Opinion: Public Health Infrastructure Cuts Threaten Progress in Physical Activity for Health and Exercise Professional Recognition

By Graham Melstrand, Government Relations Strategist, CREP/USREPS

The Trust for America’s Health report, Public Health Infrastructure in Crisis (September 2025), should be a red flag for everyone in our profession. The restructuring of HHS and CDC, combined with sweeping workforce and budget reductions, is not just a challenge for public health—it has direct and immediate implications for the fitness industry, for healthcare, and for the efforts to integrate exercise professionals as recognized providers.

Why It Matters to Exercise Professionals

Exercise professionals rely on the stability and expertise of federal public health agencies in several ways:

• Guidelines and Frameworks: The Physical Activity Guidelines for Americans and the National Physical Activity Plan provide the scientific foundation for much of our programming. Delays or disruptions to these resources undermine our credibility and consistency across the sector.
• Evidence-Based Interventions: Chronic disease prevention programs—now targeted for elimination—have historically linked exercise professionals to condition-specific interventions (diabetes, heart disease, cancer recovery). Without federal leadership, these connections weaken.
• Global Partnerships: U.S. withdrawal from global initiatives (WHO’s Global Action Plan on Physical Activity, The Lancet’s Global Burden of Disease project, OECD benchmarks) risks isolating our workforce and diminishing the international alignment we have fought to establish.

The Bigger Picture: Healthcare and Public Health

Cuts to chronic disease programs and surveillance systems affect more than public health agencies—they shift the burden onto the healthcare system. Hospitals, clinics, and payers will face rising demand as preventable conditions go unmanaged.

This creates both a risk and an opportunity for our field. If exercise professionals remain sidelined, costs and inequities will grow. But if we are fully recognized and integrated—through registration based on accredited certification programs and professional standards—we can fill the prevention gap and demonstrate measurable value.

What’s at Stake

The TFAH report highlights the termination of billions in grants supporting:

• Disease surveillance and laboratory capacity
• Immunization and vaccine infrastructure
• Emergency preparedness and workforce training

If these resources disappear without replacement, the ripple effects will be profound. For exercise professionals, the most immediate risk is the loss of authoritative, federally backed guidance on physical activity and condition-specific programming. Without it, the sector risks fragmenting into inconsistent, commercially driven messages that weaken our standing with healthcare providers and policymakers.

A Call to Action for Our Community

As representatives of a unified registry of exercise professionals, CREP/USREPS has an obligation to raise our voice in this moment. To mitigate the impact of cuts, we must:

• Advocate against the elimination of the CDC’s Division of Nutrition, Physical Activity and Obesity and for restoration of the Prevention and Public Health Fund and core CDC programs.
• Reinforce the value of registered exercise professionals as part of chronic disease prevention and management strategies.
• Strengthen partnerships with healthcare payers, employers, and community organizations to sustain condition-specific programming even if federal resources decline.
• Continue global engagement to ensure U.S. professionals remain connected to international best practices and recognition systems.

Final Word

The erosion of public health infrastructure is not just a budget debate—it is a direct threat to the progress our sector has made towards recognition as essential providers of health and prevention services.

This is the time for unity, advocacy, and action. CREP/USREPS will continue to ensure that policymakers understand the critical role exercise professionals play in addressing chronic disease, reducing healthcare costs, and strengthening community resilience.

We cannot allow decades of progress to be undone by short-sighted cuts.