Will RFK Jr. make America healthy again?

Social determinants of health – nonmedical factors that influence a person’s health and risk of disease – received much attention since the COVID-19 pandemic. Could SDOH continue to draw attention as part of the Trump administration’s Make America Healthy Again commission? Some health care observers believe it will.

Robert F. Kennedy Jr. is only a few weeks into his job as secretary of Health and Human Services. A panel of health care observers discussed how Kennedy might make America healthy again during a recent webinar by the University of Southern California Center for Health Journalism.

“At its core, MAHA has a lot of overlap with SDOH – this idea that health care really is about the life that you live. I think MAHA is somewhat consistent with that,” said Dan Gorenstein, executive editor of Tradeoffs.

“Are you going to have a Centers for Medicare and Medicaid Services that is open to thinking about ways to improve health beyond traditional health care delivery reforms and insurance reforms?  If we take Kennedy and the MAHA movement, then I would say we’ll continue to see efforts around SDOH initiatives. In the past decade and because of COVID-19, there is a lot more recognition that health care is much bigger and broader than the hospital or the doctor’s office. Under Kennedy, we are more likely to see a continuation of SDOH work than we are to see it shut down.”

RFK Jr. taking on Big Food

Kennedy has stated that he wants to take on Big Food and examine the amount of sugar and unhealthy additives in ultra-processed food. Gorenstein said Kennedy “is talking a big game. What can he really do about regulating food policy?”

One area in which he could do something is updating the Food and Drug Administration’s dietary guidelines, something that the FDA does every five years and is scheduled to do by the end of this year.

Another area is carrying out a proposed rule that would move key nutrition information to the front of food packages. Gorenstein said this could take years to implement, with a lengthy extended rules process and a possible court challenge.

What about vaccines and public health?

Infectious diseases such as measles are back in the forefront after a current measles outbreak in West Texas left one child dead and sickened more than 100 other people. Kennedy, a noted vaccine skeptic, has said he does not want to take vaccines away but that people should have a choice and he wants to make vaccine information available so that individuals can make that choice.

“What does that mean? What does that look like? No one really knows,” Gorenstein said.

As HHS secretary, Kennedy has authority over the Advisory Committee on Vaccine Practices, which Gorenstein described as “the most powerful committee that no one has ever heard of.” Kennedy has the ability to remove or add committee members at will. Gorenstein said it’s possible that Kennedy could appoint committee members who favor a more relaxed guidance on vaccines.

‘We’re off to a bad start’

“When you have the secretary of HHS fully recognizing at the beginning of his tenure that we have an absolutely preventable death of a child due to measles in the U.S., in West Texas, and does not condemn that specific situation as something of a gross failure of public health – we’re off to a bad start,” said James Hodge, director of the Center for Public Health Law and Policy at Arizona State University.

“This is not the tone I would want to hear from an HHS secretary out to protect the public’s health with every available opportunity for the use of safe and effective vaccines. That’s what’s breaking down in some communities across the U.S. That’s what we will continue to face – deaths just like this, absent real information about the utility and safety of vaccines going forward.”

If MAHA wants to advance health initiatives, state and local governments are willing to work with them, Hodge said.

“It’s the opportunity cost of doing so – when you put infectious diseases as a second-rate concern over chronic diseases, chronic diseases are what kill people but you don’t sacrifice infectious disease control efforts along the way because they will kill young children in Texas as a result.”

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at susan.rupe@innfeedback.com.