David Johnson: RFK Jr. will focus on ‘Getting America healthy again’ — and maybe it’s possible

On Aug. 23, 2024, Robert F. Kennedy Jr. suspended his 14-month campaign for the U.S. presidency. Kennedy began his campaign as a Democrat in April 2023 but left the Democratic Party that October. Kennedy’s grassroots volunteers then collected over a million signatures to place his name on the ballot in more than 30 states as an independent, third-party candidate.

In addition to suspending his campaign, Kennedy announced his support for Republican candidate Donald Trump. In exchange for his endorsement, Trump agreed to grant Kennedy broad inter-departmental authority within his new administration to address the chronic disease epidemic plaguing the nation. Given Trump’s selection of Kennedy as his administration’s Secretary of Health and Human Services, it is worthwhile considering how he will lead the agency.

A legitimate focus on chronic disease

Despite its long and often rambling character, Kennedy’s campaign-suspension speech contained a concise and cogent analysis of the existential harm that rampaging chronic diseases are inflicting upon the American people.^a His speech also included concrete recommendations for reversing the upsurge in chronic diseases along with this remarkable pledge:

If I’m given the chance to fix the chronic disease crisis and reform our food production, I promise that within two years we will watch the chronic disease burden lift dramatically. We will make Americans healthy again (MAHA). Within four years, America will be a healthy country. We will be stronger, more resilient, more optimistic and happier. I won’t fail in doing this.

Controversy aside, it’s a worthy goal

It appears, at least initially, that Kennedy will have the expansive health policy mandate that he desires. Politico Future Pulse has declared “It’s a MAHA world now._”^b In his post-election victory speech, President-elect Trump proclaimed, “He [Kennedy] wants to do some things, and we’re going to let him go to it. Go have a good time, Bobby.”

Kennedy is a controversial figure in health policy circles. His scientifically discredited beliefs regarding vaccines and fluoride are a source of legitimate concern. In a Bloomberg opinion piece titled “RFK Jr. will not be good for America’s health,” columnist Lisa Jarvis expresses extreme reservations:^c

[It’s] clear that Kennedy is enjoying an influence that could fundamentally undermine the tenets of evidence-backed medicine and public health during the second Trump administration.

For now, however, let’s assume that RFK has good intentions and not throw his health reform “baby” out with the political “bathwater.” Widespread chronic disease is robbing the American people of their vitality, lowering their productivity and decreasing their life quality. We like to think of the United States as “the land of the free and home of the brave.” On current trend lines, our country is well on its way to becoming the land of the sick and the home of the frail. This is not acceptable.

Time to challenge an unacceptable status quo

It’s clearly time for new energy and new thinking. The same status-quo approaches to reforming the broken U.S. healthcare and food systems will generate more of the same dismal outcomes, including skyrocketing costs, greater health inequities and declining life expectancy.

The healthcare and food industries, aka Healthcare Inc. and Food Inc., have failed to reform themselves from within. Instead, they use their political clout and market leverage to sustain business models that optimize revenues and profitability at the expense of the nation’s health.

Whether we agree with his political positions or not, we should support giving Kennedy the opportunity to build his team and present his reform program before Healthcare Inc. and Food Inc. have a chance to launch all-out campaigns, which they likely will do, to neutralize his impact.

The chronic disease pandemic

America was already sick in early 2020 when COVID-19 hit our shores. The pandemic preyed on individuals with one or more chronic diseases, particularly in low-income rural and urban communities. When in May 2023, HHS declared the public health emergency for the pandemic as having ended, the nation had incurred 16.9% of global COVID deaths despite having just 4.2% of the world’s population.^d

The links between unhealthy lifestyle behaviors and chronic diseases are well documented. As detailed in a fact sheet by the Stop Obesity Alliance, obesity is a leading cause of diabetes, heart disease, cancer, stroke and osteoarthritis. The fact sheet describes obesity as follows:^e

OBESITY is a complex chronic disease in which abnormal or excessive accumulation of body fat impairs health. Adult obesity rates have more than doubled since the 1980s — in the U.S. today, obesity affects over 42% of adults and 18% of youth. Obesity and its related complications are major drivers of rising healthcare costs, diminished health-related quality of life, and the recent decline in U.S. life expectancy.

A recent NIH study also links obesity to dementia and Alzheimer’s disease.^f

Improving health by reducing obesity is the best strategy for reversing the rapid rise in chronic diseases. As chronicled by Leana S. Wen, MD, in a Washington Post commentary, an obesity-first treatment regimen is emerging as the first line of defense against chronic diseases.^g Losing weight and becoming more active, particularly with children and young adults, can significantly reduce the risks of contracting many chronic conditions.

The impacts of obesity — and what’s driving them

Kennedy is particularly passionate about the life-limiting impacts that obesity and chronic diseases are having upon America’s children. In his remarks on Aug. 23, Kennedy recited a litany of dismal statistics to illuminate the threat’s magnitude.  Here are just a few:

• 18% of American teens have fatty liver disease
• 77% are unfit to serve in the military
• Young adult cancers are up 79%
• 40% of teens have a mental health diagnosis 

Kennedy identifies highly processed foods and toxic chemicals as well as catastrophic government policies as the primary sources of America’s chronic disease epidemic. By some reports, over 54% of food stamp purchases and 70% to 75% of school lunches consist of highly processed foods. ^h Collectively, they present a clear and present danger to America’s wellbeing and way of life.

Concurrently, the U.S. government subsidizes sugar, tobacco, fructose and other commodity crops far more than fruits and vegetables. These are the types of industry-influenced policy choices that Kennedy references when concluding that America is “poisoning” its children and most vulnerable adults.

A campaign that favors all Americans

It’s very hard to fault Kennedy’s sincerity in promoting new approaches to managing the nation’s health. As the following passage conveys, RFK believes a collective American effort to get healthier together can become a unifying force for transforming our divisive politics and rebuilding our collective trust in one another:

Ultimately, the only thing that will save our country and our children is if we choose to love our kids more than we hate each other…

Instead of vitriol and polarization, I will appeal to the values and goals that we could achieve if only we weren’t at each other’s throats. The most unifying theme for all Americans is that we all love our children. If we all unite around that issue now, we can finally give them the protection, the health, and the future that they deserve.

To those words, I would add that, as a nation, we can no longer afford the extreme expense generated by our addiction to processed foods and our healthcare system’s over-emphasis on disease-centric treatment. Nor can we continue to tolerate the poor health outcomes that we have reaped from these detrimental behaviors and the systems that perpetuate them.

These systems require revolutionary, not evolutionary, change. Incremental adjustments to already-broken food and healthcare systems will not improve our national wellbeing.

Big changes require big ideas and visionary leadership. Robert F. Kennedy Jr. is now well-positioned to pursue his strategy for getting America healthy again. Let’s see what he can do.

Footnotes

a. Associated Press, “LIVE: RFK Jr. suspends his presidential bid (FULL SPEECH),” YouTube, Aug. 23, 2024.
b. Payne, D., et al., “It’s a MAHA world now,” Politico, Nov. 6, 2024.
c. Jarvis, L., “RFK Jr. will not be good for America’s health,” Bloomberg, Nov. 7, 2024.
d. Statista, “Number of novel coronavirus (COVID-19) deaths worldwide as of May 2, 2023, by country and territory,” 2024; and Worldometer, “United States population,” as of Nov. 15, 2024.
e. Stop Obesity Alliance, “Fast facts – obesity-related chronic disease,” Feb. 26, 2020.
f. Flores-Cordero, J.A., et al., “Obesity as a risk factor for dementia and Alzheimer’s Disease: The role of leptin,” International Journal of Molecular Sciences, May 6, 2022.
g. Wen, L.S., “Opinion How ‘obesity first’ health care is transforming medicine,” The Washington Post, Oct. 1, 2024.
h. Leung, C.W., et al., “Food insecurity and ultra-processed food consumption: the modifying role of participation in the Supplemental Nutrition Assistance Program (SNAP),” American Journal for Clinical Nutrition, Feb. 24, 2022; and Whiteland, L., The harmful effects of serving processed food at schools,  California State University research paper citing findings by Northeastern University’s Network Science Institute, May 19, 2023.