The MAHA Report: Dead Kids Don't Get Sick

Part IV of Reading the MAHA Report so You Don't Have to

RECAP: On Feb 13 2025, President Trump issued an Executive Order to create the Make America Healthy Again Commission, and directed them report on the “childhood chronic disease crisis”. The Commission was given 100 days and on May 22, their MAHA Report was released to the public.

Which is why I’m reading the MAHA Report; so you don’t have to.¹ You can find Part I here; Part II here; and Part III here. This is Part IV. Enjoy!

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The MAHA Report on the health of American children aims to Make Our Children Healthy Again (MOCHA?), but what do they mean by Again? When do they think American children were healthy? What time do they want to return to?

The Report doesn’t say explicitly, but if you read carefully, I think it’s reasonable to conclude they are talking about the 1970s and 80s. The Report several times refers to changes over the “past four decades” and earliest time point referenced in any of their graphs or factoids is 1970.

And you know what, it makes sense a lot of sense that RFK Jr, who was born in 1954, might look fondly on the 1970s and 80s.

These were his teenage and young adult years, and although he had just lost both his father and uncle to assassination, he clearly was living a wild and exciting life full of the proverbial drugs, sex, and rock and roll.

RFK Jr frequently talks about not having known any kids with allergies or ADHD or autism during his youth. But isn’t it possible that the reason he didn’t know kids with these conditions is because he was busy being arrested for drug possession and kicked out of fancy boarding schools?

On the other hand, it is true that (from the little data we have) rates of many of these conditions were lower in the past.

The key question is: WHY?

This is the question the remainder of the MAHA Report tries to answer. They place the blame on:

• “The food American children are eating”

• “American children’s exposure to environmental chemicals”

• “American children’s pervasive technology use”

• “American children are highly medicated — and it’s not working”

But I want to propose another reason that might have contributed to higher chronic disease rates in children compared to 40+ years ago: declining child mortality rates.

Children who die cannot get sick.

This is a simple and unavoidable truth. Kids who die as infants don’t get sick as teens. Kids who die as teens don’t get sick as young adults. Dead kids can’t get sick.

And, boy, oh boy, did children used to die!

Infant mortality in the 1970s was over 2000 deaths per 100,000 live births. That’s over 2% of all babies dying before their first birthday! Back in RFK Jrs “good old days” when American kids were “healthy”.

And it wasn’t just babies dying. In 1968, 108 of every 100,000 kids aged 15-19 died before their 20th birthday.

Today, that mortality rate is down by almost a half. And death rates are down even more in younger kids too. For babies, the death rate in 2020 was only 524 per 100,000. Barely half a percent. These are major public health wins!²

And, look, before you freak out, this is NOT me saying that we shouldn’t care about the health of children today.

There are definitely health care problems for children we should be addressing. The mortality rate for kids aged 15-19 has even started to go back up again in the last decade (even before COVID). This is a problem. A big one.

But we won’t be able to address chronic health problems in children unless we actually understand where they are coming from.

And that understanding requires us to ask this question: how many of the kids who currently have chronic diseases would have simply died before developing those diseases, if child mortality rates hadn’t gone down?

This isn’t just some academic exercise either. Because RFK Jr and his cronies are actively undermining many of the things that have helped keep our young children and teens alive, including vaccinations, prenatal and postnatal care, and food safety regulations.

If their actions cause child mortality to go up, will childhood chronic diseases rates go down? And, if so, will they call that a win?

This isn’t even to say that the problems the report highlights don’t need to be addressed. Access to healthy food including fresh fruits and vegetables is an important issue we need to improve for our kids. Programs like WIC (Women, Infants, and Children Nutrition Program) help do just that. But Trump is cutting them. Just like he’s cutting environmental regulations. And access to Medicaid, a major source of health care for American children.

And if American kids are spending too much time sitting at desks and using technology, it’s worth asking how much of that is because of the massive decades long government funding cuts to school programs like art classes, physical education, music, and drama?

So, yes, American kids are sicker. And so are American adults. But they’re also alive.

Let’s make sure that while we’re Making America Healthy, we don’t simply discard those we perceive as weakest. Again.

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The MAHA Report continues for another 50 pages. But I’m not going to read it. Because the purpose of this Report, as laid out in the original Executive Order was to:

study the scope of the childhood chronic disease crisis and any potential contributing causes, including the American diet, absorption of toxic material, medical treatments, lifestyle, environmental factors, Government policies, food production techniques, electromagnetic radiation, and corporate influence or cronyism

And it is abundantly clear from the first 20 pages that the authors have not even tried to do this.

Instead, they rehashed the same old, out-dated, and simplistic ideas they’ve been spouting for years. They present a random grab-bag of factoids and graphics which give the impression that they simply re-used whatever they happened to have on hand. And they focus entirely on negative changes while ignoring the many aspects of child health which have dramatically improved in the past 40 years.

This report does not study the scope of the childhood chronic disease crisis. It doesn’t even do a very good job of establishing that a crisis exists.

And it certainly doesn’t study any and all potential contributing causes.

You can’t study the causes of chronic disease without first ruling out that you’ve simply done a better job keeping people alive.

In epidemiology, we call this survivor bias. People who live longer are more likely to have chronic diseases. This is a known and well-established fact of life. And it’s why you can’t simply look at the last 40 years of child health data and conclude “modern society makes kids sick”.

Not when modern society also makes kids live.

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1. Reminder: I downloaded the MAHA Report from the government’s website on June 1 at 10:49am. They occasionally revise and repost the Report, so, there’s a possibility things I discuss here will have been changed or removed from any version of the Report you go download later.

2. COVID turned many of these trends around, and is also making many of the chronic disease issues in kids. Unfortunately for anyone who actually cares about the health of children, the MAHA Report only mentions COVID to complain about how it made technology more pervasive in American society.