Tracking the Public Health Impacts of Federal Executive Orders
March 4, 2026
Overview
Donald Trump signed 230 executive orders (EOs) last year, a good number of which impacted critical areas of public health. What occurred in 2025 were sustained, high-velocity disruptions to the infrastructure that makes public health policy possible. As expected, these disruptions were not evenly distributed and landed most heavily on communities already experiencing the greatest health inequities. The Network’s newly launched Executive Order Watch tracks the broad range of public health issues affected by EOs, including equity, the environment, immigration and reproductive health.
On January 20, 2025, Donald Trump signed 26 executive orders in a single day, the most any president has issued on their first day in office. By the end of his first 100 days, that number had climbed to 143. By the end of the year, it reached 230. That total is the highest first-year executive order count since Franklin D. Roosevelt signed 568 orders in 1933 amid the economic collapse of the Great Depression.
But the volume alone does not capture the scope of the executive actions underway.
Each of these orders alters the legal and policy landscape that shapes the conditions in which people live, work, and seek care. The Network for Public Health Law recently launched Executive Order Watch to track the broad range of public health issues affected by these EOs. Our tracker is a publicly accessible resource documenting EOs issued in 2025 with significant public health implications. Each order in the tracker is categorized by topic area, with a corresponding summary of concrete health impacts, and links directly to primary sources in the Federal Register.
Public health is often misunderstood as something that happens primarily in clinics or hospitals. However, those in the public health community have increasingly recognized the upstream factors at play that shape the conditions that determine health outcomes: the air people breathe, the water they drink, the housing they can afford, whether they feel safe seeking care, whether their job provides health insurance, and whether public institutions are capable of responding to crises. These conditions are often referred to as the Social Determinants of Health. Decades of research show that social, economic, and environmental conditions account for the majority of health outcomes, far more than medical care alone.
Executive orders operate directly on those conditions. For instance, orders affecting immigration enforcement affect whether families seek prenatal care, vaccinations, or emergency treatment. Orders weakening environmental review requirements determine who lives with higher exposure to air pollution or toxic waste. Orders dismantling diversity, equity, and inclusion, and accessibility initiatives affect the health workforce that will, or will not, serve underrepresented communities for decades to come. This is what Health in All Policies looks like in practice; the recognition that health consequences flow from decisions made across every area of law and policy, not just agencies labeled “health.”
Many of the executive orders issued in 2025 overwhelmed the systems built to implement, interpret, and absorb federal action. Public health infrastructure—including state and local health departments, community clinics, federal agencies, disease surveillance systems, research programs, and other partners—depends on stable funding, uniform guidelines, trained staff, and time to adapt to changes in policy.
What occurred in 2025 were sustained, high-velocity disruptions to the infrastructure that makes public health policy possible at all, driven in significant part by EOs issued under the administration’s so-called Department of Government Efficiency (DOGE) initiative. Through a series of workforce restructuring and funding “efficiency” directives, these EOs triggered mass firings across federal agencies; and were subsequently followed by partial reinstatements that hollowed out institutional knowledge and pushed experienced professionals out of public service.
Additionally, executive actions tied to DOGE suspended grant disbursement mechanisms, forcing community health organizations that relied on federal funding to divert scarce resources from patient care to emergency legal action simply to remain operational. As the Network warned at the time, actions at the federal level placed unconscionable strain on a public health system still recovering from pandemic-era trauma burdens.
As expected, these disruptions were not evenly distributed and landed most heavily on communities already experiencing the greatest health inequities.
On the first day of the administration, climate and environmental justice directives that had previously directed federal attention and resources toward communities living near highways, industrial facilities, and other sources of pollution—communities that are disproportionately Black, brown, and low-income—were rescinded. Shortly thereafter, staff in the CDC’s environmental health divisions were terminated, including personnel responsible for heat-response planning, wildfire preparedness, and community cooling strategies. This occurred immediately after 2024 was confirmed as the hottest year on record. Although some staff were later reinstated, the damage from disruption, missed planning cycles, lost expertise, and delayed response, had already been done.
That same day, an executive order effectively ended federal recognition of gender identity. Additional orders followed, restricting access to gender-affirming care for people under 19, revoking equal housing protections for LGBTQ+ individuals, and eliminating federal data collection on gender identity. For transgender youth, who already face markedly elevated risks of depression, anxiety, and suicide, this was not an abstract policy dispute; it was the removal of medically necessary care and legal protections, imposed faster than courts could meaningfully intervene.
Immigration-related executive orders reverberated through emergency rooms and community clinics, too. The chilling effects of aggressive enforcement are well documented: families delay or forgo care when they fear deportation or family separation; prenatal visits are postponed; childhood vaccinations are skipped; chronic conditions go untreated. These outcomes are not speculative. They are predictable, evidence-based responses to intimidation and fear, and their consequences extend beyond immigrant families to the broader health of entire communities.
The pattern is consistent. Executive orders and related actions have disproportionately burdened communities with the fewest resources and the highest baseline health risks. This is precisely how health inequity is produced and deepened through law and policy, and why the Network is connecting these orders explicitly to public health. A better understanding of the impacts of the EOs on the broad range of health issues is crucial for public health and community partners to develop strategies and programs to protect and improve health in communities across the country.
Join us for a webinar on March 26 to learn more about the Network’s tracker, and the ongoing public health impacts of the 2025 EOs and related actions in areas including equity, reproductive health, the Federal MAHA initiative, immigration, and voting. The webinar will highlight larger public health themes, events, policies, and actions connected to these executive orders and their implications for communities and practitioners working to protect health. Register here to save your spot.
This post was written by Nina Belforte, Deputy Director, Strategic Communications; and reviewed by Phyllis Jeden, J.D., Deputy Director, Mid-States Region.
The Network promotes public health and health equity through non-partisan educational resources and technical assistance. These materials provided are provided solely for educational purposes and do not constitute legal advice. The Network’s provision of these materials does not create an attorney-client relationship with you or any other person and is subject to the Network’s Disclaimer. Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.