RFK's chronic disease push clashes with federal rollbacks
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Photo illustration: Brendan Lynch/Axios. Photos: Anna Moneymaker and Paul Morigi, Getty Images
Health Secretary Robert F. Kennedy Jr.'s stated goal of ending what he calls a chronic disease epidemic is in conflict with some of the Trump administration's early regulatory rollbacks and DOGE-directed cuts, experts tell Axios.
Why it matters: Some 129 million Americans suffer from diabetes, hypertension, arthritis and other chronic diseases, with tens of millions more expected to develop chronic illness in the next five years. A disproportionate number are low-income or otherwise disadvantaged.
- Funding freezes on chronic disease research, the relaxation of environmental standards, and other recent moves are raising questions about whether the administration is squandering an opportunity to reverse the tide.
Catch up quick: Kennedy has homed in on "safe, wholesome food, clean water, and the elimination of environmental toxins" as the keys to preventing chronic disease and has repeatedly said he wants to see more research focused on determining the "root causes" of chronic illness.
- In an interview with CBS on Wednesday, Kennedy said the Food and Drug Administration should "look at the chemicals" in food.
Yes, but: Health experts point out that there's already a compendium of research on what causes chronic diseases and how to prevent them. Many are questioning the administration's priorities and say recent proposals for ending chronic disease aren't incorporating evidence-based information.
- "We know so much about the root causes of chronic diseases but actions taken by the current administration are not aimed at addressing the real root causes," said Susan Mayne, a professor at Yale School of Public Health and former FDA official.
- "Instead they are focusing on food additives not known to have an impact on chronic disease."
- The American Public Health Association on Wednesday called for Kennedy to resign, citing "implicit and explicit bias and complete disregard for science."
What they're saying: An HHS spokesperson told Axios that the agency is "taking swift action through gold-standard, evidence-based science" and that the media cherry-picks expert sources.
- Kennedy has said that the U.S. health system is broken, citing the country's massive spending on health care and comparatively poor outcomes.
Studies have found obesity and exposure to environmental pollutants — two key risk factors for chronic diseases — are linked to individuals' socioeconomic status.
- "I wholly agree with Secretary Kennedy when it comes to his comments regarding improving the quality of our food supply and reducing the amount of toxins circulating in our air and water," Gabriel Benavidez, an epidemiologist and assistant professor at Baylor University, told Axios in an email.
- "But the focus needs to center people of low socioeconomic status if it actually hopes to gainfully improve chronic disease in the U.S.," he said.
State of play: Kennedy this week said he would direct the Centers for Disease Control and Prevention to stop recommending fluoride be added to water — a practice that public health and dental experts say helps to protect children's teeth, especially those who don't have regular access to dental care.
- Among Kennedy's claims are that fluoride is linked to thyroid cancer, bone loss and other conditions, but health experts say there isn't conclusive evidence to support those claims.
- Amid a slew of environmental regulation rollbacks, the administration also dropped a lawsuit that would require a chemical manufacturer in Louisiana's "Cancer Alley" to reduce emissions of chloroprene, which the EPA has determined to be likely carcinogenic.
- Last month, federal Medicaid regulators rescinded guidance that encouraged states to cover services that address health-related social needs, like housing and nutrition supports. One former HHS official wrote online that scrapping the guidance shows the Trump administration doesn't understand what actually drives poor health.
- The administration has encouraged states to block Supplemental Nutrition Assistance Program funds from paying for sodas, but food policy experts are skeptical that the change would significantly improve health.
Zoom in: The DOGE-directed cuts that have eliminated 10,000 jobs within Kennedy's department, on top of 10,000 others who've voluntarily left or retired, have also undercut chronic disease prevention, experts said.
- All staff working on the CDC Arthritis Program appear to have been laid off, according to patient advocates who collaborated with the program.
- "Coming in and drastically cutting without evaluating is not helping any of the programs get better for chronic disease patients," said Steven Taylor, CEO of the Arthritis Foundation.
Between the lines: Local public health departments are the engine behind diabetes education, improving access to healthy food and other efforts, Benavidez said.
- "They are historically underfunded and this administration should aim to increase the resources for local health departments, especially in many rural areas."
- But HHS has clawed back more than $11 billion in funding from state and local health departments — a move halted by a federal judge last week. Kennedy told CBS on Wednesday that he is "not familiar" with the cuts.
What to watch: A commission created by President Trump and chaired by Kennedy is within months due to submit an assessment of childhood chronic disease in America and evaluations of current programs for preventing childhood health conditions.
- "One would hope that they're again asking folks who have studied this their entire life and going to authoritative sources," said Anand Parekh, chief medical adviser for the Bipartisan Policy Center. "But it's a bit of a mystery. We don't really know."

