It’s been a good couple of weeks for anti-Trumpers. The series of indictments starting in New York City and continuing in Miami, his arraignments, and then even a tape that more or less confirms his guilt in hiding classified documents from the FBI have provided some hope that the aging mogul may finally be unelectable. Even more hope is available if one considers the feeble (if increasingly crowded) lineup of GOP candidates in general election: a still-terrified-of-Trump Mike Pence, a tired Chris Christie, a not-quite-charming Ron DeSantis, and so on. The chances of Biden enduring for another term look good. If you are lucky enough to live in a blue state, the general mood in the run-up to the 2024 elections seems to be rather optimistic.
The reality is different if you are unfortunate enough (as I am) to live in a red state. A few weeks ago, I wrote about the witch hunt of Dr. Caitlin Bernard for publicly discussing the abortion she performed on a ten-year-old rape victim. The ultra-conservative Indiana attorney general Todd Rokita and some of his allies wanted to take away her license to practice medicine and force her to disclose the name of the Ohio doctor who had referred the case of the ten-year-old girl to her. They were almost successful.
The last week has brought to the fore another depressing saga of MAGA stalwarts versus public health professionals. This story, like the one of Dr. Caitlin Bernard, reveals how the entire architecture of local governance in deep red states is being steadily altered by die-hard pro-Trump officials. In the week of June 20, as reported by Jeff Parrott of WVPE News, seven members of the St. Joseph County Board of Health in northern Indiana put in their resignations. They included the (now former) director of health equity, epidemiology and data, her assistant director, the public health emergency coordinator, the maternal and infant health coordinator, and three community health workers.
The reason for the mass resignation: harassment and a toxic work environment they say was created by two newly elected Republican members of the county council. These members are Amy Drake and Dan Schaetzle. Together, the duo who came to the county council in January have been making it impossible for the health officials to do their job. Drake’s main gripe (and seeming platform) has been an opposition to the word equity. Health director Cassy White (whose title unfortunately includes the word equity) has asserted that Drake has opposed any grant opportunity and really any programming at all that includes the word equity.
The consequences are troubling and illustrate how the lives of people, especially women in need of health services, are being affected by the far-right MAGA agenda. Sally Dixon, the maternal and infant health coordinator, wanted to use money left over from a fetal and infant health conference held last year to continue interviewing women who had lost their babies. Indiana, after all, has a high infant mortality rate (recently ranking ninth worst in the nation in that category) and babies born to mothers of color are two or three times as likely to die as those of white mothers. Despite this, Drake took issue with the money being used to interview mothers who had lost infants. Following the election of Drake and Schaetzle, Dixon was told she could not use the money in this way unless she stopped using the terms equity and racial disparities in the proposal. If she would not do this, she was told, she would have to forego using the money.
In May, Drake put her campaign against words like equity into high gear. On May 9, at a county council meeting, Drake alleged that a webpage of the county health department was actually Marxist/Critical Race Theory. The page in question is a “glossary” explaining the meaning of terms such as BIPOC, discrimination, health disparity, racism, and structural racism, among others. Based on this opposition, Drake and Schaetzle led their fellow Republican council members in a 5-4 vote tabling a $100,000 grant to expand the availability of Naloxone (the opioid overdose reversal drug). Until the web page was removed, no one in the county health department could use the significant sum of money to prevent opioid deaths. This despite the fact that the grant had already been approved by the health board and all the county commissioners had to do was sign off on it.
In an interview with the South Bend Tribune, Drake insisted that she had “no problem” with the usage of Narcan in St. Joseph County, which includes the city of South Bend. The “problem,” in her words, was that the grant “is also designed to push a political ideology—in this case, it’s equity.” If the health officials of St. Joseph County would remove that part of the health department’s webpage and renounce the expressed views, “then I could get behind you,” she said. In the following week, however, the board unanimously voted to accept the grant. And so far, the health department has not removed the offending page that provides largely dictionary definitions of the terms.
This sort of micro focus on deep red states like Indiana reveals just how the culture-war-driven racist MAGA propaganda has chipped away at mechanisms that ensure public health and safety. Drake and Schaetzle say their mission is to bring “conservative values” to the board. Meanwhile, the goal of public health provision seems to be secondary. The current situation is that St. Joseph County no longer has trained staff running these programs because of the anti-equity purge.
Indiana is not an unusual case among red states. It’s become even more right-wing following the election of Donald Trump in 2016. Only eight years earlier, the state had voted for President Barack Obama. If this is the situation in a state that has occasionally been willing to vote Democratic, the condition of states that have been conservative for decades and have only turned deeper red after Trump is likely to be worse than even Indiana. The worst ranking state in infant mortality, for example, is Mississippi, which has a long history of ranking at the bottom of social welfare metrics.
On top of this, the damage at the federal level during the Trump years remains: dark and complicated corners of the federal administration that saw zealous policies by the Trump administration are still worrisome. Take for instance the changes at the United States Customs and Immigration Service which, being an administrative agency, saw 472 changes during the Trump administration that both dismantled and reconstructed different portions of how immigration laws and regulations in the United States are enforced. According to the Migration Policy Institute, this included everything from amassing nearly $18 billion for construction of the border wall, the hiring of hundreds of new judges in the Board of Immigration Appeals, the hiring of thousands of new border guards to increase border enforcement, and changes to the citizenship test that made it harder for most applicants. All of these changes were accomplished through rule changes, broad presidential proclamations, technical adjustments in language, and similar tactics.
The Biden administration appears to be aware of this; for instance, the harder citizenship test has been scrapped in favor of the older and supposedly easier one, denaturalization (a once rarely used form of citizenship removal) has begun to drop again, and there has been some attempt at removing some of the worst Board of Immigration Appeals judges who came on during the Trump administration. These are undoubtedly a good start, but as the first Biden term comes to a close, the majority of the 472 changes remain in place, all of them chipping away bit by bit at the very concept of a nation of immigrants, or even of an immigration system that treats arriving non-citizens and asylum seekers in a humane and (gasp) equitable way.
As the electoral jockeying for 2024 heats up and most of the country has its attention diverted by the usual Trump shenanigans, the drama enhanced by the arraignments and indictments (some undoubtedly still to come), it is these structural and institutional changes that deserve some attention both by anti-Trump GOP candidates and the Biden-Harris ticket. The drama of the former may be a satisfying diversion to Trump opponents, but it does not quite address how the effort to recast both county-level and federal-level institutions in the obscurantist and vengeful style favored by the Trump wing of the GOP continues apace. How will these erosions in fair-minded governance and equity-centered institutions be corrected in such a manner that both governance and institutions are no longer flailing, bleeding trained staff and rejecting the use of power geared toward the public welfare? So far there are no answers; the brave little website of the St. Joseph County health department that dares to define terms such as racism and equity is still online and accessible now, but as the onslaught of persistent institutional destruction continues, that may not be the case even next week.