This story originally appeared in Kids Today, Vox’s newsletter about kids, for everyone. Sign up here for future editions.
One of the central claims that Robert F. Kennedy Jr. has made as secretary of the US Department of Health and Human Services and de facto leader of the Make America Healthy Again (MAHA) movement is that American kids are getting sicker.
According to experts, that claim happens to be largely correct.
A study published earlier this month in JAMA found that an American child was 15 to 20 percent more likely to have a chronic health condition in 2023 than in 2011. Americans are now more likely to die in childhood than Europeans, and their lives are increasingly marked by illness: rates of asthma, diabetes, sleep apnea, and even eye problems and hearing loss, are all on the rise.
Kids are also living with more distress than in years past. They’re experiencing more depression, anxiety, and loneliness, as well as more physical pain and fatigue, Christopher Forrest, a professor of pediatrics at Children’s Hospital of Philadelphia and one of the authors of the study, told me.
“There’s a major crisis in children’s health in this country that has been under-recognized and not addressed for decades,” Forrest said.
Some experts have applauded Kennedy for at least talking about children’s health in the MAHA report, released in May with a follow-up reportedly planned for later this year. However, the crisis identified by researchers with decades of experience in epidemiology and pediatrics is very different from the one that the MAHA commission — led by Kennedy and staffed by Trump administration appointees — describes.
The MAHA report “serves a critical purpose: exposing a disturbing reality unfolding across the nation—the scale of the chronic disease epidemic and the institutional failures that allowed it to grow unchecked for decades,” an HHS spokesperson told me in an email.
But the report breaks from scientific consensus in its discussion of the causes of kids’ illness, the solutions, and even what a childhood disease is. The result, experts say, is a document that highlights the very real problem of kids’ health while also pushing misleading ideas that could hurt or kill American kids. (The initial version of the report was criticized for citing studies that did not exist, possibly the result of using AI to compile it.)
“They get some things right, but then they embed those correct assertions in a toxic stew of misinformation,” said Philip Landrigan, a pediatrician and the director of the Program for Global Public Health and the Common Good at Boston College.
Meanwhile, rather than tackling major drivers of kids’ illness like pollution and poverty, Kennedy has so far focused on smaller issues like food dyes, experts say. At the same time, his health department exists within an administration that’s working against kids’ health on multiple fronts, from cutting Medicaid to relaxing environmental regulations.
“The attention that we’re finally getting paid to this issue is great,” said Lauren Wisk, a health services researcher at UCLA who studies pediatric chronic disease. But “I will be much more enthusiastic about this administration if they would actually make a good-faith effort to address the issue.”
What MAHA gets wrong about childhood illness
The MAHA commission and a broad swath of scientists agree that children’s health in America is a problem that urgently needs attention. But they don’t agree on what the problem is.
In a chapter titled “The Chronic Disease Crisis: A Generation at Risk,” the report cites rising rates of diabetes, childhood cancers, allergies, autoimmune diseases — and autism. Kennedy has focused special attention on autism for years, falsely linking it with vaccines and, more recently, pledging to find the cause of the supposed “autism epidemic” by September.
But “I don’t think we’ve ever considered autism an illness or a disease,” said Helen Tager-Flusberg, an emerita professor of psychological and brain sciences at Boston University who has studied autism for decades.
Autism is a neurodevelopmental condition and can be a disability, but it’s not a disease like cancer or diabetes, and it’s not helpful to conflate it with chronic illnesses that affect children, experts say.
In this way, the MAHA report is “a real blast from the past,” Zoe Gross, director of advocacy at the Autistic Self Advocacy Network, told me. Fifteen years ago, it was very common “to rhetorically compare autism to pediatric cancer or pediatric HIV — things which harm the body, which can be deadly,” she said. “It’s meant to inspire fear, to stigmatize autism by associating it with these diseases that are harmful and can hurt and kill people.” Kennedy has been accused of stigmatizing autism in the past, saying the diagnosis “destroys” families, and that “these are kids who will never pay taxes,” have a job, or “play baseball,” comments that inspired outrage from many autistic people and their families.
It’s also not clear that rates of autism are rising in the way that rates of some chronic diseases are. Autism diagnoses have been increasing since the 1960s, but in that time “there’s been an enormous and highly successful effort to bring autism to the awareness and understanding of the general population,” resulting in more diagnoses that might have been missed in the past, Tager-Flusberg said. Though factors like rising paternal age may play a role, much of the increase in autism likely comes from improved screening and awareness, experts say.
Kennedy, however, has often maintained that there must be an environmental cause of autism — if not vaccines, then perhaps a toxin introduced in the late 1980s. Much of the MAHA report focuses on environmental factors — chemicals in foods and the environment that could be making kids sick.
“Data on autism, ultra-processed foods, environmental toxins, and the overmedicalization of children has gone largely unnoticed and the Trump administration is bringing this crisis to light,” the HHS spokesperson told me.
Parents need to worry about some chemicals — but not vaccines
Many pediatricians, epidemiologists, and other experts agree that chemicals in kids’ environment could be harming them. “The increase in rates of a whole series of chronic diseases parallel increases in chemical production and in dissemination of chemicals into the environment,” Landrigan, the Boston College public health scholar, told me.
For example, phthalates, substances used in plastic packaging, can harm the development of the brain and reproductive organs, Landrigan said. Bisphenol A, a compound once used in packaging and receipts, has been linked to diabetes and heart disease. Air pollution, both outdoor and indoor, plays a role in childhood asthma, said Frederick Rivara, a professor of pediatrics at the University of Washington who co-wrote a recent JAMA editorial on children’s health.
In its discussion of possible causes of kids’ chronic illness, the MAHA report includes phthalates, bisphenols, and other substances that scientists are concerned about. But it also includes substances that scientists aren’t concerned about, like vaccines. The report cites the “growth of the childhood vaccine schedule” and parental concerns about vaccines’ “role in the growing childhood chronic disease crisis.”
There is no evidence that the childhood vaccine schedule is harmful to kids, however, and skipping vaccines can leave them vulnerable to diseases like measles, which has sickened more than 1,000 people this year and killed two children.
“There is no single public health intervention that has saved more human lives than vaccines,” Landrigan said, and casting doubt on vaccination “is going to lead to unnecessary deaths in American children.”
The Trump administration is hurting kids’ health
The MAHA report is not necessarily intended to offer policy solutions. “This report is a diagnosis,” the HHS spokesperson told me. “The second policy report will be a prescription for America.”
However, the Trump administration’s policies are often at odds with what experts say would improve kids’ health. For example, the first step in protecting children from potential environmental harms would be mandatory toxicological testing of chemicals before they come to market, as well as compounds that are already on the market, Landrigan said.
But the Environmental Protection Agency and Republicans in Congress are trying to weaken, not strengthen, regulations around chemicals in the air and water — even pollutants like lead and mercury that have been recognized as harmful for decades. As Vox’s Dylan Scott reported, Kennedy has yet to speak up around these efforts, despite pressure from some in his MAHA coalition.
Chemicals are not the only threat to kids’ health. One of the main reasons for the difference in childhood mortality between the United States and other wealthy countries is our higher rate of premature birth, Forrest, the Children’s Hospital of Philadelphia pediatrics professor, told me.
“Women are entering pregnancy less healthy,” with conditions like hypertension that can be managed with proper prenatal care, Forrest said — but that care is often unavailable. “The crisis in infant health is really a crisis in women’s health.”
Improving kids’ health and fighting chronic disease will be a multipronged endeavor, Forrest said. But an important first step would be universal prenatal care, as well as primary care for women so that they’re healthy when they become pregnant. If we could combine those supports with paid parental leave and high-quality child care, “we would be a long way towards improving the health of kids,” Forrest said.
However, the Medicaid cuts in Trump’s “big, beautiful bill” will threaten Americans’ access to health care, Rivara said. The cuts could close rural hospitals, making it even harder for pregnant people to find adequate care.
Improved access to fruits, vegetables, and other fresh foods would also improve kids’ health, experts and advocates say. “Many people do lack access to fresh produce because of food deserts and because of poverty,” Gross said. “Giving people more access to things like SNAP benefits would be a great way to fight that. Of course, this administration has just cut SNAP benefits pretty enormously in their budget bill.”
It’s possible that the second MAHA report will include more policy recommendations in line with what experts have suggested, or that Kennedy will decide to take on the EPA and others in the Trump administration who seek to weaken environmental regulation. But for now, he has largely concentrated on issues like food dyes that experts say are likely to have minimal impact on kids’ health.
“Where the MAHA report, and where MAHA generally, falls really short is in proposing any meaningful solutions,” Landrigan said.
Kids are speaking out about deportations and the presence of US Immigration and Customs Enforcement in their communities. “Last week, one of our classmates was deported,” a Maryland high school group wrote. “We’re heartbroken, we’re angry, and we’re not staying silent.”
High school students were invited to create a mural on the National Mall showing issues they face in their lives. But when they included the message “Free Palestine,” Smithsonian officials covered the mural with a tarp.
According to a couple of TikToks, Gen Alpha kids are no longer laughing at farts.
My little kid is obsessed with We Are in a Book! in which the main characters discover that they are characters and can force the reader to read words (i.e., “banana”) just by uttering them. He now demands that all bedtime stories be autofictional meta-narratives about someone telling a story to children. This kind of story might sound easy to produce, but he still yells at me a lot for doing it wrong.
