This month, the woefully mis-named Make American Health Again (MAHA) Commission released its Make Our Children Health Again Strategy Report. The commission was created by executive order 14212 and chaired by Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. It was tasked with studying “the scope of the childhood chronic disease crisis, including the American diet, absorption of toxic material, medical treatments, lifestyle, environmental factors, Government policies, food production techniques, electromagnetic radiation, and corporate influence or cronyism,” and advising President Trump with policy recommendations, which are covered in the strategy report. Rather than actually studying the causes of childhood chronic disease, the commission followed a pre-determined path, and the report is a grab bag of questionable talking points that Secretary Kennedy has been peddling long before his tenure at HHS.
The strategy followed another report published in May that identified four key drivers of chronic disease in children, drawn from the executive order’s charge:
- Poor diet
- Chemical exposure
- Lack of physical activity and chronic stress
- “Overmedicalization”
At first glance, this list might seem reasonable enough. Factors like poor diet and lack of physical activity have long been proven to contribute to chronic disease, and as an environmental health researcher, I am increasingly concerned about the growing body of data demonstrating the harmful effects of toxic chemical exposure among young children.
But look a little closer at this report, and you are met with misinformation, evasion, false solutions, and vague and empty promises.
The MAHA strategy presents 128 ideas for addressing these challenges. The list includes a broad range of topics that are not organized in any clear manner, nor justified or explained with evidence. In fact, the MAHA strategy includes not one citation or reference for any of the claims made, and there is no guiding framework or rationale for why the four drivers were chosen. For example, the report and strategy glaringly fail to mention social determinants of health, such as health care access, economic stability, and our built environment in influencing child health, which are proven drivers of chronic disease. Instead, there is a harmful over-emphasis on individual choices over the role of public policy and health systems.
Actions speak louder than words
The strategy highlights a variety of proposed tactics , such as research, agency collaborations, deregulation, and public education campaigns. While it may seem an impressive and ambitious plan, it’s vague and disconnected from reality. Many of these strategies were already happening, and some have been intentionally dismantled by the Trump administration. Nothing reveals this more than the administration’s actions related to toxic chemicals.
Take, for example, the recommendation that several agencies, including the U.S. Environmental Protection Agency (EPA), will “develop a research and evaluation framework for cumulative exposure across chemical classes.” Cumulative impacts refer to the totality of exposures that chemicals and non-chemical stressors like poverty can have on individuals’ and communities’ well-being. Under the Biden administration, there was a yearslong effort to build out this work, and in 2024, EPA released its Cumulative Impacts Framework, which UCS and many others provided input on. In the name of efficiency, one might hope that the administration would use EPA’s existing framework to inform this work. But that is not so. Much of EPA’s work on cumulative impacts was cast aside alongside other efforts to related to environmental justice. The agency eliminated the National Environmental Justice Advisory Council, which advised EPA on cumulative impacts, and the staff who developed the framework were fired or pushed out.
Or take, for example, the commission’s strategy related to air quality. This theme should play an important role in addressing childhood chronic disease, as air pollution is a major driver of poor health in children. This strategy is vaguely summarized in one sentence: “The EPA and [National Institutes of Health (NIH)] will study air quality impacts on children’s health and utilize existing research programs to improve data collection and analysis.” This strategy says a whole lot of nothing. EPA and NIH have already studied children’s health, including air quality impacts, for decades. Even more, the Trump administration has attempted to slash millions in dollars of program and research funding at EPA and NIH, including studies on the impact of air quality on children’s health. And who will carry it out now that EPA shuttered its Office of Research and Development? It’s misleading to suggest that this is a new approach, and insulting our intelligence to pretend the Trump administration would actually do it.
Lastly, take the strategy related to PFAS, or “forever chemicals.” The MAHA strategy states that the Centers for Disease Control and Prevention (CDC) will “update recommendations [for] PFAS in water.” The agency with the authority to limit PFAS in our drinking water is the EPA, not CDC, and the first-ever standards for PFAS in drinking water were established by EPA under President Biden last year. This May, the administration announced it would weaken those very standards. . And just this week, the administration asked a court to eliminate all but two of these protections.
However the administration may address other parts of the strategy, when it comes to addressing “chemical exposure,” it’s smoke and mirrors. In reality, this administration is just bluntly increasing the risks of chemical exposure.
An unscientific standard
The strategy also makes a lot of claims about so-called “gold standard science,” in accordance with an executive order that misleadingly claims that the administration will “restore” the rigor and independence of science, when in reality, it eliminates accountability measures that safeguard federal science from politicization, weakens protections for federal scientists, and misuses “transparency” to undermine science in government decisionmaking.
We should all want government agencies to be guided by the best available science, but in this strategy, and across actions being carried out under this executive order, the administration is doing anything but.
One of the clearest red flags in the executive order is how it intentionally calls for political appointees, who are often not experts on the subject matter, to oversee scientific decisions and resolve concerns related to scientific integrity. This leaves agency decisions exposed to ideological political interference, which has been rife within HHS.
During Kennedy’s confirmation hearings, he stated that he wanted “gold standard science.” Yet rather than trust and invest in public health science and expert agency staff, Kennedy has acted in ways that erode public trust. He has cast doubt on science and scientists, spread dangerous misinformation about vaccines, and adopted unsupported guidance, dismantled expert advisory boards, censored and pushed out top agency scientists, and threatened to ban federal scientists for publishing in peer-reviewed medical journals. At every turn, he’s operated in ways that reduce transparency, accountability and public input.
These tactics have historically been used by authoritarian regimes, as described by public health scientist Dr. Jessica Knurick: “Leaders insisted they valued research while promoting only the science that confirmed their beliefs. They dismissed experts as corrupt or compromised, and elevated pseudoscience as alternative truth. They didn’t reject science outright, but instead, they manipulated it, rebranded it, and weaponized it to legitimize their agenda.”
This is exactly what’s happening within HHS, and particularly in the MAHA strategy. The document peddles conspiracy theories about the repeatedly debunked link between vaccines and autism, putting these fictions on an even footing with evidence-based statements, like the impacts of poor diet and lack of physical activity on chronic disease.
These tactics are dangerous. They prey on reasonable people who are trying their best to protect their families, and these tactics cost lives. Vaccine skepticism and refusal is rising in the American public, which could have catastrophic consequences for children’s health.
Empty promises
Even if the MAHA plan was full of useful and actionable strategies and the administration was fully committed to implementing them, federal agencies are simply not equipped to carry them out. Since January, HHS has pushed out or fired roughly 20,000 staff and halted or changed many areas of the agency’s work.
Just last month, a gunman motivated by COVID-19 vaccine conspiracies fired more than 180 shots at the CDC headquarters in Atlanta. The shooting terrified civil servants and resulted in the death of an officer protecting the facility, yet was met with a lukewarm response by President Trump and Secretary Kennedy. Afterward, more than 1,000 current and former HHS staff signed a letter that called on Secretary Kennedy to “stop spreading inaccurate health information, affirm CDC’s scientific integrity, and guarantee the safety of the HHS workforce.” Lawmakers and health officials have also called on Kennedy to resign. And last week, Dr. Susan Monarez, former CDC Director, testified before Congress on the chaos in the agency. She was fired by Kennedy just one month after her confirmation, testifying that was fired because she refused to ignore career staff, approve unbacked vaccine recommendations and adhere to Kennedy’s anti-science agenda. “I was fired for holding the line on scientific integrity,” Monarez said in her powerful opening statement. “But that line does not disappear with me.”
The Trump administration has spent the last eight months vilifying and destroying our nation’s public health infrastructure. The MAHA report can’t change the fact that the Trump administration’s actions, from HHS to EPA, are exacerbating the conditions that endanger children’s health. There will be no making America healthy again without funding for research, science staffing, and programs that protect public health. The US public deserves better.