The “Make America Healthy Again” Commission announced on Thursday that the drivers of childhood chronic disease are exactly what Health Secretary Robert F. Kennedy Jr. thought they were all along: ultra-processed foods, environmental toxins, technology and medications, including vaccines.
Some of the phenomena the MAHA Commission’s new report identifies as causing health issues in children — a dearth of high-quality, unprocessed foods in the average American diet, heightened exposure to chemicals like pesticides and microplastics, the inceasing rise of social media — scientists and public health experts broadly agree are problematic. But other claims — like the dangers posed by Wi-Fi radiation, antidepressants and vaccines — have far less evidence to support them.
Regardless of its scientific legitimacy, the report signifies a tectonic shift in the federal government’s language around health and wellness. Its recommendations could have major implications for the look and feel of the country’s public health infrastructure.
Among the report’s ten recommendations are a call for a “coordinated national lifestyle-medicine initiative” to test the effects of non-pharmaceutical interventions to “movement, diet, light exposure, and sleep timing.” Another suggested “next step” is a “national initiative to map gene-environment interactions affecting childhood disease risk, especially for pollutants, endocrine disruptors, and pharmaceuticals,” and increased monitoring and testing of pediatric drugs.
The report urges the president to create a task force to apply artificial intelligence to “federal health and nutrition datasets” to “detect harmful exposures and childhood chronic disease trends,” and to expand the National Institutes of Health’s autism data initiative into a “broader, secure system linking claims, EHRs, and environmental inputs.”
On the food regulation side, the report calls for reform of the Food and Drug Administration’s “Generally Regarded as Safe” designation, which some food safety experts agree does not do enough to test food ingredients. The report also calls the existing dietary guidelines “unduly influenced by corporate interests,” saying they don’t do enough to distinguish between unprocessed and ultra-processed foods. (The report doesn’t make too many criticisms of the agricultural industry’s use of pesticides; in a hearing this week, Kennedy told senators he would not do anything that could “threaten that business model.”)
A significant portion of the report is dedicated to exploring the ways corporate America has influenced the health of the country. It points out the billions of dollars the pharmaceutical industry, food industry and chemical manufacturing industry have each spent on lobbying, an issue that the Trump administration has generally not concerned itself with in the past. It suggests that the “poor health and increased morbidity” of American children is being driven most prominently by “the corporate capture of medical knowledge.”
“The distortion and influence of medical education, medical knowledge, and therefore clinical guidelines and practice, has led providers to over-diagnose and over-prescribe, and over-use by children, while largely ignoring the potential population-level impact of diet, lifestyle, and environment as focal points for health, healing, and wellness,” it states.
The Wall Street Journal reported that some elements of the report were changed at the last minute, including reducing its criticism of industry lobbying. Changes were also reportedly made to the section on vaccines, shortening it and adding language to make it clearer that vaccines can protect children from getting sick.
At times, the report seems to contradict itself in its efforts to lay the blame for childhood health challenges at the feet of its chosen scapegoats. For instance, a section titled “The Crisis of Childhood Behavior in the Digital Age” (which seems to draw significantly from Jonathan Haidt’s book “The Anxious Generation”) blames cell phones for declines in physical activity, sleep and social interaction and corresponding rises in loneliness and chronic stress in kids — problems that have resulted in “a real rise in youth mental health struggles,” the report states.
But the report immediately goes on to insist that behavioral and mental health issues are being overdiagnosed. It cites a study that it says shows that mental health programs in schools can make things worse for some children, though it admits that the evidence is “debated.”
The next section of the report, “The Overmedicalization of Our Kids,” then claims that the rise in the number of children taking prescription medications like antidepressants, GLP-1 inhibitors and antibiotics has also been driven primarily by corporate influence. It takes aim at the childhood vaccine schedule, saying that the U.S.’s schedule outpaces that of other countries and that more research is needed to determine if vaccines cause chronic illness. (The vast majority of scientists say they do not.)
The report also has a tendency to juxtapose real scientific research and genuine areas for improvement with unproven conjecture without making a distinction between the two.
Many of the report’s claims are backed up with citations from peer-reviewed journals or information issued by long-standing scientific institutions like the Centers for Disease Control and Prevention. But at times, the MAHA commission’s allegations go far beyond what can be reasonably backed up with scientific research — and it doesn’t seem to see a problem with that.
“The above examples represent harms that have been carefully studied and thus well proven,” the report states at one point after listing medications that studies show were overprescribed in children. “However, in the setting of childhood growth and development there remains an important likelihood of undetected but potentially major long-term repercussions. Established harms in children may therefore be thought of as the tip of a potentially vast iceberg representing both detectable short term negative effects, and potentially hidden negative effects with long term implications.”
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Margaret Manto is a NOTUS reporter and an Allbritton Journalism Institute fellow.