Casey Means and MAHA Remove the 'Public' From Public Health
On Wednesday, Donald Trump nominated Casey Means, a holistic doctor and wellness influencer, to be the next U.S. surgeon general. If confirmed, Means will be the first surgeon general who openly practices alternative medicine. She is an unusual candidate for surgeon general but an unsurprising one. Under an administration that is senselessly gutting science and research funding, "MAHA" priorities largely put the wellness dreams of the wealthy before public health.
The Office of the Surgeon General is responsible for communicating scientific information to the public and addressing public health issues. Means' record would normally be considered antagonistic toward this fundamental goal, but Trump has praised the nominee as having "impeccable 'MAHA' credentials." Means describes herself as someone who left "traditional medicine," and has expressed health beliefs that flirt with pseudoscience and closely align with those of Robert F. Kennedy Jr.
Co-author of Good Energy: The Surprising Connection Between Metabolism and Limitless Health and co-founder of Levels (a company that sells continuous glucose monitors), Means has peddled health claims that are questionable at best and dangerous at worst. Like other wellness influencers, she has dabbled in some Goop-esque activities, like consulting with a spiritual medium and taking part in a full moon ceremony, which are a little woo-woo but don't harm anyone else. Of greater consequence to public health is Means' skepticism of vaccines. She has also called birth control use "disrespect of life" and endorsed the supposed health benefits of raw milk. The prospect of having a surgeon general who believes such things is terrifying.
Beyond the pseudoscience, Means' general orientation toward health is out of touch with the needs of average Americans. She has built her career and reputation on promoting lifestyle choices such as healthy eating and exercise. From afar, her takes may appear sensible, and at times, even compatible with sound medical advice. A healthy diet and exercise are important, but they alone do not translate to good, humane policies.
Means has suggested that health issues like "depression, anxiety, infertility, heart disease, erectile dysfunction, type 2 diabetes, Alzheimer's dementia, [and] cancer" are "under our control and simpler than we think." Simpler for whom? An emphasis on lifestyle ultimately assigns structural and institutional problems to individual Americans to solve for themselves. In a country where wealth buys health, how many Americans can afford to insulate themselves and their families from risks of disease and disability? The federal minimum wage has been stagnant at $7.25 since 2009. Meanwhile, the cost of necessities like housing, food, and child care have increased precipitously.
WASHINGTON, DC - MAY 12: U.S. Health and Human Services Secretary Robert F. Kennedy Jr. speaks alongside President Donald Trump during a press conference in the Roosevelt Room of the White House on May 12,...
WASHINGTON, DC - MAY 12: U.S. Health and Human Services Secretary Robert F. Kennedy Jr. speaks alongside President Donald Trump during a press conference in the Roosevelt Room of the White House on May 12, 2025, in Washington, DC. MoreIn her "health wishlist" for the Trump administration, Means says we need leaders who will "inspire people to care about their health, the food they eat, and their fitness." Americans do not need inspiration. Americans need access. It is cruel to push the idea that people are unhealthy simply because they do not care. Our most urgent public health problems cannot be solved with personal empowerment and lifestyle choices. For instance, 7.2 million children live in food-insecure households. Meanwhile, the House of Representatives is planning to cut $12 billion from federally funded school meal programs.
Health care is also inaccessible to many Americans because, unlike many of its peer countries, the U.S. does not offer universal health coverage. Even for those who do have health insurance, coverage is often insufficient, causing many to accrue medical debt. The Trump administration has added new public health problems: the Food and Drug Administration recently suspended quality control for milk, the Department of Agriculture withdrew a proposal to reduce Salmonella in raw poultry products, and the Environmental Protection Agency has loosened restrictions on mercury pollution. Meanwhile, Kennedy continues to fuel vaccine hesitancy amid a national measles outbreak.
MAHA priorities are misaligned with public health needs. Means' sunny website—where she promotes her book, recipes, and newsletters—frames good health as an individual project. Means' wish list to the Trump administration proposes actions that would address processed foods, "Big Pharma," vaccine safety, alternative medicine, and paternalistic restrictions on SNAP. It is apparent that her and Kennedy's health concerns reflect the airy worries of the rich. Their brand of health care is for people who can choose to be healthy, people with the time and money to pursue health optimization, and people comfortable enough to be fussy over food dyes.
Pandering to the desires of the upper class, MAHA pushes products and services that are out of reach for the average American. The surgeon general is supposed to be the nation's doctor. Means is just an entrepreneur who peddles an expensive lifestyle.
Catherine Tan is an Assistant Professor in Sociology at Vassar College. She is the author of Spaces on the Spectrum: How Autism Movements Resist Experts and Create Knowledge, published by Columbia University Press.
The views expressed in this article are the writer's own.
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