When Robert F. Kennedy Jr. was named as Secretary of Health and Human Services, Calley Means, a former Republican lobbyist, expressed a common misconception: “The public health expert class has given us a public health collapse. We are on the verge of, at best, a health crisis and, at worst, a societal collapse with 20% of GDP going to health expenditures. (We’re) getting sicker, fatter, more depressed, more infertile for every dollar we spend.”
The Trump movement has given snake oil salesmen new life because their conspiracy-mindedness fits seamlessly into the MAGA analysis of the world: You are not responsible for anything that has gone awry in your life. Sinister elites have betrayed you. They’ve shipped your job overseas, halved your neighbor’s salary through bad trade deals, stolen elections and picked your pocket to fund forever wars. In that spirit, the notions that vaccines cause autism, that antidepressants cause school shootings, and that COVID-19 spares Jews and Asians seem to demand a fair hearing.
In the early days of Trump 2.0, even reasonable adults who should know better told reporters that it might be good to have Kennedy as our chief public health officer because, after all, we do have a serious problem with chronic health conditions like Type 2 diabetes, heart disease and obesity.
But the reality is that most of what causes chronic medical conditions in America is almost entirely outside the remit of government. Obesity, lack of exercise, smoking, drinking and poor diet all contribute mightily to chronic poor health — and they are behaviors that are extremely difficult to change. By contrast, government is indispensable in certain crucial areas — prevention and treatment of infectious diseases, promoting research on new drugs and funding scientific studies on best practices. In all of those, Kennedy is not only failing to do his job well; he is doing the exact opposite of what he should.
Please don’t get me wrong: People get cancer and Parkinson’s and ALS and lots of other ailments due to simple bad luck. But chronic conditions like Type 2 diabetes, obesity and heart disease are closely linked to behavior. Even cancer rates can be affected by eating habits: consuming lots of fruits and vegetables has been shown to be protective against several forms of cancer. Again, this is not to blame people for their diseases or to suggest in any way that they don’t deserve treatment and care. But as a matter of epidemiology, it’s important to be clear-eyed about what we can control and what we can’t.
People who are obese have a 28% higher risk of heart disease than do people of normal weight. Carrying excessive extra pounds also increases cancer rates, stillbirths, preeclampsia, strokes, arthritis, Type 2 diabetes, kidney disease, infertility, gout and mental health challenges.
Sitting for most of every day also does not conduce to good health.
We Americans (and, to be fair, many people around the globe) do a lot of that. A British study found that adults who watch six or more hours of TV a day had twice the all-cause mortality of those who watched two hours or less.
Everyone knows that the best path to good health is eating healthy foods, getting a decent amount of exercise, avoiding cigarettes, drinking alcohol in small amounts (no more than one drink per day for women, two for men) and maintaining a healthy body weight. A study in the journal Circulation found that women who followed these recommendations lived an average of 14 years longer than those who did not, and men lived an extra 12. But take a guess at how many American adults actually follow all five of those recommendations? According to a University of Oregon analysis, only 2.7%.
So, yes, we are plagued by diabetes, heart disease, strokes and cancer. But it’s not because we use food dyes, or because drug companies have conspired to keep us sick, or because Wi-Fi is frying our brains. The only way to grapple with these conditions is to change our behavior — and that’s hard.
Meanwhile, what is not hard, or shouldn’t be, is to hire a government that does the basics of public health, like empanel experts to advise on the composition of the yearly flu vaccine, or provide guidance on which vaccines are needed for children and at what ages, or fund research on vaccines to prevent future pandemics. On all of these fronts, Kennedy has done the opposite, disbanding advisory committees of academics and physicians, canceling funding for mRNA vaccine research, changing the recommendation for COVID vaccines for pregnant women and babies, and creating a panel stacked with frauds to “reexamine” the nonexistent link between the MMR vaccine and autism.
Kennedy’s crusade will not overcome our chronic disease problem. But it is very probable, if he is not stopped, that former plagues like measles will make a big comeback; that we will be far less prepared to cope with the next epidemic because we cut research on the miracle of mRNA technology; that rates of vaccine hesitancy will continue to rise; and that trust in government professionalism will be shattered.
Mona Charen is policy editor of The Bulwark and host of the “Beg to Differ” podcast.