The Cato Institute Trashes the MAHA Report

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Again? Make America Healthy Again? It’s an odd slogan in a country that has long ranked last in health outcomes among its peers. If the United States were merged with Canada, Greenland, and Panama, our average health statistics would improve overnight. Consider, for example, the pellagra epidemic that began at the start of the 20th century and lasted into the 1940s.

Between 1900 and 1940, some three million US citizens developed pellagra, of whom 100,000 died—this when pellagra was rare outside the home of the brave and the land of the free. Pellagra is a debilitating disease known for the four Ds (diarrhea, dermatitis, dementia, and death). Pellagra’s prevalence was disproportionately high in the Jim Crow South, where systemic racial injustice shaped both diet and disease.

Its cause was discovered by an immigrant, Dr. Joseph Goldberger, a graduate of New York University. While working for the precursor body of the National Institutes of Health (NIH), he demonstrated that pellagra was a disease of malnutrition. Pellagra is a vitamin deficiency that occurs in people who eat little but industrially milled corn. Indeed, it’s hard to acquire pellagra because the key vitamin [Niacin] is found in practically all foods except industrially milled corn.

Dr Goldberger made his key observations at the Georgia State Sanatorium, a mental asylum where pellagra was rampant. For his experiment, Goldberger fed a group of patients a balanced diet of, you know, meat and vegetables and stuff. Whereupon their pellagra was cured. Once the experiment was complete, the fiscally responsible burghers of the peach state promptly returned the subjects to their former diet of industrially milled corn and industrially milled corn alone. And their pellagra promptly returned. . . .

Happily, the Commission already knows why US children are uniquely unhealthy. By a strange coincidence, these reasons happen to be the ones the Commission’s chairman, one Robert F. Kennedy Jr., has been trumpeting for years. They include US children’s consumption of ultra-processed food, their use of smartphones, the chemicals in their environment, their lack of exercise, their stress levels, their lack of sleep, and their overmedicalization, especially with those pesky vaccines.

Oddly, however, the data in the report bears little relationship to its conclusions. For example, the first sentence of the introduction reads: “Despite outspending peer nations by more than double per capita on healthcare, the United States ranks last in life expectancy among high-income countries—and suffers higher rates of obesity, heart disease, and diabetes.” But the graph the Commission supplies shows that, dating back to 1970, the US has always ranked last in life expectancy among comparator nations. Were Americans back in 1970 dying sooner than Canadians, Europeans, or the Japanese because of ultra-processed food, smartphones, chemicals, a lack of exercise, stress levels, a lack of sleep, and overmedicalization? Probably not.

The reason for the US’s poor medical performance lies in the culture that gave us pellagra, which includes the nation’s unusually high level of social inequality for a rich country, regulatory barriers to access to health care, its extraordinarily high levels of road traffic deaths (which are today seven times higher in the US than in Sweden), its unusually high levels of gun deaths (which are today 340 times higher in the US than the UK for example), its extraordinarily high incarceration rate (prisoners may die from natural causes 20 years earlier than the general population), and other obvious social factors—which is why Mississippi has a life expectancy 8 years lower than states like Hawaii or Washington.