Donald Trump’s policies are likely to drive soaring rates of lung disease and premature death, according to a wide-ranging new study by pulmonary specialists and public health experts.
The analysis, published in the American Journal of Respiratory and Critical Care Medicine, examines policies adopted during Trump’s second term across 10 areas, including healthcare access, environmental regulation, workplace protections and vaccine uptake.
The moves are likely to increase lung disease incidences, worsen existing illness and undermine care for patients already suffering, threatening children and adults’ pulmonary health, the researchers say. Taken together, they amount to “an attack on Americans’ lungs” that could mean millions “die needlessly in the years ahead”, warned Adam Gaffney, a pulmonary physician and professor at Harvard Medical School who led the report.
Reached for comment, White House spokesperson Kush Desai said: “The Trump administration is not jeopardizing healthcare access for anyone.”
Among the most immediate concerns highlighted in the report are healthcare cuts included in Trump’s second-term tax and spending package. Known as the One Big Beautiful Bill Act (OBBBA), it slashed over $1tn from health programs, marking the largest federal healthcare rollbacks in American history.
The cuts could jeopardize access to care for millions relying on Medicaid, lowering vaccination rates for respiratory illnesses, diminishing emergency treatments and decreasing medication access, the analysis says.
“Let’s say you have a patient with chronic obstructive pulmonary disease who loses coverage, stops going to their primary care physician, stops seeing a pulmonologist, no longer has someone to prescribe their inhalers,” said Gaffney. “The simple fact is that modern medicine saves lives, and when you take it away, it does harm.”
Desai said the OBBBA included “commonsense work requirements, eligibility verification, and other reforms to slash waste, fraud, and abuse in Medicaid, which will strengthen the program for the Americans who rely on this vital lifeline.” He added that the administration was “pushing an ambitious overhaul of American healthcare”.
Over the past year, the Trump administration has also rolled back or weakened dozens of air pollution standards, including those limiting soot, airborne mercury and tailpipe emissions. These may increase profits for some companies but will lead to new asthma cases and more hospitalizations for respiratory illness, threatening the lung health of hundreds of thousands, the study warns.
“At every turn, this administration is putting the potential economic gains of polluters ahead of clean air and the respiratory health of Americans,” Mary Rice, director of the Center for Climate, Health, and the Global Environment at Harvard and study co-author, wrote in an email.
Officials have also delayed clean energy projects, forced fossil fuel power plants to operate long after planned retirement, and pushed Congress to remove California’s authority to mandate electric vehicle sales. If successful, these moves will lead to even more air pollution, the authors write, with potentially “irreversible” effects for lung health.
Desai did not comment on the researchers’ concerns about air pollution.
Other risks highlighted in the paper include delayed workplace protections for coal miners exposed to silica dust, cuts to public health funding at the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration, and declining vaccine uptake under health secretary Robert F Kennedy Jr. The risks are likely to compound, with many people “finding themselves at the center of various vectors of harm”, said Gaffney.
A patient with chronic obstructive pulmonary disease may face higher soot exposure due to weakened emissions standards while also losing healthcare coverage. If they smokes, further increasing their risk, they may also lose access to tobacco cessation programs due to slashed CDC funding. If the patient consumes misinformation distributed by Trump officials, they may also forgo vaccines for Covid and influenza, to which they are highly vulnerable. And in the years to come, environmental rollbacks will also exacerbate global warming, fueling worse and more frequent wildfires that may expose the patient to more lung-harming smoke, said Gaffney.
“Recent federal actions will cost Americans dearly,” said Liz Scott, a senior director at the American Lung Association who did not work on the study. “The study highlights the stark impacts these federal actions will have on the health of all Americans, especially children and others most vulnerable in our communities.”
Because lung disease affects people across the socioeconomic spectrum, no population will be completely insulated. But certain populations will suffer most because of different policy choices. While certain occupational health rollbacks will worst affect coal miners in red states, other effects may hit hardest for Black communities, who experience disproportionate rates of asthma.
“We have a very unequal society in many respects, and we know lung disease hurts working class people and poor people the most of all races,” Gaffney said.
Scott said the study makes clear that federal agencies “must return to their public health-focused mission, protect our children and ensure that all communities have the opportunity for a healthier future.”
Gaffney, who has advocated for Medicare for All, said broad change is needed.
“The array of harmful policies we are seeing is unprecedented,” he said. “We need to do more than turn them back. We need to actually pursue positive policies that will ensure the health of all Americans.”
