beyond immediate care.
Discrimination can shape health, survival of Black Americans
Stress from discrimination may lead to poorer health and shorter lives for Black Americans, two new studies find.
Black Americans die at younger ages than white Americans, a gap that has resulted in more than 1.6 million additional deaths over the past two decades, primarily from chronic illnesses such as heart disease and cancer. The new research suggests long-term stress and related immune system changes may help explain part of that disparity.
In one of the studies, published in JAMA Network Open, researchers found Black Americans were more likely to report higher levels of cumulative stress and had higher levels of inflammation later in life than white people. They also died sooner.
Using data from blood tests and personal information collected from study participants, researchers found that stress and inflammation together explained about half of the difference in survival between Black and white people.
Another new study, published in Brain, Behavior & Immunity-Health, examined how everyday discrimination may affect the immune system.
Researchers found people who reported more everyday discrimination had higher levels of immune cells that had been repeatedly activated over time. The cells — specific types of T cells and B cells — were considered to be in an exhausted state and were less effective at fighting infection. The study did not find similar changes in newer immune cells.
Together, the studies suggest that discrimination-related stress may take a physical toll over time, affecting inflammation, immune function and longevity. As of 2023, life expectancy for Black Americans trailed that of whites by more than four years, according to the Centers for Disease Control and Prevention.
Study flags unexplained pauses in federal health surveillance data
Dozens of health surveillance databases at the Centers for Disease Control and Prevention stopped sharing new data last year under the Trump administration, potentially putting U.S. public health response at risk, new research finds.
Published in the Annals of Internal Medicine, the study found that as of October 2025 — 10 months into the new federal administration — nearly half of CDC databases that had previously been revised monthly had stopped updating without public explanation.
Vaccination data accounted for the largest share of the disruptions. Eighty-seven percent of the paused databases focused on immunization, a topic that has come under attack by administration health officials in recent months. Other paused systems included databases related to respiratory diseases, such as disease burden and prevention measures, and a database focused on drug overdose deaths.
Among the paused systems, 89% had not posted new data for more than six months. When researchers checked again in early December 2025, only one of the databases had resumed updates.
Federal health surveillance data are widely used by clinicians, health care administrators, professional organizations and policymakers to inform guidance and decision-making. Interruptions in the data streams, particularly when unexplained, may limit the ability of public health officials to respond effectively to emerging threats, researchers said.
The audit comes amid broader concerns about CDC’s capacity to maintain timely data collection and reporting following staffing and funding losses and shifts in federal health policies under the Trump administration. Among those shifts were Jan. 5 revisions to federal childhood vaccination schedule that cut recommended immunizations by a third — a move that was widely condemned by leading public health and medical officials.
Student loan debt widespread in public health workforce
More than 40% of people working in governmental public health have a student loan balance, a new study in the American Journal of Public Health finds.
The analysis, based on a 2024 survey of nearly 57,000 state and local governmental public health staff, shows that student loan debt is widespread across the workforce and substantial for many employees. The average balance for workers with debt was nearly $48,000, according to the study, which was published online Jan. 22.
About 70% of workers reported they had taken out student loans at some point. Younger workers were more likely to have student loans than older employees, and workers with graduate degrees carried higher balances than those with bachelor’s degrees. Black employees reported higher remaining balances, on average, than white employees, the study found.
Student loan debt was also linked to workforce stability. Workers who considered leaving their organization within the next year reported higher average loan balances than those who were not considering leaving.
The study estimated that total student loan debt across the governmental public health workforce exceeds $4.5 billion. That burden, researchers said, adds to longstanding challenges such as stagnant wages, uncompetitive benefits and high turnover during COVID-19 emergency response.
Loan repayment and forgiveness programs have historically helped support public service careers, but recent changes to federal repayment and forgiveness policies may limit those options, they noted.
Other recent public health news of note includes:
• Fine-particle air pollution, also known as PM2.5, contributes to about 100,000 premature U.S. deaths each year, with about 40% of those deaths linked to pollution that crosses state lines, a new study in Environmental Research Letters finds. More than half of U.S. states are net exporters of PM2.5 pollution, the research found, with Florida the largest exporter, followed by Vermont and Iowa, affecting downwind states and communities.
• The health harms of plastics could more than double globally by 2040 if current production and consumption trends continue, a new study predicts. Published in The Lancet Planetary Health, the research estimates 83 million years of healthy life could be lost, largely through greenhouse gas emissions, air pollution from plastics production and toxic chemical releases.
• Exposure to the “forever chemical” perfluorooctanoic acid, also known as PFOA, may interfere with female fertility by disrupting hormones and embryo implantation, a new study suggests. Published in Reproductive and Developmental Medicine, the research found mice exposed to PFOA had reduced progesterone levels, changes to uterine surfaces and problems with successful implantation. PFOA has been used in products such as nonstick cookware and stain-resistant fabrics, as well as in firefighting foam, and persists widely in the environment.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.