A grenade just landed in the midst of lively discussions about what it means to make policy decisions more evidence-based. On December 14, the Trump administration told policy analysts at the US Centers for Disease Control and Prevention (CDC) that “evidence-based” is now among seven words and phrases they are forbidden to use.
Banning the terms “evidence-based” and “science-based” from documents the CDC is preparing for next year’s budget is particularly troubling because of its broad reach. It flies in the face of rare bipartisan agreement, enunciated most recently by the US Commission on Evidence-Based Policymaking (CEP). In a CEP report released in September, the commission held that government officials need evidence, whether their decisions concern funding allocations, new regulations, or processes for efficiently providing services. “Without the use of evidence in our democracy,” the commission unanimously concluded, “we are only guessing at whether government programs and policies are achieving their intended goals.”
Over the last hundred years, the United States has made enormous progress by agreeing that we must strengthen our ability to create better lives for all Americans, including the most “vulnerable” (yet another banned word!). We need evidence and science to guide policies and practices toward that goal. Americans share many aspirations, although we differ in our convictions of what it will take to achieve them. But even when our beliefs vary about which social supports should come from family, neighbors, the market, philanthropy, or government, we agree that we must base decisions aimed at promoting better lives in the future—especially if they involve public funds—on solid evidence.
Forbidding the use of “evidence-based” and “science-based” suggests a shocking dismissal of some of America’s most valuable achievements, including dramatic reductions in infant and maternal mortality over the last 50 years, rising life expectancy, vaccines that are preventing more than 21 million hospitalizations and hundreds of thousands of deaths among children born in the last 20 years, and the manifold tobacco control efforts that resulted in 8 million fewer premature deaths between 1964 and 2012. The accumulation of evidence from both research and experience made every one of these triumphs possible.
Reports over the weekend suggest that some officials are now walking back the original directive, which would be great news. But the mindset that produced the ban, suggesting that government officials would craft budgets in ignorance of facts and expertise, is very scary indeed.
There is nothing wrong—and everything right—about continuing our debates about methodology. Some believe evidence should come primarily from randomized experiments that verify what works. Others of us seek to be more inclusive: We believe that we will get better, more scalable results by expanding what we consider strong and credible evidence to include rigorously analyzed experience from the daily work of improving and building on previous successes. We believe that we need research not only on program effectiveness, but also on the root causes of the problems we must solve. We also believe that that evidence-based public and philanthropic funding should encourage flexibility and continuous improvement, as well as tracking of results.
But none of us wants to see debate obscured by culture wars, in which carefully analyzed data has no place in public decisions.
One has to wonder: Are proponents of the ban afraid that evidence- and science-based arguments will invigorate political support for the funding and implementation of more effective social services, education reforms, and public health advances? Citizens, not just experts, must examine the new restrictions and ask whether dictates that lack any rationale now threaten future advances. Citizens, not just experts, must stand against attempts to besmirch evidence and science as inherently untrustworthy. We must make sure that when it comes to budgets and the daily work of improving lives, “ideology-based” and “politics-based” will not replace “evidence-based” and “science-based.”