MAHA report outlines chronic disease crisis

The Make America Healthy Again Commission, created earlier this year by an executive order, released its first report detailing the nation’s chronic disease crisis.

Why it’s important: It lays out Department of Health and Human Services (HHS) Secretary Kennedy’s views and gives a sense of where HHS will target its efforts.

• It focuses on many of the same issues Kennedy and his MAHA advisers have been emphasizing — ultra-processed foods, environmental chemicals, childhood behavior (e.g., physical activity, mental health), and “overmedicalization.”

The details:

• The report argues that children’s use of smartphones, social media, and gaming is contributing to lower levels of physical activity and has “likely helped to drive mental health declines through social deprivation, sleep disruption, attention fragmentation, and addiction.”
• Lack of sleep, chronic stress, loneliness, and excess diagnosis or treatment are also listed as possible contributors to childhood mental heath problems.
• The report also highlights the role of “family dynamics and socio economics,” noting that “frequent family meals are associated with teens having lower rates of disordered eating, alcohol and substance use, violent behavior, and feelings of depression or thoughts of suicide in adolescents.”
• It also questions the use of prescription medications such as stimulants, antidepressants, and antipsychotics in children. It calls out kids’ “overmedicalization,” citing a 1,400% increase in antidepressant prescriptions for American adolescents 1987-2014, as well as increased prescribing of stimulants, antibiotics, and asthma drugs.

The broader context: The report diverges drastically from standard government thinking about chronic disease prevention.

• The Centers for Disease Control and Prevention (CDC) says that “most chronic diseases are caused by a short list of risk factors: tobacco use, poor nutrition, physical inactivity, and excessive alcohol use.”
• But: The report does not mention smoking or excessive alcohol use. The Trump administration has dismantled the Office of Smoking and Health at CDC and has fired the top tobacco regulator at the Food and Drug Administration. There is also little discussion of how socioeconomic factors like poverty are underlying drivers. The report comes amid a dismantling of the federal public health and research apparatus that might provide answers and solutions to the questions and problems posed.

Next steps: The commission now has about 80 days to create a strategy for how the federal government should respond to the crisis it lays out.

Read more: 4 takeaways from the MAHA commission’s report on children’s health; Kennedy and Trump Paint Bleak Picture of Chronic Disease in U.S. Children; 5 key takeaways from the MAHA commission report; MAHA Commission report paints a dark picture of U.S. children’s health