Co-opting health

The impacts of ideology on the public's health

I believe deeply in the power of language and its impact on our culture. Growing up, I watched my grandfather, a local elected official, navigate this responsibility with care. His commission meetings were televised, and while the audience might have been small, he spoke with precision and purpose, avoiding overt politicking and focusing on the tasks at hand. This was an era before the internet and social media amplified every word to millions.

I learned a lot about how to talk on difficult issues carefully. I learned the importance of listening, really listening, so that the person in front of you felt heard. But perhaps most importantly, I learned how policy should always be about the people and not just the political ideology behind a party.

With this formative experience as a backdrop, I am watching with great interest all that’s happening at the Department of Health and Human Services (HHS).

Robert F. Kennedy Jr., the new Secretary of HHS, has embarked on a sweeping health initiative that leans heavily on pseudoscience and some interesting fringe theories. His "Make America Healthy Again" (MAHA) platform, while ostensibly aimed at improving public health, often sidesteps credible, evidence-based practices. Instead, it promotes ideas like vaccine skepticism and exaggerated fears about fluoride and pesticides, extending its influence into agencies like the USDA and EPA.

Even as I write this post, Secretary Kennedy is sitting in front of committees in Congress doing his best to sell his reorganization plan (which is being challenged in court) and his FY 2026 budget cuts. This is a hard job, and no committee in Congress is easy to sit in front of, but there’s just so much at stake so it’s hard not be a bit critical of what’s happening.

Unfortunately, so far, there’s been more health theater than health policy and that can be dangerous. We’ve seen what happens over and over when “belief based policy” wins out, and it’s not good for the American public (I am looking at you, work requirements and Medicaid!).

Public health relies on trust; a trust that has eroded over recent years, particularly during the COVID-19 pandemic. Now, that trust is further jeopardized by leadership that prioritizes ideology over expertise. Just as one example, Kennedy has made past comparisons of vaccine mandates to Nazi Germany and his contradictions of scientific consensus on nutrition and environmental safety send a concerning message.

The MAHA agenda might appear appealing on the surface, including addressing chronic disease and advocating for a cleaner food system; however, when policies are based on unverified beliefs rather than vetted science, they don't just fail, they backfire, harming the very communities they're meant to help.

Consider the recent measles outbreak in the U.S., the worst in 25 years, resulting in multiple deaths and hundreds of hospitalizations, primarily among unvaccinated children. Kennedy's response included downplaying the severity and suggesting that natural immunity is preferable to vaccination. These actions have drawn sharp criticism from health experts and have led to resignations within the HHS, including the top vaccine official at the FDA.

The mental health implications of these decision are profound. In an era marked by anxiety and institutional fatigue, the public needs clarity and factual guidance. Instead, they're met with confusion and mixed messages, fueling distrust and doubt that extend beyond health into broader societal skepticism.

Moreover, Kennedy's alignment with wellness influencers could raise ethical concerns. Some of these influencers businesses have reportedly benefited from HHS policies, blurring the lines between public service and private gain.

The recent nomination of Dr. Casey Means as Surgeon General further exemplifies this trend. Means, a wellness influencer without an active medical license, promotes alternative health perspectives that align with Kennedy's MAHA ideals. Her nomination has sparked backlash, even within Trump's base, highlighting internal divisions over the direction of health policy.

And let’s be clear: it’s the contradictions at the heart of MAHA that are the most problematic. As Dr. Leana Wen pointed out this week, the MAHA movement claims to prioritize disease prevention, yet openly shuns vaccines, one of the most proven tools we have. Kennedy has railed against obesity drugs, antidepressants, and ADHD medications, offering instead vague promises of “healing farms” and gut health revolutions. But when it comes to preventing infectious disease? Suddenly he pivots to treatment, refusing to promote the MMR vaccine even in the middle of the worst measles outbreak in decades. It’s a logic puzzle, avoid pharmaceuticals for chronic disease, but also avoid preventing infectious ones? If MAHA’s north star is better health, its actual path looks more like ideology than a science-based strategy.

What’s equally troubling is the broader dismantling of the scientific infrastructure that supports real and lasting health progress. In another article examining MAHA, Robert Klitzman warned how the Trump administration’s deep cuts to research funding and education, including gutting the NSF and eliminating the Department of Education, threaten the very engine of medical and public health advancement. You can’t claim to be making America healthy while defunding the institutions that make modern health care possible.

And then there’s the National Institutes of Health (NIH).

In a recently published JAMA article examining what’s been cut at the NIH, between February and April 2025, 694 grants across 24 of its 26 institutes and centers amounting to $1.81 billion with $544 million unspent at the time of termination. The cuts disproportionately affected the National Institute on Minority Health and Health Disparities (NIMHD), which lost nearly 30 percent of its total active grant funding, and the National Institute of Mental Health which was cut just as much.

As an academic and someone who used to be fully dependent on grants to support my time and research, I was extremely worried how many of the terminated grants weren’t just large scale research projects (58 percent) but close to 20 percent of these cuts were early-career or training grants. It’s obvious to me, but cutting these funds truly undermines our future workforce development in science and medicine.

While questioning and reforming health systems is necessary, it must be grounded in rigorous research and data, expert insight, and ethical responsibility not populist showmanship or conspiratorial crusades. Kennedy's overreach might score short-term political points, but in the long run, it risks leaving a deeper scar: a country more divided, confused, and anxious about whom to trust regarding health. Language matters.

And just when it seemed the mental health landscape couldn’t be more under threat, the administration quietly signaled plans to rescind the federal mental health parity rule, which I am sure that every reader to this Substack knows is a key protection that requires insurers to cover mental health care at the same level as physical health. Let that sink in: while Kennedy talks about reimagining mental health, the administration is actively dismantling one of the most meaningful, practical supports for people looking to get help for mental health. You can’t claim to prioritize mental health while gutting the very rules that make access to care possible. I just don’t see it.

And where’s the strategy in all of this? Maybe that’s my bigger question.

We must advocate for a return to evidence-based health policies that prioritize public well-being over political agendas. The integrity of our health systems and the mental health and well-being of our communities depend on it.