False Promises: RFK Jr. and Chronic Disease

Emily K. Abel

Opposition to the appointment of Robert F. Kennedy, Jr. to lead the Department of Health and Human Services (HHS) rightly focused on his outlandish conspiracy theories and his false health claims, especially about vaccines. His dangerous response to the measles outbreak (first labelling it “not unusual,” then prioritizing unconventional treatments over vaccines, and then blaming poor diet and health for the outbreak) serves as a reminder that health advocates had reason to worry. Kennedy’s misleading statements about chronic disease, however, have largely escaped scrutiny. Chronic diseases are ailments that last for at least three months; many worsen over time. Some of the most common ones are heart disease, stroke, cancer, diabetes, arthritis, and dementia.

Kennedy blamed vaccines for the high prevalence of chronic disease in the United States. He was right—though not in the way he has indicated. Rather than make people sick, vaccines have contributed more than any other medical intervention to the dramatic increase in life span since the early 1900s (from 49 to 77 years). But everyone dies of something. Those fortunate enough not to have succumbed to injury or illness in their youth are likely to develop one or more chronic conditions that eventually prove fatal in old age. Chronic diseases that are less likely to result in death also accumulate as people grow older. To a large extent, then, the high prevalence of chronic diseases today is the inevitable result of an aging society. More than 80 percent of Americans 65 and older have multiple chronic conditions, compared to 7 percent of those younger than 17; 18 percent of those 18-44; and 49 percent of those 45-64.

Nevertheless, the high prevalence of chronic disease is cause for alarm. Americans live more years with chronic disease than do people in 183 countries belonging to the World Health Organization. As a result, Kennedy’s promise to combat chronic disease won praise even from some of his harshest critics. “I have to say,” wrote Marion Nestle, the renowned nutritionist and health policy advocate, “it’s thrilling to see chronic disease prevention at last getting the attention it totally deserves.” Tom Frieden, the former director of the Centers for Disease Control and Prevention, wrote, “Donald Trump and Robert F. Kennedy Jr.’s campaign to ‘Make America Healthy Again’ gets some things right: Our country is beset by chronic disease.” And Bernie Sanders, co-chair of the Senate health committee, remarked, “I think a lot of what RFK is saying is kind of crazy and driven by conspiracy theory. Some of what he’s saying is not crazy…. The amount of chronic illness that we have is just extraordinary.” As Daniel Payne, professor of pediatrics at the Cincinnati Children’s Hospital Medical Center, wrote, “When it comes to chronic disease, which Kennedy attributes to toxins in our environment and food, public health officials say he’s onto something.”

Several critics pointed out, however, that an administration with close ties to the food and chemical industries and a determination to loosen regulations was extremely unlikely to enact necessary reforms. Those critics did not have to wait long after Kennedy’s confirmation to be proven right. In the middle of February, Elon Musk fired several hundred employees in HHS. Jim Jones, the top food official in the Food and Drug Administration, the HHS agency responsible for protecting 80 percent of the nation’s food, immediately resigned. “I was looking forward to working to pursue the Department’s agenda of improving the health of Americans by reducing diet-related chronic disease and risks from chemicals in food,” he wrote in a letter. “It has been increasingly clear that with the Trump Administration’s disdain for the very people necessary to implement your agenda, however, it would have been fruitless for me to continue in this role.”

The following month the public had new evidence that the administration had no intention of fighting the chemical industry. In his March 4 address to Congress, Trump promised to “get toxins out of our environment” in order to reduce the high prevalence of childhood cancer. Three days later the Justice Department withdrew the case against the Denka Performance Elastomer plant in LaPlace, Louisiana, a city with a disproportionate number of African Americans in an area known as “Cancer Alley.” Located close to an elementary school, the plant had been accused of emitting toxic emissions of cancer-causing chloroprene. The company said that the dismissal of the case was “long overdue” because it had been “a draining attack on our business.”

And then, on March 11, Lee Zeldin, administrator of the Environmental Protection Agency, announced the closure of the eleven offices charged with promoting environmental justice. The agency previously had defined environmental justice as “the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income.” Zeldin, however, called it “forced discrimination.” Seventeen Congressmen protested his action, noting that “communities across the country remain exposed to pollution that causes cancer and respiratory illnesses. Many of these areas were deliberately targeted due to their demographics for the siting of polluting activities.”

The toxins we ingest represent only one factor in the etiology of chronic disease. Today medical researchers increasingly highlight what they call “the social determinants of chronic disease,” including poverty, stress, lack of physical activity, and lack of access to healthy food and healthcare. “When we move beyond thinking of health as just biological disease,” stated Felicia Hill-Briggs, a physician who is an expert on diabetes, “then we’re able to see that the conditions in which people are born, grow, work, live, and age play a very, very key role in influencing who gets disease and what the outcomes of the disease are.” Those issues also affect the personal health behaviors Kennedy recommends to ward off chronic ailments. (“The first line of response should be lifestyle,” he told a CNBC interviewer shortly after the election.) Yet people who live in dangerous neighborhoods cannot exercise regularly in the easy way so many Americans do, with a daily walk. Those who live in areas without supermarkets or grocery stores cannot buy healthy, fresh food.

Unsurprisingly, people who are poor and/or members of racially marginalized groups are especially likely to be diagnosed with chronic conditions. A recent New York Times article focused on Cora, a 64-year-old woman with diabetes who lived with her partner in rural West Virginia. They had less than $100 in their joint bank account. Although Cora finally qualified for food stamps, they rarely lasted until the end of the month. She did not have a car to go shopping, and the only sources of food within walking distance were a Pizza Hut, KFC, Taco Bell, Little Caesars, a dollar store, and a tiny, expensive convenience store. A visiting nurse reported that the only food items at Cora’s house were a bottle of mustard, half of a microwave meal, a package of American cheese, a bag of old potatoes, and boxes of cornflakes and flour. Cora’s physical symptoms included chronic pain, respiratory infection, numbness on her hands and feet, depression, and hypertension. She understood she could manage her diabetes better if she avoided ultra-processed food, but that would require transportation to a full-service grocery store, more community resources, and more money—none of which she is likely to receive under Trump.

An administration truly committed to reducing the prevalence of chronic diseases would enact broad-based social, political, and economic reforms. The current administration is doing just the opposite.

Sources

Lisa Friedman, “Justice Dept. Drops a Case that Asserted a Cancer Risk,” New York Times, March 10, 2025.

Emily K. Abel, Elder Care in Crisis: How the Social Safety Net Fails Families (New York University Press, 2022)

Tom Frieden, “What Trump and RFK Jr.’s Make America Health Again’ Gets Right—and Very Wrong,” STAT News, October 31, 2024

Rino Rappuoli, “Vaccines: Science, Health, Longevity, and Wealth,” PNAS, August 26, 2014.

Teddy Rosenbluth, et al., “Fact-Checking Health Claims in Kennedy’s 2^nd Day of Confirmation Hearings,” New York Times, January 30, 2025

Mia de Graaf, “Bernie Sanders Says Elon Musk Is ‘A very Smart Guy’ and RFK, Jr. “Is Right’ about Our Unhealthy Society,” Business Insider, December 4, 2024.

Rachel Roubein, Lena H. Sun, and Carolyn Y. Johnson, “Trump’s Firings Strike the Nation’s Health Agencies,” Washington Post, February 18, 2025.

Tom Frieden, “What Trump and RFK Jr.’s ‘Make America Healthy Again’ Gets Right—and very Wrong,” Statnews, October 31, 2021.

Marion Nestle, “The MAHA Saga Continues: Senator Sanders’ Bipartisan Hearing on Chronic Disease Prevention,” December 10, 2024, https://www.foodpolitics.com.

Eli Saslow, “She’s a Foot Soldier in America’s Losing War on Chronic Disease,” New York Times, March 2, 2025.

Roni Caryn Rabin, “Medical Care Alone Won’t Halt the Spread of Diabetes, Scientists Say,” New York Times, October 5, 2022.

Emily K. Abel is professor emerita at the UCLA-Fielding School of Public Health. Her most recent book is Gluten Free for Life: Celiac Disease, Medical Recognition, and the Food Industry.