Gostin Lawrence O, Finch Alexandra, Lurie Peter
Hastings Cent Rep. 2025 Jul 14. doi: 10.1002/hast.5020.
Chronic diseases impose enormous health and economic burdens in the United States, especially on marginalized populations, and demand evidence-based, equity-focused interventions. To combat chronic disease, the Trump administration established the Make America Healthy Again Commission, chaired by Department of Health and Human Services Secretary Robert F. Kennedy Jr. However, the MAHA Commission appears to be both ideologically driven and scientifically unsound, and as a consequence, its prospects of proposing policies that meaningfully address chronic disease are exceedingly low. Instead of adopting an evidence-based approach, in his actions and comments to date, Secretary Kennedy has undermined established science, particularly on vaccines; gutted U.S. science and public health infrastructure, including segments responsible for addressing chronic disease; and prioritized concerns that have little basis in science. This essay describes the burden of chronic diseases in the United States, digs deeper into the MAHA agenda, discusses the ethics of chronic disease prevention, and identifies evidence-based policies that would actually be effective in combating chronic diseases.
在美国,慢性病给健康和经济带来了巨大负担,尤其是对边缘化人群而言,因此需要有基于证据、关注公平的干预措施。为了抗击慢性病,特朗普政府设立了“让美国再次健康委员会”,由卫生与公众服务部部长小罗伯特·F·肯尼迪担任主席。然而,“让美国再次健康委员会”似乎既受意识形态驱动,又缺乏科学依据,因此,其提出能切实解决慢性病问题的政策的可能性极低。肯尼迪部长至今的言行并未采取基于证据的方法,而是破坏了既定科学,尤其是在疫苗方面;削弱了美国的科学和公共卫生基础设施,包括负责应对慢性病的部门;还将那些几乎没有科学依据的问题置于优先地位。本文描述了美国慢性病的负担,深入探讨了“让美国再次健康委员会”的议程,讨论了慢性病预防的伦理问题,并确定了在抗击慢性病方面真正有效的基于证据的政策。