The Trump administration's Make America Healthy Again (MAHA) Commission has released a comprehensive report calling for urgent federal action to address what it describes as a national crisis in children's health. The 73-page assessment, developed in just over three months, presents alarming statistics on chronic disease among American youth and outlines a strategy requiring coordination across multiple government agencies.
Rising Chronic Disease Rates Among American Children
According to the MAHA report, more than 40% of U.S. children now have at least one chronic health condition. Childhood obesity rates have more than tripled since the 1970s, with over 350,000 children currently diagnosed with diabetes. Neurodevelopmental disorders show concerning trends, with autism now affecting 1 in 31 children. Mental health challenges are also surging, with one in four teenage girls experiencing a major depressive episode in 2022, and suicide ranking as the second leading cause of death among teens.
The report identifies four primary drivers behind this health crisis: poor diet dominated by ultraprocessed foods, widespread environmental chemical exposure, sedentary and digitally-driven lifestyles, and excessive medical intervention.
"We will end the childhood chronic disease crisis by attacking its root causes head-on—not just managing its symptoms," said HHS Secretary Robert F. Kennedy Jr., who chairs the commission. "We will follow the truth wherever it leads, uphold rigorous science, and drive bold policies that put the health, development, and future of every child first."
Dietary and Environmental Factors
The American diet has shifted dramatically toward ultraprocessed foods (UPFs), which now constitute nearly 70% of children's caloric intake, according to the report. These foods, high in added sugars, refined grains, and synthetic additives, are strongly linked to obesity, diabetes, and nutritional deficiencies.
Environmental exposures represent another significant concern. The report states that children are exposed to more than 40,000 chemicals through food, water, and air—often during critical developmental windows—yet current regulatory systems fail to evaluate the combined risks of these exposures.
Children's increasingly sedentary and screen-focused lifestyles—averaging 9 hours of daily non-school screen time—are contributing to rising rates of physical inactivity, chronic stress, poor sleep, and declining mental health, the commission found.
Pharmaceutical Industry Influence and Overmedicalization
The report takes direct aim at what it terms "corporate capture" of public health policy, particularly by pharmaceutical companies. It notes that the pharmaceutical industry spent $4.7 billion on lobbying between 1999 and 2018, more than any other sector, and highlights that 9 out of the 10 past FDA commissioners have gone on to work for industry.
"Corporate capture entails the systematic distortion of scientific literature, regulatory processes, clinical practices, and public discourse by pharmaceutical and healthcare industries, all aimed at maximizing profits," the report states.
The commission expresses concern about overmedicalization, noting that one in five children receives a prescription medicine in any 30-day period. The report specifically questions the growing use of GLP-1 drugs in children to treat obesity and suggests that the American Academy of Pediatrics' clinical guidance on this issue was influenced by industry.
Vaccine policies also feature prominently in the report, which calls for "more rigorous clinical trial designs" to examine potential links between vaccines and chronic disease. This aligns with HHS's recent policy requiring vaccines to be tested in placebo-controlled trials prior to approval, a move that has drawn criticism from some medical experts.
"If you look at that MAHA document that just came out, 70 page document, I mean, it's just full of distrust," said Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia and a member of the FDA's Vaccines and Related Biological Products Advisory Committee.
Proposed Solutions and Expert Reactions
The MAHA Commission proposes a whole-of-government strategy to address these challenges, including redirecting policy to focus on prevention, food quality, environmental safety, and independent scientific research. It advocates prioritizing American farmers and whole foods, and supporting "gold-standard" science free from corporate interference.
Specific recommendations include:
- A National Institutes of Health initiative to improve the reproducibility of science
- Establishing a real-world safety data monitoring system for pediatric drugs
- Creating programs to independently replicate findings from industry-funded studies
- Expanding NIH and Centers for Medicare and Medicaid Services' autism initiatives
- Implementing large-scale lifestyle interventions
- Conducting long-term drug safety research on commonly prescribed pediatric medications
However, some experts have questioned the effectiveness of the proposed solutions. Philip Landrigan, MD, MSc, professor of pediatrics at Boston College, told NPR: "They make a great diagnosis and they have a very weak treatment plan. It's impossible to read this report and not think about the disconnect between the noble words in this report and the reality of what the Kennedy team is doing on the ground to EPA and CDC and the National Institutes of Health."
Critics also note that the report lacks a comprehensive examination of socioeconomic factors and social determinants of health that contribute to childhood disease patterns.
A more detailed strategy is expected to be released in another report and implemented within 180 days of the February executive order establishing the commission. The MAHA initiative aims to balance consumer protection and economic interests, particularly regarding pesticides and chemicals commonly used in agriculture.
The commission includes leaders from Management and Budget, Agriculture, Education, the Environmental Protection Agency, Veterans Affairs, the FDA, and other federal agencies, reflecting the administration's stated commitment to a coordinated approach to this public health challenge.
