We are at a decisive moment for children’s health. Chronic diseases like diabetes, obesity, and respiratory disease are rising at alarming rates among youth, threatening their health and their futures. The prevalence of chronic conditions in children ages 3 to 17 increased from 39.9% in 2011 to 45.7% in 2023, according to a July 2025 study published in the Journal of the American Medical Association. And today, U.S. children are 15% to 20% more likely to have a chronic illness than they were a decade ago.
In response to this growing crisis, the federal government released the Make America Healthy Again (MAHA) report on September 9, 2025, which identifies key drivers of childhood chronic disease like poor diet; chemical exposures; lack of physical activity and chronic stress; and overmedicalization, and proposes new research and partnerships to address them.
While Children’s Health Fund shares this commitment to advancing child health, we believe that the broad goals outlined in the MAHA report fall short. The report lacks the scientific detail needed to develop a data-driven strategic plan on how to best address childhood chronic disease. And worse, it questions proven interventions and overlooks key social drivers that shape children’s health outcomes.
To make our children healthy again, the federal government must implement a rigorous, evidence-based plan rooted in science, proven interventions, and health equity to ensure measurable progress toward improving the health of America’s children.
We already know what works: interventions like improved access to vaccines and fluoridated water are proven to keep children healthy. Yet, the report suggests otherwise.
Consider vaccines. Vaccines are a cornerstone of modern public health. A 2024 Lancet study estimated that 14 common vaccines have saved 154 million lives worldwide since 1974, with 95% of them being children under five.
As with any medical intervention, vaccines carry some risk. However, serious adverse events, such as severe allergic reactions, are rare, occurring in roughly 1 per 1.2 million doses. These risks must be acknowledged, but the benefits of vaccination vastly outweigh them. Further, when children and communities remain unvaccinated, their health is put at far greater risk.
After the United States eliminated endemic measles in 2000, we’re now seeing a dangerous resurgence. By December 2025, the CDC reported 1,828 cases across the United States, two-thirds of which were amongst children 19 and under, including two pediatric deaths and 147 hospitalizations. Ninety-six percent of all cases were in unvaccinated or partially vaccinated individuals. Yet, the science is unequivocal: when 95% of a community is vaccinated, outbreaks are prevented.
Still, despite evidence of their effectiveness, the lifesaving impact of vaccines is barely addressed in the MAHA report. The same pattern appears with the report’s discussion of water fluoridation. Fluoride occurs naturally in water, and most U.S. communities have small amounts of it in their water supplies. Research shows that water supplemented with fluoride reduces tooth decay by 25% or more in children and adults, and saves communities an average of $32 per person annually by preventing cavity treatments. Like any intervention, ingesting fluoridated water can carry some risk, but decades of research confirm its overall safety. Yet, the MAHA report calls the science “inconsistent” and proposes another review—despite overwhelming consensus among scientists and public health agencies.
Calgary, Alberta offers a cautionary tale for what can happen when communities lack adequate access to fluoridated water. When the Canadian city stopped fluoridating its water in 2011, severe dental infections among children skyrocketed—leading to a 700% increase in hospitalizations for intravenous antibiotics to prevent death from tooth infections. The city reinstated fluoride this year. That’s the cost of ignoring evidence.
Beyond disregarding scientific evidence, the report largely ignores social drivers that prevent many families from accessing nutritious food or being able to live in healthy environments free from gun violence, housing instability, pollution, and unsafe drinking water. At the same time, harmful policy changes, including $900 billion in cuts to Medicaid and reductions to the Supplemental Nutrition Assistance Program (SNAP), threaten families’ access to care, nutrition, and other resources. Instead of prioritizing evidence-based interventions that protect children, the report overlooks how the policies and programs that advance health equity and keep children healthy are being eroded.
When it comes to addressing childhood chronic disease, the bottom line is clear: science-driven, evidence-based policies, implemented now, are the only way to ensure healthier generations to come. The Make America Healthy Again report highlights a real problem, but it cannot be the final solution.
To truly make America healthy, all children need access to quality primary care that focuses on preventive care, including timely vaccines, safe environments, and socioeconomic support. Policymakers must follow science, protect essential programs, and ensure that children’s health is a priority and not just an empty promise.