The Autistic Self Advocacy Network condemns the release of the Make America Healthy Again (MAHA) Commission’s most recent report. The Commission was created to try and lower the rate of “autism and other chronic health conditions” in the United States. Lowering the rate of autism is not possible given that autism is a hereditary developmental disability.
Much of what the report talks about is not actually a problem. It presumes that a condition getting diagnosed more often, or more people getting care for it, must mean that the condition is getting more common or getting worse. The truth is that in many cases there have been improvements to the accessibility of health care, as well as improved criteria for diagnosis. For example, the increased prevalence of autism diagnosis is thanks to better access to screening and improved understanding of autism, especially for people of color, women, and LGBTQI+ autistics. Doing a better job of identifying a condition and helping more people get supports for it is a good thing, not proof of an “epidemic.” ASAN remains committed to debunking disinformation and scare tactics from the MAHA Commission.
The report continues to peddle disinformation and spread fear about autistic and other disabled people. It lumps together the wildly different conditions of childhood cancer, asthma, autoimmune disease, autism, allergies, and children existing in higher-weight bodies all in the same bucket of “increasing chronic conditions” and talks about them as a collective problem. present normal parts of disabled people existing, like necessary medications and special education programs, as threats to the American public. Rather than engaging the autistic community or other disabled communities about what our true health needs are and how to address them, this report focuses on directing fear and disgust towards our community. It treats us as a sign of a societal problem to be eliminated, instead of human beings with health needs worth addressing. It also intentionally avoids taking responsibility for problems the administration itself is causing to our community through efforts such as threatening the Department of Education and the Administration of Community Living.
Vaccines
The MAHA Commission purports to invest in children’s immune health, but this administration’s every action runs counter to that goal, whether through the appointment of quack David Geier, the public communications blackout from the Centers for Disease Control, the limitation on COVID vaccines from the Food and Drug Administration (FDA), and so much more. This report is one of many instances where the current administration is attacking the immune health of this whole country.
The MAHA Commission repeats the same dangerous lies about vaccines that have been disproven for decades. The authors cast doubt on credible medical research under the pretense of transparency, neutrality, and examining all sides. It casts unfounded doubt on vaccine safety by alluding to a debunked conspiracy theory about a database called the Vaccine Safety Datalink (VSD). It claims that social media companies are “silencing” anti-vaccine content, when in fact Facebook and Instagram have weakened their fact checking features in response to political pressure. Perhaps most insidiously, it then suggests vaccines must undergo additional placebo-controlled trials before being approved. While that may appear reasonable, placebo-controlled vaccine trials actually force researchers to “unethically withhold proven protection from some patients” and risk causing unnecessary delays in the creation of vaccines for seasonal variants of diseases like COVID-19
The reality is clear: vaccines are safe, effective, and life-saving, and they do not cause autism. There is no evidence that vaccines overload childrens’ immune systems, and today’s vaccines in fact contain fewer antigens, not more. The report makes cherry-picked comparisons to foreign vaccine schedules in some European nations but fails to assess the impacts any such differences have for protection from vaccine-preventable diseases. For example, the report fails to note that Europe is experiencing the worst measles outbreak in 25 years, or that Denmark – one nation the report singles out – is facing rising rates of pertussis (also called whooping cough).
The efforts of Kennedy and his allies to continue relitigating the issue of vaccines and autism harms autistic people and our families, and poses a public health threat to all Americans by eroding confidence in the safety and efficacy of vaccines.
Clinical Research
The MAHA Commission critiques various industries’ influence on clinical research. There are certainly legitimate conflicts of interest when pharmaceutical and agricultural corporations fund studies. But this report’s critiques stand in contrast to its authors’ policy actions. The current administration does not actually care about independent, high-quality clinical research. If they did, they would not be gutting the National Institutes of Health (NIH), which is the federal driver of clinical research. The administration is directing Congress to deny NIH funding, in part by attempting to cap indirect costs (which is a matter of ongoing litigation). This administration is also directing NIH to drastically reduce its employees and deny grants for studies focused on health equity. All of these decisions will drastically reduce the amount of federally funded clinical research done in America. The President and Secretary have defended these actions by noting that private industry pays lower indirect cost rates and suggesting that research institutions should use private funds instead. This would increase the influence of private industry on research, not decrease it. It means the federal government would be doing less to support independent clinical research.
Robust clinical research is necessary to inform medical best practices. Without a functioning NIH, clinical research will decline in both quality and quantity. The impact will lead to worsening health outcomes in this country and worldwide, particularly for the most marginalized.
Chemicals
The report’s claim that there is more exposure to synthetic chemicals is also an unhelpfully broad characterization of a more complicated problem. Everything is technically chemicals. Chemicals as a category are not dangerous. Some chemicals, like lead and PFAs, are dangerous, and are often more common in areas where marginalized communities live, leading to worse health outcomes. We talk about this in our Crisis In Our Communities toolkit about environmental racism. Dealing with that problem requires regulation, such as that from the CDC and its childhood lead poisoning prevention program, from a plan to limit the spread of PFAs in water, from the Food and Drug Administration and from the Environmental Protection Agency. The administration is, instead, trying to reduce the regulation of these things. Rather than addressing those real problems, the report focuses on the presence of a number of different chemicals whose impact on human health is unconfirmed. The report attempts to connect them to an increase in “childhood chronic conditions” – the unhelpfully broad category they use to include both diseases and disabilities like autism.
In particular, the report claims fluoride has been linked to an increase in intellectual disability — this is false. It’s based on a flawed study that looked at naturally-occurring fluoride, at levels many times higher than what is added to water in the U.S, and could not separate the impact of fluoride from other contaminants like lead, which we know can cause intellectual disabilities. The results can’t be used to make any claims about the amounts of fluoride used to improve dental health. It also heavily implies that autism and other developmental disabilities are tied to chemical exposure, which is a long-debunked theory. Attempts to “cure” autism based on this theory have killed at least one child.
Food & Nutrition
The report claims that 70% of children’s diets come from “ultra-processed foods” and that this can lead to health conditions such as type 2 diabetes. This is a more complicated issue than the report indicates. Not all processed foods have negative health impacts. For example, cereals are often fortified with added vitamins and minerals. While the report criticizes nutrition guidance for treating fortified foods the same as nutrients from other sources, it offers no evidence that added nutrients are not as helpful as naturally-occurring ones. The report acknowledges the criticism that “ultra-processed foods” does not have a consistent definition. Diabetes and having a higher-weight body (what the report calls “childhood obesity”) are both related to a number of genetic factors, not only diet. There’s also research that suggests a lot of the negative health outcomes from being in a higher-weight body are related to medical discrimination rooted in anti-fat bias, and weight cycling from repeated dieting.
The increase of processed foods in children’s diets is not happening in a bubble. America has high and worsening levels of food insecurity– a fact that the report fails to acknowledge or discuss in depth, despite being a clear and concerning factor for children’s nutrition. In many parts of the US, this food insecurity includes the presence of food deserts. Food deserts are places in the US where it is difficult or impossible to get much food, particularly fresh food. This makes access to less processed foods difficult in many areas, especially for people who cannot drive or are poor. People often eat more processed food because it is available where they live and what they can afford. It is what will allow them to survive.
One critical program that helps low-income people access food is SNAP, which serves one in five children in America. The report notably does not recommend improving SNAP access, despite admitting the fact that SNAP provides incentives for buying healthy foods. Instead, RFK Jr. is part of an administration currently trying to cut SNAP, which would only increase the amount of people who will rely on the foods he is demonizing. This points to the true nature of the report – aiming to blame individuals for making choices necessary to survive rather than highlighting the systemic issues that the government has the power to change.
Medicine
The claim that youth are being “overmedicalized” is extremely concerning. The report takes issue with more children being diagnosed with and receiving medication for ADHD and mental health conditions. RFK Jr. has stated that people taking mental health medication should instead be institutionalized in forced labor farms, and falsely claimed that psychiatric medications like SSRIs are responsible for mass shootings. Given that clear bias, we disagree with what the commission considers a normal amount of children taking medication, particularly where mental health disabilities are concerned. As RFK Jr himself has noted: people should not take medical advice from him. They should take medical advice from their own trusted, trained medical care providers.
Medication for medical conditions, including brain-based conditions, is not inherently good or bad as long as the medication has been tested for the intended use and everyone knows the potential risks, benefits, and side effects. Disabled kids have enough to deal with — thanks in no small part to the administration’s attempt to literally destroy the education system and its disability protections. The last thing they need is an increase in stigma driven by a commission led by individuals biased against thoroughly tested medical treatments.
We already have federally funded bodies whose job it is to make sure drugs are safe before they hit the market — unfortunately, the administration has chosen to undermine that, too.
Conclusion
Ultimately, this report continues the trend that the creation of MAHA itself began: spreading fear of disabled and chronically ill people to serve a eugenic vision of what it means to be healthy. This way of thinking equates health and human value to productivity and especially “military readiness.” Instead of offering real solutions for the people most often neglected or discriminated against by America’s health systems, it continues to cherry-pick and misuse data to stigmatize us further. It ignores the things the administration itself is doing that will make americans less healthy, like supporting drastic cuts that will mean 13.7 million Americans will lose health care and 34 million children will lose food and nutrition supports, as well as eliminating the Administration for Community Living, which funds and oversees a number of programs aimed at helping people with disabilities stay in their communities, including assistance with job and housing searches.
The MAHA commission was not made for us. It will not help us. We will continue to debunk the ableist misinformation produced by Secretary Kennedy and his Commission as it comes out.