Shortly after the confirmation of Robert F. Kennedy Jr. as the new Health Secretary, the Trump Administration issued a new executive order establishing the ‘Make America Healthy Again’ (MAHA) Commission. A significant focus is on addressing the health of American children, including plans to in vestigate root causes of chronic disease and generate strategies for improvement. I’m a pediatrician and a mother of three young children, and I am concerned that the outlined plan will fail in helping our children achieve the administration’s goal of improving child health outcomes. Lauren Palladino MD To be clear, I applaud prioritizing the health of children in policymaking. Intuition and research tell us that investing in young children makes sense – one study showed every $1 spent on high quality preschool yielded $7-12 returned to society. However, the list of perceived threats outlined in the executive order felt out of touch with my experience caring for children in the emergency department and my familiarity with the data of what harms kids. The leading killer of children ages 1-17 is firearms, so to take children’s health seriously means the commission must address children’s access to guns by championing policies supported by the majority of Americans, including background checks, assault rifle bans, safe storage and red flag laws. A healthy generation of children doesn’t grow from kindergarteners doing active shooter drills and kids mourning loved ones lost to gun violence. Credit: Kaiser Family Foundation The executive order appropriately highlights the serious mental health crisis, which I see daily in the children coming to the emergency department for depression, anxiety, and suicidality. However, labeling life-saving, evidence-based medications like selective serotonin reuptake inhibitors and antipsychotics as threats to child health is counter-productive, misguided, and dangerously stigmatizing. Instead, the commission should focus on strengthening community-based prevention and treatment and expanding access to behavioral health care. It is impossible to meaningfully discuss improving children’s health without acknowledging the immense impact that poverty plays. Here in Connecticut, children in zip codes with higher levels of poverty can expect to live 15 years less than children in wealthier ones, even if those children live 15 minutes apart. Children living in poverty are more likely to suffer severe asthma flares requiring ICU stays. Kids who don’t have safe spaces to play, lack access to fresh fruit and vegetables, and endure adverse childhood experiences all face worse health outcomes. Investing in health equity research and supporting policies like the child tax credit, expanded Medicaid access, and WIC to lift children out of poverty are crucial to accomplishing the commission’s goal. This is of course not to say that we shouldn’t care deeply about our children’s nutrition or exposure to unsafe chemicals; I do. My concern is that spending resources scrutinizing medications and vaccines that rigorous research show are safe and effective while ignoring the above issues is not going to move the needle on children’s health as the commission aims to. No matter your political party, we are united in that we all want the best for the children in our lives. I urge the MAHA Commission to partner with child health experts like those in the American Academy of Pediatrics who share their goals to effectively promote policies that enable our children to thrive. Lauren Palladino, M.D. of Guilford in a pediatrician at Yale New Haven Children’s Hospital. ...read more read less