In May, the Make our Children Healthy Again Assessment (MAHA) commission report on children’s health was released. It identified four main drivers of the chronic disease crisis in children: poor diet, accumulation of environmental chemicals, lack of physical activity, and chronic stress, along with what they termed “overmedicalization.” The assessment aimed to provide a foundation on these issues and highlight the clearest opportunities for progress, but fell short of achieving this goal.

The report outlines how children are exposed to environmental chemicals through the air they breathe, the water they drink, and the food they eat, and how the cumulative impact of these exposures can pose a long-term risk to their health and well-being. However, the very institutions set up to protect children from harmful environmental exposures are currently being dismantled. For instance, the US Environmental Protection Agency (EPA) recently dissolved its Office of Children’s Health, which managed a 25-year-old program, “America’s Children and the Environment,” that monitored childhood diseases. Yet, the report referenced some of the work accomplished by the program. The Office of Children’s Health ensured that EPA’s regulations were adequately protective of children, who are more susceptible to environmental hazards, such as air pollution exposure,  than adults. On the one hand, the authors identify and highlight the research conducted by these federal scientists; however, those offices are now being eliminated or restructured. Additionally, the authors raised concerns about cumulative environmental exposures to harmful air pollutants, including carbon monoxide, ozone, particulate matter, and volatile organic compounds, and their connection to chronic diseases in children. Again, the same administration is proposing to roll back protective regulations from the Clean Air Act.  Moreover, the authors were silent on the sources of these environmental exposures, which we know include the fossil fuel industry, power plants, and transportation-related emissions —all of which are currently slated by the administration for relaxed pollution requirements.

This contradiction represents a regulatory system or framework that we have been countering in Texas for decades: one that prioritizes economic growth over children’s health. Can these two be prioritized together? Yes, but in our current system, where regulatory agencies often seem to be colluding with the industries they are supposed to regulate, perhaps not. The European regulatory system, which the report claims stifles growth, actually safeguards children from harmful exposures in their air, water, and food. For example, several European countries have banned harmful chemicals, additives, and pesticides in food, thereby protecting children; however, most of those compounds are still used and found in food in the US.

Finally, there was another glaring oversight in the report regarding which children are the most unhealthy. Health disparities, vulnerable populations, and equitable access to healthcare services are all relevant issues that contribute to chronic disease, but were also omitted. This is quite an omission given the fact that Black, Indigenous, children of color, and low-income children are and continue to be disproportionately exposed to environmental exposures, food deserts, and other social inequities. This is a well-established fact, supported by the health data on which the report is based. 

In conclusion, the MAHA report effectively identified the existence of a chronic disease crisis in children and named environmental exposures as one of the major causes; however, besides naming the problem, it fell short of presenting concrete solutions to address it effectively. There was no mention of strengthening regulations or proposing policy solutions. They discuss the cumulative impacts of multiple environmental exposures, yet their recent actions to close critical EPA offices and undo protective standards convey a narrative that is in stark contrast. 

Children are among our most vulnerable. They do not make decisions about where to live, about what air they breathe, or what water they drink. It is our moral obligation to ensure these conditions are safe and healthy for our kids. If this administration truly wants to make children healthy again, it would hold the sources of harm truly accountable.