Mark Herz: Every month we check in with the state’s top public health official, the commissioner of the Department of Public Health, Robbie Goldstein. We’re asking Dr. Goldstein for some clarity this month on the Health and Human Services recent report on the causes of childhood chronic diseases and on COVID vaccines. And a note, this was recorded before the news of HHS canceling a contract with Cambridge-based Moderna to develop vaccines to prevent flu pandemics, including bird flu. Good morning.

Robbie Goldstein: Good morning!

Herz: Let’s start with this HHS report I mentioned. It’s from Secretary Robert F. Kennedy’s MAHA, or Make America Healthy Again, Commission. And among other things, it talks about kids having high rates of obesity and asthma. What was your take on this report?

Goldstein: I think, like a lot of what is coming out of the Trump administration, and in particular out of Secretary Kennedy’s HHS, there is some truth behind the work that they’re doing. We do know that children across this country are facing rising rates of chronic diseases. We know that they are facing raising rates of mental illness, anxiety and depression. And we should, as a nation, be committed to making sure that children can be healthy and children can have access to healthy food, clean water, clean air, all of the things that we know are important to health. But what’s unfortunate is that the report also peddles in myths and disinformation. It puts out lies instead of facts. It leans on reports that don’t go through the scientific method, but rather reports that were cherry picked to make a specific point of the secretary or a specific points of the commission. And I worry when health and science get turned into politics and words that aren’t necessarily true, but words that can definitely confuse and misdirect the work that we’re trying to do to protect the health of children.

Herz: Well, let’s un-confuse it then. When it comes to obesity, I mentioned asthma. The report also mentions autoimmune conditions, and you mentioned behavioral health problems. What do you want the residents of the commonwealth to know about these conditions in kids?

Goldstein: I think everyone here in Massachusetts should know that these are real issues. We are seeing rising rates of obesity in our children. We know that asthma is increasing, in particular in certain communities here in Massachusetts, a lot of black and brown communities where the environment has resulted in increased diagnoses of asthma and increased complications. The next thing is what do we do about it, right? And the way we invest in public health here in Massachusetts, the way invest in our communities, to make sure that people have the education they need to know about healthy living, physical activity, that we invest in the built environment that helps address some of the environmental concerns that result in asthma diagnoses. That’s how we should be addressing the rising rates of these diseases. Unfortunately, what we’re seeing from the federal government is actually they’re taking away the funding for those types of opportunities. They’re shutting down parts of the Environmental Protection Agency, or EPA, that supported asthma work in communities here in Massachusetts. They’re reconfiguring the Centers for Disease Control and Prevention, and the CDC is shifting away from its commitment to chronic diseases. So, we know there’s work to do, and we want to do that work here in Massachusetts. We’re not seeing the federal government meet us in that desire.

Herz: And the report points the finger at four major issues: diet, chemical exposure, stress and lack of exercise, and what it calls "over-medicalization." I wanted you to weigh in on this.

Goldstein: Yeah, so again, there’s some truth there to the words that are initially put out. We do know that diet is really important. We want our kids to have access to healthy school lunches. We want them to be able to eat fruits and vegetables that are locally grown and brought right to their school. We know that the environment matters, that if we pollute the environment, if we pollute air, we’re going to result in worse health for children here in Massachusetts. But what’s unfortunate is that they go a step further and start to really bring lies and areas that aren’t proven by science to try to make their point. That’s where this is risky. This is where there could be harm, actually, that comes from the actions of the federal government. What we’re going to do in Massachusetts is we’re gonna rely on the science. We’re going rely on evidence. We’re gonna invest in the interventions that we know work because we have the track record of seeing the progress, seeing what happens when we invest in that way.

Herz: Was there anything specific that you’re saying is a lie or unscientific that you wanted to correct?

Goldstein: I think the over-medicalization pieces are really challenging. As someone who’s a physician, as someone who oftentimes relies on medications to help individuals through a chronic disease, an infectious disease, or a behavioral health condition, medications have a time and a place. They’re important and we should not be thinking about removing medications that we know have a proven benefit for our children and for adults in the commonwealth simply because the Secretary of Health and Human Services at the federal level thinks that we’re over-medicalizing our kids.

Herz: And we’ve been hearing the past couple of days that the COVID shot is not recommended for children and pregnant women. Was this a surprise to hear this?

Goldstein: If you follow what’s been happening at the federal level, I’m not sure that this is a surprise. We know that Secretary Kennedy is anti-vaccine. We know he has pushed a lot of misinformation about vaccines, the COVID vaccine in particular. Look, I’m a scientist. I believe in science and I do think that we should continue to question science. We should look for more data. We should evaluate those data in the context of the current environment. I’m all for that. But what I can’t support is a federal government that is actually removing science from the discussion, that is making decisions in the political realm and not allowing the scientific advisors to provide their input, their evaluation of the data. We will see what will happen over the next few months, but I do think that this is a call to us here in Massachusetts, a commonwealth that believes in vaccines. We are going to have to dig into the science and data, and then we’ll make a recommendation and make sure that everyone in Massachusetts has access to the vaccines that are best for them.

Herz: Well, just remind us what are the current recommendations for COVID vaccines.

Goldstein: Currently, per the Department of Public Health and per our recommendations, everyone six months and older should get a yearly COVID vaccine. There are some people who should get more frequent COVID vaccine, those are folks who are 65 and older, people who are severely immunocompromised, we recommend that they get a COVID vaccine every six months to make sure they’re maintaining that protection. Now obviously, a lot of folks have kind of moved on from this and we know here Massachusetts, less than 30% of folks in the state got the COVID vaccine this past season. We can do better and we wanna do better, but we really need to think about who’s at highest risk for COVID-19, for severe illness, for emergency room presentation, for hospitalization, and unfortunately, at risk for death. Those are folks who are 65 and older, those are folks are 50 and older who have underlying medical conditions, and those are people who are five years and younger. Which is something that the federal government didn’t talk about a lot in this recent announcement, but we do know even here in Massachusetts, and we look at the past season, the group that had the second or third highest rate of emergency room presentation were kids five and younger.

Herz: Well, also when we’re talking about vaccines, they have a lot of long-term benefits, it seems like, and not just COVID vaccine, right?

Goldstein: That’s true. You know, each vaccine is different and each vaccine has a different benefit profile. That’s the science, that’s the data that we should be digging into and really trying to use those benefits to make sure we’re targeting vaccine recommendations to the right group.

Massachusetts’ top health official worries about what he called “disinformation” and “lies” in a new federal report on the health of American children.

The report was released last week by Robert F. Kennedy Jr.’s Make America Healthy Again Commission. It describes a “chronic disease crisis” among children for diseases such as obesity, asthma, autoimmune conditions and behavioral health problems. It further identifies the root causes of these diseases as a combination of poor diet, chemical exposure, stress and lack of exercise, and what it calls “over-medicalization.”

Dr. Robbie Goldstein, the commissioner of the Massachusetts Department of Public Health, says the report does contain some truth — like rising rates of chronic disease among children.

“What’s unfortunate is that the report also peddles in myths and disinformation. It puts out lies instead of facts,” he said on GBH’s Morning Edition Thursday. “It leans on reports that don’t go through the scientific method, but rather reports that were cherry-picked to make a specific point of the secretary, or a specific points of the commission.”

Goldstein warns that the report’s misleading information undermines the public’s safety.

“I worry when health and science get turned into politics and words that aren’t necessarily true, but words that can definitely confuse and misdirect the work that we’re trying to do to protect the health of children,” he said.

Among the misinformation the report contains, Goldstein says, are claims about over-medicalization.

“As someone who’s a physician, as someone who oftentimes relies on medications to help individuals through a chronic disease ... medications have a time and a place,” he said. “We should not be thinking about removing medications that we know have a proven benefit for our children and for adults in the commonwealth simply because the secretary of Health and Human Services at the federal level thinks that we’re over-medicalizing our kids.”

Goldstein also pushed back on recent statements from Kennedy about COVID vaccines, particularly in light of his department’s decision to stop recommending the vaccine for healthy children and pregnant women.

“We know that Secretary Kennedy is anti-vaccine. We know he has pushed a lot of misinformation about vaccines, the COVID vaccine in particular,” he said. Goldstein says that the recommendation was made without appropriate scientific input.

“I do think that this is a call to us here in Massachusetts, a commonwealth that believes in vaccines,” he said. “We are going to have to dig into the science and data, and then we’ll make a recommendation and make sure that everyone in Massachusetts has access to the vaccines that are best for them.”