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      Key takeaways: RFK Jr’s ‘Maha’ report on chronic disease in children

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      Donald Trump’s health secretary and long-time vaccine skeptic, Robert F Kennedy Jr, presented a highly anticipated report on children’s health this week.The “Maha commission” report, referring to the “Make America healthy again” movement, was required by a presidential executive order in February. The report focuses on chronic disease among children.The 68-page report broadly summarizes five areas affecting children’s health, with a focus on ultra-processed foods, environmental chemical exposure, lack of physical activity, “overmedicalization”, and “capture” of regulatory agencies.It notably omits some of the most common causes of chronic disease and death in children, insinuates there could be harms where there is lack of evidence, and avoids discussing how Republicans have already changed the health system in ways researchers believe are harmful.Art Caplan, a professor of bioethics at New York University’s Grossman School of Medicine, told the Guardian that the report has “interesting ideas about health and children’s health and crackpot fringe tin-hat-wearing nonsense – it’s got it all”.Here are five of the key takeaways from the report.1. The report ignores some common dangers to childrenThe most common causes of death among children are car crashes and firearm accidents. The report ignores these issues, as well as behaviors that often start in adolescence and lead to chronic disease in adulthood, such as smoking and alcohol use. It also criticizes water fluoridation, without mentioning its protective effects against cavities.Also, absent from the report is a discussion of how the administration has already changed the health department in ways that advocates argue will benefit industry and could exacerbate chronic disease.For instance, Kennedy eliminated two smoking prevention offices at the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) in what one former regulator told Stat was “the greatest gift to the tobacco industry in the last half century”. He also eliminated a world-leading sexually transmitted infection laboratory.In another example, one of the nation’s leading researchers of ultra-processed foods quit his “dream job” after facing what he described as censorship from the administration (the health department reportedly asked him to return). In a similar vein, the Trump administration cut a program that delivered local whole foods to schools soon after taking office, in spite of Kennedy calling for healthier school meals.2. The report focuses on issues key to Kennedy’s view of healthThe report is roughly broken up into five sections focusing on ultra-processed foods, environmental chemical exposures, children’s mental health, “overmedicalization” and “corporate capture” of regulators by the industries they are supposed to oversee.Kennedy has harped on many of the issues listed in the report for months in public appearances and even though his defunct presidential campaign – especially including ultra-processed foods and obesity. Although some of these concerns may find bipartisan support – such as the focus on “forever chemicals” such as Pfas – it also pushes into areas where the science is unsettled.For instance, the report mentions that high levels of fluoride are potentially associated with reduced IQ, but does not mention its well-established protective effects against cavities – the most common chronic condition in children, according to the National Institute of Dental and Craniofacial Research.Similarly, the report argues that the childhood vaccine schedule is causing concern among parents for,“their possible role in the growing childhood chronic disease crisis” – without citing evidence that vaccines are linked to any specific chronic disease.3. It’s likely to face diverse pushback – and create new alliancesEven before the report was published, congressional lawmakers were being bombarded by calls from agricultural and chemical lobbyists wary of how the report would criticize their products – and indeed it did.One of the report’s sections questions whether “crop protection tools” including “pesticides, herbicides and insecticides” could harm human health. It then specifically name-drops glyphosate, the key ingredient in Roundup, and atrazine, a common herbicide. That is sure to make for strange political bedfellows and consternation within the Republican party. Similarly, the report cites synthetic dyes and ultra-processed foods are potentially harmful.Chemicals and food additives have been issues of concern for decades on the left. However, the Maha movement has also catalyzed opposition to them on the right.4. The report’s authors are not namedThe commission’s members are made up of the heads of intersecting agencies, including Kennedy at the Department of Health and Human Services, and the heads of the departments of agriculture, housing, education, veterans affairs and the Environmental Protection Agency, among others.However, the exact authors of the report are unknown. This contrasts with Kennedy’s repeated promise at his confirmation hearing that his health department would practice “radical transparency”.The work of the “Maha” commission was reportedly spearheaded by senior Kennedy adviser Calley Means, a former food lobbyist and healthcare entrepreneur who rose to prominence as a Maha truth-teller. Means co-wrote a bestselling book with his sister, current US surgeon general nominee Casey Means, which blames many of America’s ills on sedentary lifestyle and poor diet.5. Changing any of the issues identified is likely to be toughOne of the key issues the report identifies is the influence of food, pharmaceutical and chemical companies on American policy. They are monied and powerful.As a result, getting real change through Congress is certain to be tough – especially in an administration devoted to reducing regulations. More

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      Republicans are attacking childcare funding. Their goal? To push women out of the workforce | Moira Donegan

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      Last month, the White House issued a proposed budget to Congress that completely eliminated funding for Head Start, the six-decade-old early childhood education program for low-income families that serves as a source of childcare for large swaths of the American working class.The funding was restored in the proposed budget after an outcry, but large numbers of employees who oversee the program at the office of Head Start were laid off in a budget-slashing measure under Robert F Kennedy Jr, the head of the Department of Health and Human Services. On Thursday, Kennedy said funding for the program would not be axed, but more cuts to childcare funding are likely coming: some Republicans have pushed to repeal a five-decade-old tax credit for daycare. The White House is entertaining proposals on how to incentivize and structurally coerce American women into bearing more children, but it seems to be determined to make doing so as costly to those women’s careers as possible.That’s because the Republicans’ childcare policy, like their pro-natalist policy, is based on one goal: undoing the historic gains in women’s rights and status, and pushing American women out of the workforce, out of public life, out of full participation in society – and into a narrow domestic role of confinement, dependence and isolation.The New York Times reported this week that the White House is now not only looking for ways to make more women have children, but to encourage “parents” to stay home to raise them. “Parents” here is a euphemism. Roughly 80% of stay-at-home parents are mothers: cultural traditions that encourage women, and not men, to sacrifice their careers for caregiving, along with persistent wage inequalities that make women, on the whole, lower earners than their male partners, both incentivize women, and not men, to drop out of the workforce and stay home when they have children.This state of affairs has been worsened by the dramatic rise in the cost of childcare, which is prohibitively expensive for many parents. The average cost of childcare per child per year in the US is now well north of $11,000, according to Child Care Aware of America, an industry advocacy group. In major cities such as New York, that price is significantly higher: from $16,000 to $19,000 per year. Existing tax credits need to be expanded, not eliminated, to reduce this burden on mothers and their families and to enable women to join the workforce at rates comparable to men and commensurate with their dignity and capacities. Currently, 26% of mothers do not engage in paid work, a figure that has barely budged in 40 years. Largely because of the unequally distributed burdens of childcare, men participate in the paid labor force at a rate that is more than 10% higher than women.One might think that the solution would be to invest more in high-quality childcare, so that providers could open more slots, children could access more resources, and women could go to work and expend their talents in productive ways that earn them money, make use of their gifts and provide more dignity for women and more stability for families. This is not what the American right is proposing: Brad Wilcox, a sociologist who promotes traditional family and gender relations, has called such policy initiatives “work-ist”. Conservatives are proposing, instead, that women go back to the kitchen.The Trump administration, and the American right more broadly, wants the rate of women’s employment to be even lower, because it is advancing a lie that women are naturally, inevitably, uniformly and innately inclined to caregiving, child rearing and homemaking – and not to the positions of intellectual achievement, responsibility, leadership, ingenuity or independence that women may aspire to in the public world. “We cannot get away from the fact that a child is hardwired to bond with Mom,” says Janet Erickson, a fellow at the rightwing Institute for Family Studies, who once co-authored an op-ed with JD Vance calling on “parents” to drop out of the workforce to raise children. “I just think, why should we deny that?”This kind of vague, evidence-free gesturing toward evolutionary psychology – the notion that babies are “hardwired” to prefer mothers who are not employed – is a common conservative tick: a recourse to dishonest and debunked science to lend empiricism to bigotry. There is in fact no evolutionary reason, and no biological reason, for mothers, and not fathers, to abandon independence, ambition or life outside the home for the sake of a child. The only reason is a sexist one.Over the past decade, the left launched few vigorous defenses of a feminist politics that seeks to advance and secure women’s access to public life, paid work and fair remuneration. The American left has launched vigorous criticisms of the “girlboss”, a figure of malignant female ambition who seemed to make the exploitations of capitalism more offensive by virtue of her sex, and it has instead offered critiques of women’s ambition and romantic defenses of the labor of “care” that just happens to overlap with women’s traditional – and traditionally unpaid – roles in the home. This leftwing rhetoric has at times mirrored the similar romanticization of the unpaid housewife of yesteryear from the right, which has embraced tradwives, homesteading fantasies and an aestheticized rustic simplicity that aims to contrast feminist gains in the workforce with a fantasy of women’s rest. Together, these strains of rhetorical opposition to women in the workforce have made anti-feminism into a new kind of “socialism of fools” – a misguided misdirection of anger and resentment at the rapaciousness of capitalism towards a social justice movement for the rights of an oppressed class.skip past newsletter promotionafter newsletter promotionBut what is on offer from the political right is not about the refashioning of work and life to be less extractive and exploitative for women, and particularly for mothers. It is instead about a sex segregation of human experience, an effort to make much of public life inaccessible to women. Combined with the right wing’s successful attack on the right to abortion, the Trump administration’s dramatic cuts to Title X programs that provide contraceptive access, and the rescinding of federal grants aimed at helping working women, what emerges from the rightwing policy agenda is an effort to force women out of education, out of decently paid work and into pregnancy, unemployment and dependence on men.Theirs is an effort to shelter men from women’s economic competition, to revert to the regressive cultural modes of an imagined past, and to impose an artificially narrow vision of the capacities, aspirations, talents and desires of half of the American people.Murray Rothbard, the paleoconservative 20th-century economist whose ideas have had a profound influence on the Trumpist worldview, once vowed: “We shall repeal the 20th century.” As far as the Republican right is concerned, it seems to want to repeal the gains of 20th-century feminism first.

      Moira Donegan is a Guardian US columnist More

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      Republicans say they want more American babies – but which kind?

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      Some of the children were too young to stand on their own. Instead, they sat on their parents’ knees or in their parents’ arms, waving American flags. Many of them seemed confused about what, exactly, was even happening.But these kids were in the midst of making history: their families were among the first to take advantage of Donald Trump’s February executive order granting white South Africans refugee status in the United States, on the grounds that Afrikaner landowners – who make up just 7% of South Africa’s population yet, decades after the end of apartheid, control about half of its land – are facing persecution. While the doors to the US refugee program have been slammed shut to virtually everyone else, these Afrikaners showed up in the US earlier this week, their refugee status promising a path to US citizenship.Days later, the Trump administration took a far narrower view of who deserves access to the American polity. On Thursday morning, a lawyer for the Trump administration argued in front of the US supreme court that the 14th amendment does not guarantee citizenship to the American-born children of “illegal aliens” – a view contradicted by more than a century of legal precedent.This split screen raises a vital question: is the Trump administration really interested in helping children and families flourish – or only the “right” families?Over the last several months, the Trump administration’s policies on immigration, families, and children have been pockmarked by all kinds of contradictions. The administration is reportedly considering numerous policies to convince people to have more children, such as “baby bonuses” of $5,000 or medals for mothers who have six or more kids. The Department of Transportation has issued a memo directing the agency to “give preference to communities with marriage and birth rates higher than the national average”. And JD Vance has proclaimed: “I want more babies in the United States of America.”These moves are, in part, fueled by the growing power of the pronatalism movement, which believes that the declining birthrate in the US is an existential threat to its workforce and its future.Why, then, does the government want to exclude an estimated 150,000 babies born every year?“It’s hard to look at any of these policies and not believe that they’re created for the purpose of satisfying a political base that was promised some sort of notions of recreating a nostalgia for a white Christian nationalist nation,” said P Deep Gulasekaram, a professor of immigration law at the University of Colorado Law School.If the fate of the US workforce is really of concern, experts say immigration could help grow it – but the Trump administration has taken a hardline stance against immigrants from the Global South and their children. The administration has not only reportedly turned the refugee agency responsible for caring for children who arrive in the US alone into an arm of Ice, but also slashed funding for legal representation of children in immigration proceedings. Meanwhile, Republicans in Congress are trying to block parents who lack Social Security Numbers – such as undocumented people – from benefiting from the child tax credit, even in cases where their children are US citizens.The Trump administration has also unveiled new screening protocols that make it far more difficult for undocumented people to “sponsor”, or take custody of, children who enter the US alone. Just last week, the National Center for Youth Law and the legal advocacy group Democracy Forward sued the Trump administration over the changes, which they say have forced kids to languish in government custody. Between December 2024 and March 2025, kids went from spending an average of two months in government custody to spending an average of six.“This administration has compromised the basic health and safety of immigrant children in egregious ways,” Neha Desai, managing director of children’s human rights and dignity at the National Center for Youth Law, said in an email.In March, KFF, a charity that conducts health policy research, conducted focus groups of Hispanic adults who are undocumented or likely living with someone who is undocumented. Many spoke of the effect that the Trump administration’s policies are having on their families and kids.“I have a six-year-old child. Honestly, I’m afraid to take him to the park, and he asks me, ‘Mom, why don’t we go to the park?’” one 49-year-old Costa Rican immigrant woman told KFF. “How do I tell him? I’m scared.”“Even the children worry. ‘Mom, did you get home safely?’ They’re already thinking that something is going to happen to us on the street,” added a 54-year-old Colombian immigrant woman. “So that also makes me very nervous, knowing that there might come a time when they could be left here alone.”The supreme court arguments on Thursday centered not on the constitutionality of birthright citizenship, but on the legality of lower court orders in the case. Still, some of the justices expressed concerns about what the case could mean for children.Eliminating birthright citizenship, Justice Elena Kagan suggested, could render children stateless. The high court needed a way to act fast, she said.If the justices believe that a court order is wrong, she asked, “why should we permit those countless others to be subject to what we think is an unlawful executive action?”Both the historical and legal record make clear that the 14th Amendment encapsulates birthright citizenship, Gulasekaram said. But, he said, predicting the supreme court’s moves is a “fool’s errand”.“There’s really no way of getting around the the conclusion that this is a call to some form of racial threat and racial solidarity as a way of shoring up support from a particular part of the of the of the Trump base,” Gulasekaram said. “Citizenship and the acquisition of citizenship has always been racially motivated in the United States.” More

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      Give birth? In this economy? US women scoff at Trump’s meager ‘baby bonuses’

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      In theory, Savannah Downing would love to be a mom. At 24, the Texan actor and content creator is nearing the age at which her mother had kids. Some of her friends are starting families. But having children in the United States is wildly expensive – and so when she saw the news that the Trump administration was considering giving out $5,000 “baby bonuses” to convince women to have kids, Downing was incensed.“Maybe people will want to have children more often if we weren’t struggling to find jobs, struggling to pay our student loans, struggling to pay for food,” she said. “Five thousand dollars doesn’t even begin to even cover childcare for one month. It just seems really ridiculous.”Trump officials have made no secret of their desire to make America procreate again. In his very first address as vice-president, JD Vance said at the anti-abortion March for Life: “I want more babies in the United States of America.” Weeks later, a Department of Transportation memo directed the agency to focus on projects that “give preference to communities with marriage and birth rates higher than the national average”. Then, in late April, the New York Times reported that the administration was brainstorming policies to encourage people to get married and have kids, such as giving out those baby bonuses or awarding medals to women who have at least six children.All of these moves are evidence of the growing power of the pronatalist movement within US politics. This movement, which has won adherents among both traditional “family values” conservatives and tech-bro rightwingers such as Elon Musk, considers the falling US birthrate to be an existential threat to the country’s future and thus holds that the US government should enact policies designed to incentivize people to give birth.But many of the women who are, in theory, the targets of the pronatalist pitch have just one response: Have babies? In this economy?After the New York Times report broke, social media exploded with indignation at the proposed policies’ inadequacy. “Go ahead and tell Uncle Sam what he needs to give you to make him Daddy Sam,” a woman rasped at the camera in one TikTok with nearly 1m likes. “Universal – ?” she started to say, in a presumable reference to universal healthcare. “No. No. Where did you even hear that?”“Five thousand? That doesn’t go very far!” one 24-year-old stay-at-home mother of four complained in another TikTok, as her children babbled in the background. “It costs 200, 300 bucks just to buy a car seat for these kids. I just feel like it’s really just insulting. If you want people to have more kids, make housing more affordable. Make food more affordable.”Although the cost of raising a child in the US varies greatly depending on factors such as geography, income level and family structure, a middle-class family with dual incomes can expect to spend somewhere between $285,000 and $311,000 raising a child born in 2015, a 2022 analysis by the Brookings Institute found. That analysis doesn’t factor in the price of college tuition, which also varies but, as of last year, cost about $11,600 a year at an in-state, public university.The cost of merely giving birth is more expensive in the US than in almost any other country on the planet. An uncomplicated birth covered by private insurance. which is basically the best-case scenario for US parents, tends to cost about $3,000, according to Abigail Leonard’s new book Four Mothers.Paige Connell, a 35-year-old working mom of four who regularly posts online about motherhood, had a long list of pro-family policies she would like to see adopted. For example: lowering the cost of childcare, which runs to about $70,000 a year for Connell’s family. (An April Trump administration memo proposed eliminating Head Start, which helps low-income families obtain childcare, although the administration appears to have recently reversed course.) Or: preserving the Department of Education, as Connell has children in public school and some of them rely on specialized education plans. (Trump has signed an executive order aiming to dismantle the department, in an apparent attempt to get around the fact that only Congress can close federal departments.)“They want to incentivize people to have children. I don’t think they have a real stake in helping people raise them,” Connell said of the Trump administration. “Many women that I know – women and men – do want more kids. They actually want to have more children. They simply can’t afford it.”Lyman Stone, a demographer who in 2024 established the pronatalism initiative at the right-leaning Institute for Family Studies, argued in an interview last year that “most of missing babies in our society are first and second births” – that is, that people avoid having a second child or having kids at all. Pronatalism, he said, should focus on helping those people decide otherwise.“The misconception is this idea that pronatalism is about tradwives and giant families, when it’s really about, on some level, helping the girl boss, like, girl boss in her family life a little bit earlier and harder,” Stone said.Some Americans may indeed be having fewer children than they would like. Among adults under 50 who say they are unlikely to have children, close to 40% say that they are not doing so due to “concerns about the state of the world” or because they “can’t afford to raise a child”, according to a 2024 Pew survey. A 2025 Harris poll for the Guardian found that the state of the economy has negatively affected 65% of Americans’ plans to have a child.But to say that pronatalism is about helping the “girl boss” have one or two kids is not quite accurate, given that several prominent pronatalists are deeply interested in producing “giant families”. Malcolm and Simone Collins, who have become the avatars of the tech-right wing of pronatalism, have at least four children and show no signs of slowing down. (The Collinses were behind the medal idea reported by the Times; they called it a “National Medal of Motherhood”.) Musk, perhaps the most famous pronatalist on the planet, reportedly runs something of a harem and is believed to have fathered 14 children.Republicans are also currently exploring policies that would entice more parents to stay at home with their children, the New York Times reported on Monday, such as expanding the child tax credit from $2,000 to $5,000. While these potential policies do not specify which parent would stay at home, four out of five stay-at-home parents are moms.However, this goal is seemingly at odds with Republicans’ desire to slash the US budget by more than $1.5tn. Indeed, Republicans have proposed dramatically curtailing Medicaid – a proposal that would appear to hinder the pronatalism agenda, because Medicaid pays for more than 40% of all US births.skip past newsletter promotionafter newsletter promotionPronatalism has long been intertwined with racism, eugenics and authoritarian governments. Nazi Germany and the Stalinist Soviet Union gave out medals to women who had large numbers of children, while in the United States, interest in pronatalism has historically surged in eras, such as the early 20th century, when women and immigrants were trying to participate more in public life. Today, fears about the consequences of the near record low US birthrate are often tied to concerns about the country’s shrinking workforce. Immigration could help alleviate those concerns, but the Trump administration is deeply opposed to it.All this leads to a fundamental question: do pronatalists want everybody to have children – or just some types of people?“What I’ve seen online of the pronatalist movement, it does seem very aligned with white supremacy, because it does seem like a lot of the conversation around it is more geared towards white couples having more babies,” said Madison Block, a product marketing manager and writer who lives in New York. She’s also leery of the Trump administration’s focus on autism, which could translate into ableism: “A lot of the conversations around pronatalism, in addition to being borderline white supremacist, I think are also very ableist.”Now that she’s 28, Block said that many of her friends were starting to get married and consider having babies. But Block is afraid to do so under the current administration. And when she thinks about potentially starting a family, affordable healthcare is non-negotiable.“I personally wouldn’t want to have kids unless I know for a fact that I am financially stable enough, that I can provide them with an even better childhood than what I have,” Block said. “I think, for a lot of younger millennials and gen Z, a lot of us are not at that point yet.”View image in fullscreenPerhaps the ultimate irony of the Trump administration’s pronatalist push is that it is not clear what pronatalist policies, if any, actually induce people into becoming parents.In past years, Hungary has poured 5% of its national GDP into boosting births, such as through exempting women who have four children or more children from paying taxes. This herculean effort has not worked: as of 2023, the country’s birth rate has hovered at 1.6, well below the replacement rate of 2.1. (For a country to maintain its population, women must have about two children each.) More left-leaning countries, such as those in Scandinavia, have also embarked on extensive government programs to make it easier for women to have kids and maintain careers – yet their birth rates also remain lower than the replacement rate and, in the case of Sweden, even dropped.It may be the case that, when access to technologies like birth control give people more choices over when and how to have children, they may simply choose to have fewer children. In that 2024 Pew survey, nearly 60% of respondents said that they were unlikely to have kids because they “just don’t want to”.Downing is not that concerned about pronatalism taking root among the general public. Personally, she doesn’t feel like there’s too much governmental pressure on her to have kids, particularly since she is Black and much of the pronatalism movement seems focused on pushing white women to have babies.“I feel like a lot of women are fed up. I think that’s why the birth rate is going down,” she said. “Women are realizing that they’re more than just birthing machines.”But images from The Handmaid’s Tale – the red capes, the white bonnets – haunt her.“I think $5,000 and a medal trying to coax women into having more kids is a start,” she said, “and I really am worried to see how far they will go to try to force women and have children”. More

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      This Mother’s Day, lets talk about why birth rates are really declining | Katrina vanden Heuvel

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      Mother’s Day is here, and while Donald Trump may seem an unlikely celebrant of the occasion, his administration has recently floated several proposals to incentivize motherhood – or, more accurately, giving birth. There’s the $5,000 “baby bonus” for every American mother, free classes educating women on their menstrual cycles and a National Medal of Motherhood for moms who have at least six children. (Want to guess which regime also awarded such a medal?)As usual, the president has offered ridiculous solutions to a very real problem. He’s certainly right that every American should be able to afford to raise children, and that programs like social security depend on stable demographics. But of course, every other action he has taken to undermine gender equality would suggest that this sudden interest in the wellbeing of mothers is less than sincere. That’s exactly why progressives have an opening to break up what the Republican party believes to be its ideological monopoly on pro-family policies.The roots of the fertility crisis engage the bread-and-butter issues that have long been the domain of Democrats. US birthrates have hit a record low not because the nation has become “almost pathologically anti-child”, as JD Vance asserted to the New York Times. Instead, surveys have shown that would-be parents want to own a home, repay student debt and have money for childcare before starting a family. Yet the average age of a homebuyer has climbed to 56, almost double what it was 40 years ago. And 43% of young people currently carry student debt, compared with 28% in 1993. The problem isn’t lack of interest – it’s too much interest being paid on record high loans.But most of the Trump administration’s floated fixes are unoriginal swipes from the undemocratic leaders they admire. In 2017, Vladimir Putin declared a “Decade of Childhood in Russia”, an innocent name for a program that calls for everything from defending so-called family values to encouraging conjugal trysts during workplace coffee breaks to censoring “childfree propaganda”. Meanwhile, Viktor Orbán has dedicated 5% of Hungary’s GDP to pronatalist policies, which include nationalized IVF services and lifetime tax exemptions for mothers with three children. These men are carrying on an authoritarian tradition begun by the original strongman, Benito Mussolini, whose “Battle for Births” portended literal battles that decreased Europe’s population by 20 million people.That’s why those who really care about real solutions would be wise to start offering their own plans, and, in fact, some already have. What the Trump administration didn’t plagiarize from autocrats, they took from progressives, which is why “baby bonuses” sounds an awful lot like the “baby bonds” proposed in 2021 by Senators Tammy Baldwin and Cory Booker and Representative Ayanna Pressley. The legislation would put $1,000 in a savings account at birth for every American child. The Biden-era American Rescue Plan also almost doubled the child tax credit, which nearly halved the child poverty rate. Though making that expansion permanent received bipartisan support, it was ultimately killed by the centrist triangulating of Joe Manchin.Four years later, Democrats have the chance to embrace a genuinely progressive agenda that doubles as a pro-family platform. Bernie Sanders has long called for cancelling all student debt, Elizabeth Warren has campaigned for universal childcare, and Alexandria Ocasio-Cortez was among the first politicians on Capitol Hill to offer three months of paid parental leave to her entire staff. The Congressional Progressive caucus has also called for a whole raft of policies that would lower the cost of living, from expanding Medicaid to investing $250bn in affordable housing. They understand that real relief will come not from handing out medals but from having the mettle to fight for working families.Still, even if Democrats manage a progressive populist revival not seen since Franklin Delano Roosevelt, it probably wouldn’t be enough to lift birthrates. In social democracies like Finland and Sweden – which offer 13 months of paid parental leave and cover 90% of preschool costs, respectively – fertility remains below replacement levels.Does that indicate the problem may be more fundamental? One sociologist, Dr Karen Benjamin Guzzo, has attributed this dilemma to apprehension: “People really need to feel confident about the future.” But whether it’s 60% of young people feeling very worried about the climate crisis, or 80% of new mothers feeling lonely, or 90% of voters feeling that American politics is broken, the state of the world doesn’t seem too conducive to domestic bliss. The right’s response to this anxiety is embodied by Elon Musk, who keeps siring children with women he meets on X to create a “legion-level” brood “before the apocalypse”.To help avert said apocalypse, what should be on offer are authentically family-friendly policies that benefit parents and non-parents alike. In doing so, there’s a chance to persuade Americans that the next generation still might have a brighter future than the last. Or, at the very least, that progressives have a more compelling vision for American families than the one whose budget is about to take billions from children’s education, food and healthcare.It’s one thing to incentivize giving birth. Americans deserve leaders who will fight for those kids after they’re born.

      Katrina vanden Heuvel is editorial director and publisher of the Nation. She is a member of the Council on Foreign Relations and has contributed to the Washington Post, the New York Times and the Los Angeles Times More

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      Trump health cuts create ‘real danger’ around disease outbreaks, workers warn

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      Mass terminations and billions of dollars’ worth of cuts at the Department of Health and Human Services (HHS) have gutted key programs – from child support services to HIV treatment abroad – and created a “real danger” that disease outbreaks will be missed, according to former workers.Workers at the HHS, now led by Robert F Kennedy Jr, and in public health warned in interviews that chaotic, flawed and sweeping reductions would have broad, negative effects across the US and beyond.While Donald Trump’s administration is cutting the HHS workforce from 82,000 to 62,000 through firings and buyouts, grant cuts by Elon Musk’s so-called “department of government efficiency” (Doge) have also had a stark impact on state governments – and resulted in firings at state public health agencies.At the South Carolina department of public health, for example, more than 70 staff were laid off in March due to funding cuts.“Disease surveillance is how we know when something unusual is happening with people’s health, like when there are more food-poisoning cases than usual, or a virus starts spreading in a community,” an epidemiologist at the department, whose role was eliminated, said. “It’s the system that lets us spot patterns, find outbreaks early, and respond before more people get sick.”“When you lose public health staff, you lose time, you lose accuracy, you lose responsiveness, and ultimately that affects people’s health,” they added. “Without us, outbreaks can fly under the radar, and the response can be delayed or disorganized. That’s the real danger when these roles get cut.View image in fullscreen“It’s invisible work, until it’s not. You may not think about it day to day, but it’s protecting your drinking water, your food, your kids’ schools and your community.”A spokesperson for South Carolina’s public health department declined to comment on specifics, but noted employees hired through grants are temporary. “When funding for grants is no longer available, their employment may end, as happened with some temporary grant employees who were funded by these grants,” they said.In Washington, the HHS has been cut harder by Doge than any other federal department. Hundreds of grants to state, local and tribal governments, as well as to research institutions, have been eliminated, worth over $6.8bn in unpaid obligations.The HHS receives about a quarter of all federal spending, with the majority disbursed to states for health programs and services such as Medicare and Medicaid, the insurance programs; medical research; and food and drug safety. Trump’s budget proposal calls for cutting the department’s discretionary spending by 26.2%, or $33.3bn.RFK Jr, who has a history of promoting conspiracy theories and medical misinformation, was nominated by Trump and approved by the Senate along party lines, with Mitch McConnell the sole Republican dissenter.Following a reduction in force of 10,000 employees on 1 April, Kennedy Jr claimed 20% of the firings were in error and that those workers would be reinstated, though that has not happened.An HHS spokesperson blamed any such errors on data-collection issues, and did not comment on any other aspects of the Guardian’s reporting.Aids relief program ‘dismantled’At the Centers for Disease Control and Prevention, an operating division of the HHS, employees working on maternal and child health at the President’s Emergency Plan for Aids Relief (Pepfar) program were shocked to be included in the reduction in force, as earlier in the administration their work had received a waiver for parts of the program from federal funding freezes.All federal experts on HIV prevention in children overseas were fired as part of the reduction in force.“Our concern initially was that it was a mistake with the name. We hoped around that time it came out that there were 20% errors, that we would be included,” said an epidemiologist who was included in the reduction in force, but requested to remain anonymous as they are currently on administrative leave. They also noted that they were in the middle of planning and delivering a new pediatric HIV treatment medication set to be dispersed this year, and that that work was now at risk.View image in fullscreenThey said 22 epidemiologists in the branch of their CDC division had been fired. Pepfar was created in 2003 by George W Bush to prevent mother-to-child HIV transmission and credited with saving 26 million lives.“We were very shocked on April 1 that we were put immediately on admin leave,” said another epidemiologist affected by the reduction in force at the CDC. “We really feel our branch being cut was a mistake. The state department had said services were a priority and needed to continue, but then we were cut by HHS.”They noted HIV treatment had already stopped in regions of countries that had been reliant on USAID programs, such as Zambia.“It is one of the most successful global health programs in history, data driven with high levels of accountability and the dollars spent achieve impact. Our concern now is, yes, they are continuing Pepfar in name, but they are dismantling all the systems and structure that allowed it to succeed,” they added. “The US made a huge investment in this program in 20 years and a lot of it is now undone. We’ve now disrupted those systems that could have reduced and eventually removed US investment in these programs.”‘Long-term impact’ on US familiesInside the HHS, the Administration for Children and Families is responsible for enforcing court-ordered child-support payments. For every dollar it receives in federal funding, ACF says it is able to collect $5 in child support.A child-support specialist with the HHS, who requested to remain anonymous for fear of retaliation, said reductions in force at the department have increased workloads on those who were not fired by multiple times, making it so state and tribal agencies have no way of ensuring they are compliant with federal requirements.“The regional staff with direct oversight of the program are gone,” they said. “There are entire regions that have two staff members managing a quarter of the work for the program with no management, no support, no knowledge of the program.”After the Trump administration took office, the agency was under an unofficial stop-work order, where staff were not permitted to provide guidance or support to grantees or even answer phones, until late February, the specialist said. A reduction in force followed on 1 April, when, the child-support specialist claimed, about half the ACF staff working on child support were fired.Their department is responsible for overseeing child-support programs at state, tribal and local levels. States “could very well lose millions of dollars in funding” if ACF does not provide key training and assistance and the states do not have qualified staff, the specialist cautioned. “And that is the long-term impact to vulnerable children and families in the country.”They added: “The entire function of the program is to give economic stability to children and families, so that they do not depend on any other government program, or their reliance on these programs is lower, because the children are supported by both parents.”‘A living hell’At the Centers for Medicare and Medicaid Services, also within the HHS, one of 300 workers terminated as part of a reduction in force claimed it had been illegal, and had not followed any proper procedures. The National Treasury Employees Union has filed a grievance over how the firings were carried out, including incorrect information on notices.They explained that, on 1 April, they received a generic letter informing them of an intent of reduction in force. Hours later, they were locked out of their government logins. “We started emailing the management that was left, trying to get clarification on what our status was. Nobody could give us an answer,” the worker said.On 7 April, they discovered through their paystub that they had been placed on administrative leave, despite never receiving a notice. They didn’t receive an RIF notice until weeks later, after requesting it.“Based on my tenure, and as a disabled veteran, I should at least have a chance of reassignment,” they said. “I’m not mad about losing my job. It happens. I’ve been laid off. The first time was in the private sector, and it was way more humane, more empathetic, and I was given different offers.“This, on the other hand, is unbridled hate. This administration has gone out of their way to make it a living hell for all of its public servants.” More

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      Why is Trump so fixated on toys for little girls? | Moira Donegan

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      Donald Trump has found a new target for his trademark mockery and dismissal: little girls.In comments at a 30 April cabinet meeting, the president seemed to dismiss the economic impact of his chaotic tariff regime on American consumers by citing girls as the primary complainants. “Somebody said, oh, the shelves are going to be open,” Trump said. “Well, maybe the children will have two dolls instead of 30 dolls. And maybe the two dolls will cost a couple bucks more than they would normally.”Trump is prone to odd non-sequiturs, but the dolls have become something of a sticking point. Onboard Air Force One on 4 May, he doubled down on his insistence that American girls should have fewer toys. “All I’m saying is that a young lady, a 10-year-old girl, nine-year-old girl, 15-year-old girl, doesn’t need 37 dolls,” he told reporters. “She could be very happy with two or three or four or five.”In an interview with Kristen Welker of Meet the Press that same day, Trump again mentioned the dolls. “I don’t think a beautiful baby girl needs – that’s 11 years old – needs 30 dolls,” Trump said. “I think they can have three dolls or four dolls because what we were doing with China was just unbelievable.” He went on to assert that American children also have too many pencils. “They don’t need to have 250 pencils. They can have five.”In some respects, the comments seem like a rare bit of honesty from the president: an acknowledgment of the reality that his tariffs will hurt consumers and lower the American their standard of living. With steep tariffs on many consumer goods, particularly those made in China, and supply chain issues caused by retailers and producers frantic attempts to offset the costs of the new tariffs, many common products – yes, including children’s toys – will become shorter in supply and steeper in cost. Because of Trump’s policies, it is indeed true that there will be fewer presents for children underneath American Christmas trees this year – a trend that is likely to continue for years to come if Trump’s trade war triggers an economic recession, as is widely expected. Americans themselves don’t have much say in this, but Donald Trump wants us all to know that he’s comfortable with us, and our children, having less.But the selection of dolls, in particular, as Trump’s stand-in for consumer prices reflects the gendered ideas about work, money and purchasing that animate Trump’s chaotic economic policy. After all, Trump did not talk about the impact of his trade regime on toy trucks or GI Joe action figures – and he certainly didn’t mention its likely impact on things like video games, basketballs, squat racks or protein powders. The tariffs will increase prices across economic sectors and hurt consumers of all kinds of goods. But Trump did not speak in general terms about those who might like to buy a house one day, or about who will be hurt by his tariffs on Canadian lumber, or about those who would like to be treated for their illnesses but who have to pay steeper prices for the medicines they need when tariffs hit pharmaceuticals. He didn’t talk about any of the consumption that Americans are uniformly agreed to think of as reasonable, dignified or aspirational. He chose, instead, something seen as trivial, childlike, and only for girls.The comments aim to cast the pain that consumers will face as ultimately feminine and frivolous, their complaints petulant and childlike. In this respect, Trump is drawing on a long tradition of economic rhetoric that aims to cast consumption as feminine, decadent and morally suspect – and to contrast it with the supposedly more manly and virtuous productive side of the economy. It’s a laughably stupid symbolism, one that only works for those deeply committed to their ignorance about how the economy actually works: in truth, everyone consumes, and people of all genders participate in the productive economy. But Trump does not argue based on the facts: he asserts dominance. And here, he casts those Americans who would complain about the economic pain that he is inflicting on them as feminine and hence as contemptible, deserving no more respect than spoiled children.The project of masculinizing the economy – perhaps especially at children’s expense – is one that the Trump administration seems to be pushing more broadly. Trump claims, despite the near-universal assertions of economists to the contrary, that his tariffs will shift the US away from the primarily female service sector industries that have dominated the American economy since the 1970s back to a more masculine manufacturing base.To this end, his commerce secretary, Howard Lutnick, a billionaire former CEO, went on MSNBC late last month to describe his vision for the future of the American worker. “It’s time to train people not to do the jobs of the past but to do the great jobs of the future,” Lutnick said, arguing that fewer people should be aspiring to bachelor’s degrees and should expect to occupy themselves in lower-skill factory work instead. “This is the new model, where you work in these kind of plants for the rest of your life, and your kids work here, and your grandkids work here.”This is the vision for your children’s future that the Trump administration wants to put forward: deprived of material comforts and joy in childhood, then deprived of the hope for upward mobility in adulthood. They want you, and your kids, to be poor, desperate and ignorant. They want you to work in repetitive, dangerous, back-breakingly physical jobs, and they want you to have no aspiration to anything better. They want you to imagine your future, and your children’s futures, not as an open horizon of freedom and potential, but as a dark and desperate struggle, devoid of the notion that we might be anything more than useful instruments for the needs of capital. What do they offer Americans as compensation for this loss? Virtually nothing, aside from misogynist contempt, and the assurance that as our living standards sink and our prospects disappear, in our suffering, at least, we are masculine.On Fox News this past Tuesday, the treasury secretary, Scott Bessent, tried to put this spin on things. Describing what he would say to a little girl who would be denied dolls because of Trump’s tariff policy, Bessent insisted that it was for her own good. “I would tell that young girl that you would have a better life than your parents,” Bessent said. But the Trump administration is doing everything in its power to ensure that America’s children – and in particular, its little girls – have it worse.

      Moira Donegan is a Guardian US columnist More

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      Trump is trying to pay his way into a US baby boom. Experts say it won’t work

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      One of Donald Trump’s priorities for his second term is getting Americans to have more babies – and the White House has a new proposal to encourage them to do so: a $5,000 “baby bonus”.The plan to give cash payments to mothers after delivery shows the growing influence of the “pronatalist” movement in the US, which, citing falling US birthrates, calls for “traditional” family values and for women – particularly white women – to have more children.But experts say $5,000 checks won’t lead to a baby boom. Between unaffordable healthcare, soaring housing costs, inaccessible childcare and a lack of federal parental leave mandates, Americans face a swath of expensive hurdles that disincentivize them from having large families – or families at all – and that will require a much larger government investment to overcome.It is true that the US is seeing declining birthrates – and has been for some time. While fertility rates bounced around what demographers call “replacement level” – the rate at which the population replenishes ageing people with new ones – in the decades that followed the post-second world war baby boom, they have been on a steady downward trend since the 2010 Great Recession, so that now, US fertility rates sit at about 1.6 births per woman.But these numbers are far from alarming, according to demographers and policy analysts. US birthrates are still in line with those in other developed countries, where societies and economies are continuing to thrive, and concerns about the sustainability of programs such as social security can be fixed through other remedies, like raising the tax limit.In the US, the modest decline in fertility can be attributed to a drop in teen pregnancy rates, as well as more families with two working parents and delaying having children. But these elements alone do not explain the trends we’re seeing, says Paula Lantz, a social demographer and professor of health policy at the University of Michigan. While the number of people who don’t have any children isn’t changing, demographers are seeing the percentage of families who have two kids drop, and the percentage of those who have just one increase. “There is something else going on,” she said.That “something else”, Lantz and her colleagues say, is how challenging it is to raise a family in the US from a financial perspective. For many Americans, having a larger family means sacrificing quality of life.Between the costs of healthcare, including the thousands on average that Americans pay just to give birth in a hospital, childcare, housing and basics such as formula and diapers, having a baby in the US is a huge expense – one that experts say a single $5,000 payment would barely make a dent in.“I had a baby a few months ago, and a one-time payment of $5,000 wouldn’t do much if I didn’t also have paid leave that let me keep my job, good health insurance, family support, incredible childcare and the kind of job that allows me to both provide for my family and be there for pickup,” said Lily Roberts, the managing director for inclusive growth at the Center for American Progress. “Every mom in America deserves that, and every dad does too.”Stephanie Schmidt, the director of childcare and early education at the Center for Law and Social Policy, emphasized that the average cost of infant care in the US is $14,000 per year, with that number ticking up to closer to $25,000 a year in high-cost-of-living areas. “$5,000 gets you almost nowhere when you’re thinking about utilizing it to pay for the expenses of having a young child,” she said.Schmidt also noted that when other countries have tried similar approaches, they made little to no difference in how many children people choose to have.In Australia, where a $3,000 baby bonus was put in place in 2004 to reverse declining fertility rates, there was a brief spike in birthrates immediately after a bonus was offered, but those rates dropped again in subsequent years. Experts say this is because families simply move up their timelines, having the same number of kids they already intended to have, only earlier.“They want to make sure they get [the benefit] before that policy is changed by the next government,” said Ron Lee, the director of the Center on the Economics and Demography of Aging at the University of California, Berkeley.Plus, most of the other countries that have tried baby bonuses also have robust social and healthcare systems, so the cash payments went further than they would in the US. “It’s not working in those contexts, so it’s certainly not going to work in ours,” said Lantz.To change minds and behaviors, there need to be much more substantial policy changes, experts say, that address the housing crisis, offer childcare subsidies, make healthcare accessible and affordable and guarantee paid family leave.“[This] would have such a more significant impact for families because it’s not a one-time investment,” said Schmidt.Deliberate efforts to address the climate crisis could also encourage more people to have children as younger people are delaying or forgoing starting families because of climate anxieties, says Lee, pointing to surveys that suggest this trend. Evidence also shows that people have fewer children during times of political uncertainty and instability – a dynamic experts say this administration is only intensifying.“If the problem they’re trying to solve is addressing a low birthrate, then create the conditions to make birth possible and make raising a family possible,” said Mary Ignatius, the executive director of advocacy group Parent Voices California.That isn’t to say that $5,000 wouldn’t be well-received, says Roberts. It might help pay for a month or two of childcare; help families buy a new crib, stroller and other gear, all of which are poised to become more expensive with rising tariffs; or offset hospital costs.For lower-income families especially, research shows that receiving no-strings cash bonuses can help them reach a point of financial stability, especially when kids are younger.But experts emphasize that other actions taken by the administration to dismantle programs that already support American families and children belie any honorable intentions. To date, the Trump administration has proposed eliminating Head Start, a program that supports families with very low incomes in accessing childcare, as well as cutting funds to Medicaid, which provides healthcare coverage for low-income Americans. (Congress also let the child tax credit – which expanded eligibility for pay outs of up to $3,600 for American families – expire in 2021, even though it’s been credited with lifting millions of children out of poverty.)“Those are the things that women need to be able to make the choices of how they want to be a parent,” said Ignatius. “Eliminating the programs at Medicaid, Head Start, TANF [temporary assistance for needy families], food stamps – that equates to much more than $5,000 in support for low-income families.”The dismantling of the federal workforce in the Department of Education, the justice department, which oversees juvenile justice initiatives, and the Department of Health and Human Services, where staff responsible for distributing funds for state welfare and foster care programs were gutted, will also have a negative impact on American families. “Even the little things that improve a family’s life, like children’s museum grants and public libraries, are reeling from cuts”, said Roberts. “All American families are going to feel the impact of this administration, and creepy plans to give moms a medal absolutely won’t make up for what they’re taking away.”For Schmidt, the White House’s actions speak to a fundamental disconnect between statements that encourage Americans to have children and actions that make doing so increasingly out of reach. “There is such an emphasis in this administration on birth, and such a lack of support for people once they’re here,” she said. 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