Guest Opinion

Robert F. Kennedy Jr., despite lacking medical training and promoting anti-vaccine views, has drastically reduced the Health and Human Services workforce.

The author expresses concern over the administration’s focus on deregulation and dismantling research infrastructure, potentially jeopardizing public health progress.

The nomination of Robert F. Kennedy Jr. as the Secretary of Health and Human Services was controversial due to his lack of medical training and history of promoting fringe anti-vax theories. Since his confirmation, he has slashed the department’s full-time work force by roughly 25%, including agencies like the CDC and FDA, and fired all 17 members of the CDC’s Vaccine Advisory Panel. This after telling members of congress that he would not target vaccines.

All of this restructuring is part of an initiative Kennedy calls “Make America Healthy Again.” I wonder when our golden age of health was.

Perhaps not 1681, when my eighth great-grandmother, the Puritan Sarah Whipple Goodhue, was expecting her eighth and ninth child. She had a premonition that she would not survive this birth, so she left a “valedictory” regarding the dispersal of her children to various relatives and outlining moral teachings for them to follow.

She gave birth to twins on July 20, 1681, and died three days later. Her advance directives were published throughout New England. (https://historicipswich.net/2020/03/13/notable-persons/) The disproportionate risk of childbirth continued into the 19th century, when Hungarian obstetrician Ignaz Semmelweis realized that childbed fever was due to poor hygiene and handwashing practices among physicians. Germs, y’all.

In the 18th century, infectious diseases threatened to change the course of history. During the Revolutionary War, smallpox proved to be deadlier than the British soldiers. In 1777, smallpox survivor George Washington required that Continental soldiers be inoculated.

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During the Civil War, disease once again proved to be a formidable enemy. Typhoid, dysentery, measles, and tuberculosis were rampant in Army camps. In a register of 23 deaths of union volunteers in 1862, 17 were caused by diseases such as typhoid, diarrhea and cholera; six, including my ancestor, Asahel Downey, died of wounds.

I grew up in the 1950s, when men were men, women were homemakers, and the top marginal income tax rate was 80-90%. Were we healthier then?

Polio peaked in 1952, the year I was born. Nearly 60,000 children were infected; thousands were paralyzed and more than 3,000 died. When the Salk vaccine was released in 1955, my mother dragged me kicking and screaming to get poked.

It wasn’t just polio, though. There were no vaccines for measles, mumps, chicken pox, and the like. So other contagious diseases ran through our neighborhood like a hot knife through butter. I did not escape a single one — mumps, measles, chicken pox (varicella) and the so-called “German” measles (rubella.)

Since then, vaccines have been developed for all of those diseases. My sons — born in the 1980s — escaped them all but chicken pox (the vaccine was not approved in time.)

We were certainly leaner back in the 1950s, yet death from cardiovascular disease was much higher. We didn’t know what caused it or how to treat it. Smoking was even pitched as healthful until the 1964 Surgeon General’s Report on Smoking and Health.

When my 43-year-old mother had a heart attack in the early 1960s, she was lucky she survived. Even so, she suffered major damage to her heart, damage that might have been prevented by the treatments used today.

It wasn’t until the 1960s that large-scale studies like the Framingham Heart Study demonstrated the contributions of cigarette smoking, diet, physical inactivity, high blood cholesterol and high blood pressure to the leading causes of death. You know — the kinds of studies funded and conducted by scientists at the NIH. It seems like we would want to keep those folks around.

Death rates from cardiovascular diseases have plummeted over the past 50 years, partly because we can better manage chronic conditions like high blood pressure and treat patients during acute events.

Death rates for other chronic diseases such as diabetes, cancer, chronic lung disease and kidney disease have not dropped as much, or have, in some cases, increased. The decline in cigarette smoking has been countered by the rapid increase in obesity. It has been suggested that environmental pollutants may contribute to higher cancer rates among young people. That would seem to provide opportunities for Secretary Kennedy and colleagues who want to make America healthier.

Yet, this administration seems bent on eliminating regulations that protect our air and water. They’ll leave the pesticides and microplastics and remove the fluoride. Worse, they seem determined to eliminate proven government policies and dismantle the research infrastructure that have fueled scientific progress.

CS Chima is a writer and retired health administrator living in Asheville.