Updated May 22, 2025 at 4:46 PM MDT
The Trump administration released a sweeping report Thursday, offering its analysis of what's driving chronic disease among the nation's children.
The report titled, "The MAHA Report: Make Our Children Healthy Again" catalogues in detail a "chronic disease crisis," including high rates of obesity, asthma, autoimmune conditions and behavioral health disorders among kids.
The 72-page document is a product of the MAHA commission, which was established by President Trump through an executive order on Feb. 13. The commission, chaired by Health Secretary Robert F. Kennedy, Jr., enlisted various Cabinet members, including the secretaries of agriculture and education and the head of the Environmental Protection Agency, and met in private over the last few months.
"There is something wrong and we will not stop until we defeat the chronic disease epidemic," Trump said at a White House event on Thursday, flanked by Secretary Kennedy and other members of the commission.
Much of what's detailed reflects the views Kennedy has articulated during his many public appearances.
The report identifies four major drivers behind the rise in childhood chronic illness: poor diet, environmental chemicals, chronic stress and lack of physical activity, and overmedicalization. In keeping with the messaging that has animated the MAHA platform, the report pins much of the blame on conflicts of interest and corporate influence in the food, chemical and pharmaceutical industries.
The report lays the groundwork for the MAHA commission to develop a strategy for addressing childhood disease, which is supposed to happen by mid August according to the February executive order.
The proposition that nutrition, lifestyle and exposure to pollution and other harmful chemicals are conspiring to harm children's health is not controversial among longtime researchers in public health.
"Many of us have been calling for some attention to these issues for decades now," says Dr. James Perrin, a professor of pediatrics at Harvard Medical School. "This is a real American problem, and it's not one that we're seeing quite so dramatically in other countries."
But the report doesn't resolve some of the central tensions that have characterized Kennedy's MAHA platform from the outset.
"They make a great diagnosis and they have a very weak treatment plan," says Dr. Philip Landrigan, a professor of pediatrics and public health at Boston College.
Among the concerns: The report doesn't contain a thorough discussion of the socioeconomic factors like poverty, which is a key predictor of chronic disease.
"They acknowledge that ultra-processed foods are cheaper, but aren't acknowledging that growing poverty and the wealth gap is leading more people, and children, to relying on cheaper foods," says Carmen Marsit, a professor of environmental health at Emory University.
The report also questions vaccine safety and suggests that possible links to childhood disease have not been thoroughly studied.
"That is simply not true. There have been abundant studies," says Landrigan.
More broadly, the emphasis on advancing research and public health initiatives runs counter to many of the recent actions taken by the Trump administration.
For example, the report outlines the risks of exposure to harmful chemicals on children's health – an area that Sheela Sathyanarayana, a professor of pediatrics at the University of Washington, says deserves much more attention. And yet the Trump administration is cutting staff at key agencies and dissolving an office in the Environmental Protection Agency that studies the toxic effects of chemicals,
An overarching theme of the report is a push to refocus federal health agencies on prevention rather than disease treatment.
"I do agree that our medical system and our research infrastructure is too focused on treatment and cure, and we really need to move more into a prevention model," says Sathyanarayana.
"But some of the other actions they have taken actually undermine prevention," she says.
As head of the Department of Health and Human Services, Kennedy has directed the firing of thousands of federal workers, cuts to the Centers for Disease Control and Prevention and elimination of billions of dollars of contracts and grants from the National Institutes of Health, all of which support the kind of research and data that underlie the report.
Dr. William Dietz, a childhood obesity researcher at the George Washington University, says the MAHA commission's emphasis on the harms of ultra-processed foods is warranted, though the report paints the topic with a broad brush, when, in fact, certain kinds of processed foods are more problematic than others.
However, he worries the federal government may not even be able to accurately track its progress on obesity in the future.
"I'm really concerned the scalpel that's been taken to CDC in general threatens the ongoing ability to monitor health. And those are going to be some of the same data sets that are needed to assess progress in many of these areas," he says.
The report reserves space at the very end to sketch out a range of proposed solutions: Asking the National Institutes of Health to fund new trials on whole-food diets and on potentially harmful ingredients in the food supply; pushing NIH and the Food and Drug Administration to improve post-marketing surveillance of pediatric drugs; supporting new pediatric drug safety research; and launching a national lifestyle-medicine initiative.
It's not clear where the funds or staffing would come from for these priorities.
Lauren Wisk, who studies chronic disease in children at UCLA, says the numbers cited on the rates of childhood disease are "reasonable."
But she worries about Kennedy's rhetoric that seems to favor the idea of "magic bullets" like eliminating food dyes instead of focusing on large-scale programs that provide access to healthy food for low-income families or tackle air pollution, which is linked to asthma and other conditions.
"This administration has not been as excited to talk about the social policies that need to be in place to address onset of pediatric disease," she says.
"They have been looking at things that are splashier, easier to point the finger at, but again when you really actually think about the epidemiology of this it's not going to be the most effective strategy if they want to be serious about curbing this issue."
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