With President-elect Donald Trump’s nomination of environmental lawyer Robert F. Kennedy Jr. to lead the U.S. Department of Health and Human Services (HHS), supporters of the current public health establishment are circling the wagons to prevent this from happening. A recent opinion piece went so far as to suggest Kennedy “could destroy one of civilization’s best achievements,” modern public health, while we believe the opposite is true. Great achievements in public health may have been true over 20 years ago, but let’s look at where things stand today and why improvements are needed.

First, scientific evidence strongly suggests children’s physical and mental health is deteriorating, a huge concern for both Kennedy and the American people. Government now reports “more than 40% of school-aged children and adolescents have at least one chronic health condition” — asthma, food allergies, diabetes, obesity, epilepsy or oral health. One chronic health condition, autism, was relatively rare in Utah in the mid-1980s (4 per 10,000). By 2008, Utah autism rates had skyrocketed to 1 in 47 and were among the highest rates in the nation. U.S. autism rates continue to grow (1 in 36 children and 1 in 23 boys) with continued increases projected. All Americans are or should be concerned about these trends in chronic health conditions and ask the question: What has gone wrong and why has our public health establishment failed our children?

Second, when it comes to adults, health indicators are not any better. Chronic diseases affect more American adults than ever before. During COVID-19 the United States saw a much higher drop in life expectancy than comparable wealthy countries. Currently, the average life expectancy of Americans is roughly five years less than in these countries even though the amount per person spent on health care in the U.S., $12,555, is almost double the average expenditures of these other countries, $6,651.

Third, the current American health care system generally focuses on treatment rather than on prevention. So, rather than asking why the obesity and diabetes rates are so high and working to lower those rates, public health officials along with Big Pharma focus on treating the problem while Big Food continues to promote the very things that may contribute to poor health.

When Kennedy is accused of promoting conspiracy theories, we see it more as Kennedy challenging the lack of transparency and the negative impact that Big Pharma and Big Food have on Americans’ health. Near the top of Kennedy’s list of concerns are the conflicts of interest that exist when government agencies that are supposed to be protecting Americans from Big Pharma and Big Food are run by people who move between these agencies and the entities they are supposed to be regulating. Another concern occurs when government employees collect royalties from private companies to license medical innovations developed by taxpayer funded, government scientists.

When Kennedy calls for more transparency in the testing process of vaccines, challenges the safety of certain vaccines, and asks why vaccine manufacturers are granted immunity by Congress from liability for “damages arising from vaccine related injury or death,” he is labeled as an anti-vaxxer rather than more accurately as a vaccine safety advocate. Currently, taxpayers are footing the bills and have paid out over $5 billion thus far for vaccine injuries while big Pharma continues to avoid liability. With Kennedy’s help, one Utah mom’s vaccine injury case “could break through a wall of legal immunity surrounding vaccine makers.”

Americans’ trust in science hasn’t recovered since the COVID-19 pandemic, so it is not surprising that Kennedy continues to draw public support for his position on research integrity such as transparency, ethical behavior, free speech, open discussions among scientists with varying points of view and protection against conflicts of interest. All of these values are principles HHS claims to support yet fails to follow. Accountability is now needed.

So, we strongly support the nomination of Kennedy to head up HHS. Given the failure of the public health establishment over recent decades and the sad state that the American public health system finds itself in now, what have we to lose? Will Kennedy be able to save the current badly flawed public health system? To be frank, we don’t know. But we do know that what we have is not working and that doing more of the same is not an acceptable option.

Judith Pinborough-Zimmerman, Ph.D., was an assistant research professor at the University of Utah between 2005 and 2013 and was the principal investigator on multiple grants funded by the Centers for Disease Control and Prevention. She was a program manager and speech pathologist at the Utah Department of Health between 1978 and 2005. Dr. Zimmerman has prevailed against the state of Utah on whistleblower-related claims in state and federal court.

Ronald Mortensen, Ph.D., currently focuses on preventing the unauthorized use of Utahns’ most sensitive personal identifiable and medical information for research or other purposes.