Trump’s New Executive Order on Federal Grants: What It Means for Public Health and Equity

On August 7, 2025, President Donald Trump signed an executive order titled Improving Oversight of Federal Grantmaking. On its face, the order claims to increase accountability in how taxpayer dollars are spent.

But for those in public health, especially those working in health equity, community-based research, and inclusive education, the implications are significant and troubling.

What the Executive Order Does

The order centralizes oversight of federal discretionary grants in the hands of senior political appointees, requiring that funding opportunity announcements and awards be reviewed for alignment with “national interests” and the President’s policy priorities. It explicitly prohibits funding for:

• Programs that use race or proxies for race as a selection criterion.
• Initiatives that deny “the sex binary” or recognize gender as a spectrum.
• Services for undocumented immigrants.
• Projects it defines as promoting “anti-American values.”

It also directs agencies to:

• Streamline applications into plain language (ostensibly to make the process more accessible).
• Prioritize institutions with lower indirect cost rates. (Not opposed to this one!)
• Broaden the pool of recipients beyond repeat awardees.
• Include clear, measurable benchmarks for funded projects.
• Permit grants to be terminated for “convenience” if they no longer align with the administration’s priorities.

The Framing Problem: Politics Over Evidence

From a public health perspective, the biggest shift is not in requiring accountability. Public health practitioners already value transparency and measurable outcomes, but are replacing evidence-based funding decisions with ideologically driven reviews.

Peer review, a cornerstone of scientific integrity, is maintained in name but stripped of decision-making authority. Political appointees will have final say, and the order explicitly discourages “routine deference” to expert recommendations. This opens the door to funding decisions based less on research quality or community impact and more on alignment with the administration’s worldview.

For example, many health equity initiatives, from maternal mortality reduction programs targeting Black women to HIV prevention work with LGBTQ+ youth, use race, ethnicity, sexual orientation, or gender identity as key criteria for engagement. Under this order, such programs could be disqualified, regardless of their public health value or the strength of their evidence base.

Implications for Health Equity and Vulnerable Populations

Public health is inherently about meeting people where they are and addressing the structural factors that drive disparities. That often means working with marginalized communities (immigrants, racial and ethnic minorities, LGBTQ+ populations) to design interventions that are culturally and contextually relevant.

By prohibiting funding for projects that acknowledge systemic racism or gender diversity, the order undermines core public health principles of inclusion and responsiveness. Programs serving undocumented individuals, for example, address pressing public health needs such as infectious disease prevention, maternal and child health, and workplace safety. Cutting funding to these efforts doesn’t make communities safer.

It increases preventable harm.

Similarly, the order’s ban on “racial preferences” ignores decades of evidence showing that targeted outreach is often necessary to close persistent health gaps. Without such targeting, we risk widening inequities rather than narrowing them.

Chilling Effects on Research and Innovation

The order also empowers agencies to terminate grants midstream if they no longer match administration priorities. For multi-year studies, common in public health, this creates uncertainty that could discourage innovative or politically sensitive research.

Researchers may self-censor, avoiding work on topics that could be perceived as controversial, even if those topics address urgent health threats. Community organizations may avoid partnerships with federal agencies altogether, fearing that shifting political winds could jeopardize funding.

Why This Matters Now

This order comes at a time when the U.S. faces overlapping crise, from climate-related health threats to opioid overdoses to declining trust in public institutions. Addressing these challenges requires sustained investment in community-led solutions, robust research, and inclusive programming.

Public health professionals should be aware of these changes, both to anticipate how funding landscapes might shift and to advocate for policies that keep science and community needs, not partisan ideology, at the center of grantmaking.

Moving Forward: Defending Equity in Public Health Funding

In the months ahead, it will be critical for public health advocates, researchers, and community organizations to:

• Track changes in funding opportunity announcements for restrictive eligibility language.
• Document the impacts of funding cuts or disqualifications on community health outcomes.
• Collaborate with allies in law, policy, and advocacy to challenge rules that undermine evidence-based, equity-focused work.
• Diversify funding streams to reduce dependence on politically vulnerable federal sources.

Public health is at its best when it is inclusive, evidence-based, and guided by the needs of communities most affected by health inequities. This new executive order risks pulling us in the opposite direction, at a time when we can least afford it.