The MAGA movement’s child health manifesto is a muddle

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Released with great fanfare, The MAHA Report: Making Our Children Healthy Again, is a 72-page articulation of the MAGA movement’s health priorities.

The Make America Healthy Again report is a strange muddle of self-loathing, bravado, and revisionist nostalgia, claiming U.S. children are “the sickest generation in American history” and vowing to reverse the crisis in chronic illness in children by tackling the root causes.

The root causes identified, unsurprisingly, echo the obsessions of U.S. Health Secretary Robert F. Kennedy Jr., zeroing in on four culprits: ultra-processed foods; exposure to synthetic chemicals; sedentary lifestyles dominated by screens; and overmedicalization by prescription drugs.

While these can all have important health implications, are they really the greatest threat to the health of Americans, and children in particular?

Sure, it’s unsettling that 70 per cent of food consumed by young people is ultra-processed, and that young people spend more hours playing on screens than they do playing outdoors, but the reality is they face much bigger threats in their everyday lives.

There is nary a mention in the report of gun violence or motor-vehicle collisions (the number one and two causes of death of American children and teens).

Nor does the MAHA manifesto include a single mention of the social determinants of health: The devastating health impacts of poverty, precarious housing, poor education, unaffordable food, and an unhealthy physical environment, never mind the shocking race-based health disparities in the U.S.

At the report’s release last week, Mr. Kennedy said it was “an invitation to the American people ... to have a complex conversation about a nuanced subject.”

But there is little nuance in what is being offered up.

The report is larded down with alarmist statistics: four in 10 American children have at least one chronic illness; one in five has taken a prescription drug in the past 30 days; one in six are obese; one in 31 have autism, one in 10 ADHD; one in four have allergies; childhood cancer diagnoses are up 40 per cent since 1975; and more.

But there is little context to accompany the cherry-picked data.

Are there more kids with autism and ADHD today than a couple of generations ago, or do we just have clearer diagnostic criteria? And, sure, there are more cancer diagnoses, but mortality has plummeted; is better diagnosis and treatment of pediatric cancers a bad thing?

More importantly, behind all the dire data are two broad assumptions: 1) Things used to be a lot better in the good old days (read: the mythical Ozzie and Harriet era) and; 2) all this horribleness could be reversed if only kids ate better and didn’t take medications like vaccines.

Yet, a child born today can expect to live a decade longer than one born in 1960. Child mortality in the U.S. today is 5.7 per 1,000 live births, compared to 26.6 per 1,000 in 1960.

Then there are the blatant contradictions. The Trump administration is anti-regulation and embraces a “drill baby drill” approach to the environment, yet the report bemoans the use of everything from food dyes to pesticides. How exactly will that change if you don’t regulate?

While the report rails against chemicals from food dyes to microplastics, and paints prescription drugs as evil, it says nothing about tobacco, alcohol, cannabis, opioids and other substances that pose a real and present risk to young people.

And are PFAS, fluoride and food additives really a greater threat to children’s health than climate change? Because those words don’t appear in the report either.

It’s all well and good to say kids should eat whole foods, but how will you make these more affordable than junk food? And if we want kids walking to school, why do we continue to build cities for cars and not people?

There is a lot of MAHA rhetoric about the importance of prevention but, as Health Secretary, Mr. Kennedy has savaged the U.S. Centers for Disease Control and Prevention, which, among other things, is responsible for preventing chronic disease. In fact, the prevention arm of the CDC has been eliminated.

Mr. Kennedy said that the MAHA report is a diagnosis of what’s wrong with the health of American children. If so, it’s a dubious one.

In 100 days, the recommendations on how to fix the “crisis” are expected. Hopefully, those will be a little more than magical thinking about food and drugs.

But we shouldn’t hold our breath.