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Today on Vox, senior reporter Keren Landman is exploring the ways polarization is encouraging Americans on both sides of the political aisle to “distrust experts, dislike policies with clear health benefits, embrace policies with clear health risks, and make self-destructive choices.”  

That mistrust is in many ways embodied in — and complicated by — the rise of Robert F. Kennedy Jr., who initially ran for president as a Democrat, then an independent, and is now Republican President-elect Trump’s pick to lead the Department of Health and Human Services.  

A preeminent anti-vaxxer and peddler of conspiracy theories around health, he speaks to a broad range of Americans who’ve come to doubt the expertise of the scientific community. Though not a physician nor a scientist, if confirmed by the GOP-led Senate, Kennedy would be at the helm of the nation’s foremost health agency. He’s already making his policy agenda clear through his MAGA-adjacent movement, which he’s dubbed Make America Healthy Again. 

It’s probably not surprising that there’s plenty of conjecture — and misinformation — about just what he might do, from creating “wellness farms” for people to quit longstanding, FDA-approved medications to inveighing against weight-loss drugs such as Ozempic, whose manufacturer he has accused of taking advantage of unwitting American consumers.

So, this week, I spoke with Keren, a physician trained in internal medicine, epidemiologist, and one-time disease detective at the US Centers for Disease Control and Prevention, as she covers Kennedy and his growing influence on American health. (Our conversation has been edited for length and clarity.) 

Lavanya Ramanathan: In broad strokes, what should we know about Robert F. Kennedy Jr.? 

Keren Landman: Really, his contact with health, at least his professional contact with health, is that he has helped lead an organization called the Children's Health Defense. But he's a lawyer by training — an environmental health lawyer, and he spent a lot of his career litigating cases around pollutants causing health effects in people. 

I think he feels that gives him a lot of legitimacy, and I think a lot of people feel it gives him a lot of legitimacy, to talk about various things in the environment or medicines and link those with various health effects. But he really over-simplifies a lot of the things that science aims to understand better, and he really distrusts people who actually trust science.

In that way, his rise intersects with what’s happening on a larger cultural level in the United States, right?

He and Trump both style themselves as people who know what’s really going on, who are the ones who can fix the problems that have been created by the rest of the world. They offer simple solutions to people, and they are convinced that the way forward is in those simple solutions, and not in the more complex approaches to problem-solving that intellectual elites have. I think this is really appealing to a lot of people. 

They really distrust the elites. They distrust experts. And that's a way to hook people who also feel like they have not been given good reasons to trust experts. 

Healthcare is a mess now, right? A lot of people have trouble even finding a primary care doctor, much less finding health coverage. We’re constantly getting surprised by bills that turn up, even despite the No Surprises Act. We have to wait six months for an appointment just to see a new doctor in certain markets.  So just from stem to stern, Americans’ interactions with healthcare are bad. Unless you’re following healthcare policy, it's really hard to figure out why, so a lot of people are just angry. 

Kennedy gives people a much simpler solution that's completely outside that whole system, that says you don’t need all that. You can do your own research. You don’t need all the stuff they’re trying to sell you. You just need good food and exercise and clean water.

So Kennedy has proposed Make America Healthy Again, a movement intertwined with Make America Great Again. What does this slogan mean, and what does it actually look like as a series of policy proposals?

This is a direct outgrowth of his campaign. He wrote out a platform that is now wiped from the website, but you can look at its exact points in an archived version. It had five key aims that it listed, like combating the chronic disease epidemic, especially cancer, diabetes, and heart disease, by tackling its root causes of poor diet, environmental toxins, and inadequate health care. Sounds great, right? Promote regenerative agriculture, restore natural ecosystems to benefit human and animal health, and mitigate the environmental harms of American industry and agriculture; reduce corporate influence in government, especially in public health and environmental agencies; and then remove chemicals and toxins from America’s food, water, and air. 

It sounds terrific, and when I say that, I mean that some of the things he says appeal to people like me. This is straight out of the playbook for any public health agency right now, pretty much.

In fact, I looked at a few other really important public health organizations’ missions, and there was tons of overlap. But a lot of what MAHA actually is is in between the lines here. That's because what he regards as toxins and what he describes as corporate influence are non-traditional definitions. To him, vaccines are considered a toxin. Another thing he might consider a toxin is fluoride, which, in small amounts really reduces cavities in children and tooth loss in adults with very, very little toxicity. I think he would consider raw milk, which we know is linked to diarrheal disease and food-borne ailments, and tallow, which is full of saturated fats that are strongly linked with heart disease, healthy foods. 

If you define toxins or healthy foods, or even climate change in a wildly untraditional, non-evidence-based way, then MAHA suddenly becomes a very, very different platform than what a public health person might think is a good direction for the nation to take.

Where do you see MAHA going from here? And for people who are worried about its impact, who are worried about losing access to things like vaccines and FDA-approved medications, what should they know about the next four years? 

I can't tell people not to worry. I myself am worried enough about the chaos that has followed this administration in the past — like their evident willingness to break norms, especially those related to transparency and preserving trusted institutions from severe conflicts of interest.

Those are the things that make this a very unpredictable moment. The one thing I will say that gives me a bit of doubt is that we're going to see huge changes very quickly. Trump is a business-minded guy. Rich people have his ear, and Wall Street has his ear. 

If he's committed to anything, he's committed to preserving a profitable world for big business, and pharma is one of the biggest businesses. Anything that would change their profits substantially would not happen without a lot of litigation.

We'll have to wait and see which norms they break, and just how many surprises they're willing to throw our way before we get too worried about losing access to medicines that many Americans rely on. 

Related story:

What RFK Jr. can — and can’t — actually do as Trump’s health secretary

By Keren Landman MD

Kennedy has promised to overhaul American health care. How much can he actually change?

Sean Gallup/Getty Images

The annual international climate-change conference is over. What did we learn? COP29 drew more than 60,000 delegates and activists to try to address the world’s climate goals, just as the hottest year on record drew to a close. But while a potential US withdrawal from the Paris Treaty could occur under Trump, China — a worldwide powerhouse on solar energy, wind power, batteries, and electric vehicles — is showing a willingness to fill the gap. 

A curious reversal on government assistance programs: Fifty years ago, policymakers worried that welfare benefits encouraged too many births outside of marriage. Today, some conservatives are making the opposite argument in hopes of reversing the nation’s falling birthrate: that government assistance programs are contributing to too few births by penalizing marriage. Now, they’re embracing the notion of removing so-called marriage penalties in the tax code, hoping it will encourage people to wed.  

The surprise outcome of the Land Back movement: Since European colonization, Indigenous nations across North America have lost nearly 99 percent of their land. But a growing movement to repurchase and reclaim stolen tribal lands is changing that, acre by acre. It’s shown promise as a way to restore lands and use tribal experience to add resilience against climate change. 

Is it worth it to pay someone to manage your investments? There’s no single right answer that applies to everyone, but here are some good questions to ask yourself — and some important things to know about what investment advisors can actually help with. 

Alcohol deaths have doubled: The amount of deaths caused by alcohol-related diseases has seen an increase across all age groups, more than doubling between 1999 and 2020. [The New York Times]

Walmart is cutting its diversity efforts: The massive retailer has signaled that it will stop using terms such as “DEI,” review its support for Pride, and cease considering race and gender in deciding on supplier contracts. Some conservatives are declaring it a victory in an ongoing pressure campaign on companies. [Bloomberg]  

Joe Raedle/Getty Images

Post-“Glicked” weekend, it might seem crazy to so soon attempt another day in a movie theater full of joyously shrieking children. But Moana 2 might convince you. Opening today, eight years after the first installment, the movie brings back our heroine, Moana, and her guide Maui, for another adventure full of environmental and cultural messages that speak to kids. 

Lin Manuel Miranda is not in charge of the score this time (bummer), but nearly a decade later, perhaps it’s fitting that it’s a pair of TikTok breakouts — Barlow and Bear — who have created the all-important sounds for this new Gen Alpha-geared sequel. 

Jesse Grant/Getty Images for Disney

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