The Make America Healthy Again (MAHA) Commission has brought long-overdue national attention to the health and well-being of U.S. children — marking the first White House–level focus on child health since 1971. While this renewed interest is welcome, a closer review shows that the Commission’s strategy falls short of addressing the core conditions driving poor child health outcomes in America.
As outlined by Dr. James M. Perrin and Dr. Tina L. Cheng, who recently chaired a National Academies of Sciences, Engineering, and Medicine (NASEM) study on improving children’s healthcare, the MAHA Commission’s report misses foundational opportunities to transform the current landscape.
America’s Children Are in Crisis — and Falling Behind Other Nations
Both the MAHA report and the recent NASEM study agree on a troubling reality:
U.S. children experience worse health and more chronic illness than children in other high-income countries.
The indicators are alarming:
- The U.S. continues to see rising rates of chronic childhood conditions, including asthma, obesity, mental health disorders, and developmental challenges.
- A recent military study found that 77% of American youth are unfit for military service, primarily due to poor health — a finding that raises concerns about the future workforce and national security.
- In 2023, three military branches failed to meet recruitment goals for the first time in the modern era.
- Despite these realities, the MAHA Commission omits several major threats to child well-being.
Major Health Threats Overlooked by the MAHA Commission
1. Firearms — the #1 cause of death among U.S. children
The report does not address firearms, which have surpassed accidents and disease as the leading cause of child mortality.
2. Drug overdoses and motor vehicle injuries
These rising causes of death and disability receive little to no attention, despite their growing impact on youth.
3. Child poverty — a major driver of poor health outcomes
Perhaps the most concerning omission is the Commission’s silence on child poverty, even though the U.S. has one of the highest child-poverty rates among industrialized nations.
Child poverty is directly associated with:
- Higher rates of asthma
- Obesity
- Behavioral and mental health conditions
- Reduced access to healthy foods, safe housing, and healthcare
Research shows that policies such as child tax credits, nutrition assistance, and paid family leave significantly improve child health outcomes — yet these strategies are not acknowledged in the MAHA framework.
A Narrow Approach to Children’s Diet & Nutrition
The MAHA report highlights children’s diets but focuses primarily on reducing food dyes and ultraprocessed foods. Experts warn that these recommendations do not match the scale of the childhood obesity crisis.
Key factors influencing children’s diets are overlooked:
- Food insecurity
- Aggressive food-industry marketing
- Cost barriers to healthy eating
- Limited access to fresh, nutritious foods in low-income areas
Without addressing economic and structural barriers, dietary recommendations will have limited real-world impact.
Environmental Chemical Exposure: A Missed Chance for Reform
Although environmental chemicals are mentioned, the proposed solutions are minimal — limited to new research projects with no regulatory changes. Tens of thousands of chemicals remain unstudied for long-term child health effects.
Low-income children face higher exposure to harmful chemicals but receive no targeted policy protections under the MAHA framework.
Physical Activity, Stress, and Mental Health: Important but Underfunded
The Commission calls for increased physical activity and stress reduction but offers few strategies or resources to support implementation.
The past 30 years of pediatric science have shown:
- Early-life stress has long-term effects on brain development
- School- and community-based activity programs improve health outcomes
- Early-intervention programs (HealthySteps, Reach Out and Read) are effective and scalable
Yet, the MAHA report does not propose investments, incentives, or reforms to support these proven strategies.
Overmedicalization: The Underlying Problem That Requires Systemic Change
The Commission raises valid concerns about medication overuse, especially psychotropic medications in children. However, it stops short of addressing the real driver: healthcare financing.
Current payment models reward:
- Short visits
- Quick diagnoses
- Medication-based interventions
What’s needed is a shift toward:
- Prevention
- Integrated behavioral healthcare
- Multidisciplinary care teams
- Family-centered support
- Longer, relationship-based visits
Medicaid and CHIP, which cover nearly half of U.S. children, present a major opportunity to redesign incentives — yet the Commission does not recommend bold payment reform.
Where Do We Go From Here? Going Beyond the MAHA Commission
Drawing from decades of evidence and the NASEM findings, experts recommend a more comprehensive path forward.
1. Establish a national, long-term focus on child health.
Federal leadership must prioritize all aspects of child well-being — physical, mental, social, environmental, and economic.
2. Strengthen evidence-based prevention.
Policies must address diet, physical activity, screen time, chemical exposure, and vaccine confidence using proven strategies.
3. Address child poverty head-on.
Economic stability programs and family-support policies have immediate and long-term health benefits.
4. Transform healthcare financing to reward prevention.
Medicaid, CHIP, and private payers should adopt payment models that incentivize improved outcomes, not volume-based care.
5. Expand and modernize child-health research.
Research must start earlier in life, include long-term impacts, and inform policy and community interventions.
A Call to Action
The MAHA Commission has sparked a national conversation — but real change requires evidence-based strategies and meaningful investment in children and families.
The health of the next generation depends on more than awareness.
It requires leadership, policy reform, and a commitment to equity, prevention, and whole-person care.
At ATLMed, we stand with the medical community in calling for stronger, more comprehensive action to ensure every child in America has the opportunity to grow up healthy and thrive.
