Public Health's Modern Battle - September 27, 2025

Another jam-packed and chaotic week in public health. To start, I focus on some things that make me especially angry these days. I hope you indulge me for one week of rage! I’ve got several exciting and positive stories for you at the end, to sweeten the deal. Let’s dive right in with more RFK Jr and MAHA madness.

RFK Jr ran against Trump for the presidency and failed. He’s a lawyer by trade and has a long history of denying science. After hearing Dr. Monarez’s testimony on September 17th, I’m convinced he completely despises public health as a whole, as well as the institutions now under his control, as director of the HHS. If we look at what he’s doing, as opposed to what he says he’s doing, I think we can see what he really wants to accomplish.

RFK Jr has previously compared Trump to Hitler and described MAGA-types as stupid. Consistent with his work as an environmental lawyer, he also claimed that Trump would “destroy the climate.” He clearly didn’t like Trump, yet here he is, working with Trump to fire federal employees almost as fast as he’s creates mistrust across the country in basic public health measures many take for granted. Everything shifted for RFK Jr in 2024, when he started working with the Means siblings, who firmly believe that all problems with the American healthcare system are related to metabolic issues caused by bad diets.

If you want a deeper dive into how the MAHA “movement” emerged in 2024, check out the first hour of this video, which heavily details what Calley and Casey Means have been doing in RFK Jr’s shadow:

So, RFK Jr pivoted his public opinion on Trump in exchange for a very powerful government seat. He’s aligned with two quacks that want to sell wearable tech, and he’s been freely promoting the idea that everyone should wear a device like the one they sell. In the botched Tylenol debacle (more on that later), folinic acid came up as as an alleged treatment for autism. This prompted lots of questions about whether Dr. Oz (current administrator of the Centers for Medicare & Medicaid Services) would benefit directly from the sale of this supplement, as he’s invested in a company private company that sells folinic acid. The Tylenol debacle also caused drops in the stock price of Kenvue, the company that owns the brand. Many seem to think that the Trump administration is intentionally manipulating the stock market for personal gain. Is the Tylenol story related to that? Maybe he’s just enriching his lawyer buddies that could try to go after Kenvue in any class action lawsuits against the company?

It’s obvious to me that RFK Jr is not interested in making anyone healthier. He just wants a powerful seat that allows him to enrich himself and others in the Trump admin while controlling the healthcare and health outcomes of Americans. Unfortunately, the overly simplistic pandering behind the MAHA message that doctors don’t focus on the “root cause of disease” is effective. It’s not true, as doctors study pathophysiology extensively and medical research into new treatments often target the “root cause” of a condition. Public health has also shifted into targeting social determinants of health, or social reasons that diseases emerge in some populations and not others. The details and nuance that doctors and public health officials work in is lost on people that are looking for easy answers that don’t really require them to do more than listen to the podcasts the MAHA leaders love to frequent, sadly.

From where I’m standing, there are two fronts to the fight for public health. The first is the obvious: oligarchs with a lot of money working their hardest to protect their money. RFK Jr’s goals align with this front. Dismantling public health and health systems across the nation will drive people to pay for private “solutions” (and death, in many cases). Framing the public health system as a tax burden that should be slashed protects oligarchs from taxes that they hate, as they grossly despise anything and everything that isn’t related to growing their profits. We all have seen that billions of dollars are clearly not enough for them.

The only way to win against people with more money and power than god is to mobilize the masses, who largely support public health and improving the healthcare system, already. Why can’t we just mobilize people to take action in support of public health? And why don’t politicians capitalize on this high support for public health?

This is the front public health should really focus on: American helplessness and hopelessness. I see this everywhere across the Internet. The American subconscious consists nearly entirely of the idea that things can never get better.

There’s a recurring example that periodically rears its head online: viral videos of Kensington Avenue in Philadelphia. If you don’t know, there is an area of Kensignton Ave where it’s easy to get drugs, so you can find a lot of people here that are high in public. The drugs they take give them a specific haunting look with rigid muscles and a folded standing posture. Videos of Kensington go viral with regularity because seeing large groups of people high and in an uncomfortable frozen posture upsets viewers. This week on Reddit, I saw a video of Kensington Ave showing a sidewalk populated with high people, once again, on the top of several subreddits.

Many ask “what can we do to help these people?” in the comments of videos like this one and are met with an onslaught of hopeless thinking. People argue over Switzerland’s success in drastically lowering heroin overdoses, HIV infections, AND home burglaries by implementing evidence-based drug policy and programs. You see, the Swiss can do that because the country only has 9 million people, according to hopeless Redditors. The US has over 350 million people! Nevermind that Philadelphia has 1.6 million people living in Philadelphia county, WE CAN NEVER MAKE IT BETTER HERE.

I say we try the science-backed Swiss methods in Philadelphia and adapt and change programs as needed to meet the differences between Switzerland and America. Why the fuck wouldn’t we try something that works? Republicans love to bitch that cities in America aren’t safe. The people featured in these video deserve help (and privacy and dignity). If we get drug users off the streets and into programs like the Swiss model, it’s a win-win for safety and health, right??? RIGHT????

Rather than accept there is a way forward, this hopeless approach to problem solving causes Americans to scapegoat anything else as the cause of a drug problem, like immigration or border policy, instead of anything concretely and scientifically understood to drive drug use like what’s regularly seen on Kensington Ave. Even when people do correctly identify that a strong social safety net can keep people from turning to drugs, they are completely hopeless that we can ever see an improvement in the American social safety net.

I see this American hopelessness with every public health battle of the modern era: Medicare for all, housing the homeless, safe injection sites, improving access to childcare, strengthening rural healthcare systems, stopping mass shootings, increasing public transit options, addressing climate change, lowering inflation and unemployment, and on and ON!!! For fuck’s sake, America!

We have done tremendous thing in public health in the last century. Here’s an old CDC page (that hopefully won’t be taken down before you get to it) that details many achievements in just the first ten years of the 21st century. I think public health officials and Democrats need to really start trying to rally hope in the American people. With all we’ve accomplished, you’d think it would be easy! But I’m not holding my breath in the current climate of the Democratic party…

In case you completely missed this story, on Monday Trump tried to declare that autism is caused by taking Tylenol during pregnancy. He struggled to pronounce the generic name of the drug, acetaminophen, but confidently declared autism solved!

I was not expecting nearly everyone to hate Trump’s Tylenol bullshit, to be honest. I have been relishing the hate for RFK Jr from all sides (especially the MAGA antivaxxers!) in repose to Monday’s announcement. Trump is still going on about this, if anyone even cares:

Despite the tsunami of criticism from the medical community, news publishers, and antivaxx groups, some people are legitimately convinced that Tylenol is the cause of autism thanks to this botched announcement and the simplistic promises of MAHA. Here’s some info for your back pocket, in case you want to fight back against anyone suddenly and emphatically talking about the evils of Tylenol:

Don’t let the MAHA hysterics keep you down. There are some exciting things happening in public health! Let’s celebrate some of these successes together to wrap up another chaotic week.

Huge public health news week, all told! Thanks for sticking with me. I’ll see y’all next week.

PB