Secretary Kennedy’s War on Miasma

“These decisions reflect a broader, emerging worldview promoted by what I call ‘Germ Deniers’ — individuals and groups who question or outright reject the established scientific understanding of how much microorganisms cause disease and death.” – Dr. Jay Varma, former epidemiologist at the CDC

This is the distillation of many of the arguments made about Secretary Kennedy’s views on chronic illness. It is often made with the counterfactual argument that diseases, particularly infectious diseases, are a result of the miasma, or Secretary Kennedy’s misunderstanding of miasma as emphasizing “preventing disease by fortifying the immune system through nutrition and reducing exposures to environmental toxins and stresses.” But could Secretary Kennedy’s worldview contain a kernel of truth that we will ignore at our peril?

Miasma

Definitions of miasma often begin by stating that it is an abandoned medical theory explaining the origin of ancient diseases, which were primarily infectious, as resulting from miasma, from the Greek for pollution, “bad” air. Malaria, in Italian, literally means "bad air." Hippocrates raised concerns about environmental factors influencing illness, and while his word choice may seem outdated, he identified seasonality, climate, water quality, food quality, and geography as relevant considerations. So, as with my historical documents, they must be understood in the context of their time.

For infectious diseases, the role of miasma has been supplanted by our understanding of germ theory. But are we throwing out the baby with the bathwater? Water, in the case of cholera, and air, in the case of many respiratory diseases, served as conduits for germs to spread. The story of John Snow, identifying the source of London’s cholera and typhoid outbreaks to water and his request to have the Broad Street pump handle removed is cited as an argument for germ theory. However, it was miasmatic theory that contributed to control, as it was contamination that public laws invoked to encourage owners to clean their homes and connect them to London’s growing sewer system, itself instigated by the “Great Stink,” befouling the air. 

While miasma theory gave air and water a starring role, they now serve as supporting actors for germs. The germ theory has led to the development of pharmaceuticals, including vaccines, which have reduced the impact of infections on the population, especially in high-income countries like the US. To better understand Secretary Kennedy’s thought process, we need to revisit his legal career.  

A Career Built Upon Pollution

Robert F. Kennedy Jr. built a career holding polluters accountable across a wide range of environmental fronts. His early environmental work for the Natural Resources Defense Council (NRDC) was part of a probation agreement after he was convicted of felony possession of heroin. A year later, after successfully passing the NY State Bar, he served as counsel for Riverkeeper, where he sued municipalities and General Electric to stop discharging pollutants into the Hudson. He also spearheaded a battle to close the Indian Point nuclear power plant, arguing that renewables could be substituted. (Paradoxically, carbon emissions from electrical generation in NY increased after the plant’s closure.) 

• He established an Environmental Litigation Clinic at Pace University, where he continued to bring suits requiring municipalities to comply with the Clean Water Act.
• As President of the Waterkeeper Alliance, he launched a “Clean Coal” program targeting a host of practices, including slurry pond construction and mercury emissions from coal-burning utilities and ash piles. He also sued a series of factory farms, arguing that they produced “lower-quality, less healthy food, and harm independent family farmers by poisoning their air and water.”
• In 2000, he founded the law firm Kennedy & Madonna, which went on to challenge pollution from industrial farms and was part of the legal team that secured a $70 million settlement for property owners whose properties had been contaminated by an adjacent Superfund site.
• As co-counsel with Morgan and Morgan, he sued Monsanto over Roundup, as a cause of non-Hodgkin lymphoma.
• In 2005, he opposed an offshore wind farm in Cape Cod, arguing that it was too costly.

For Secretary Kennedy, his current focus on chronic illness is an extension of his decades-long concern over pollutants. As Paul Offit opines,

"The miasma theory is the notion that there are environmental poisons, not necessarily rotting organic matter. For him [Kennedy], those environmental poisons are electromagnetic radiation, pesticides, vaccines. Vaccines are, for him, a modern-day miasma."

While Kennedy’s early legal activism targeted measurable pollutants, e.g., chemical runoff, based on enforceable environmental statutes and scientific data, his more recent claims about vaccines and electromagnetic radiation depart from that empirical foundation. It is tempting to view all of Kennedy’s health claims as extensions of his environmental advocacy, but doing so risks normalizing pseudoscience by cloaking it in the language of legitimacy. Unlike industrial toxins, his assertions about vaccines as “modern-day miasmas” lack broad scientific consensus and are contradicted by decades of epidemiological research. Conflating these arenas risks elevating personal belief to the same evidentiary status as well-established environmental science, lending those ideas an unwarranted veneer of credibility. A consistent worldview does not guarantee consistent scientific validity. To conflate skepticism with science is to erode the very standards of evidence that made his earlier legal victories possible.

An Obesogenic Environment

Consider for a moment the concept of an obesogenic environment, defined by, in the words of Secretary Kennedy, the “corrupt” Lancet:

“Obesogenic environment, environmental factors determining both nutrition and physical activity, are key determinants for overweight and obesity, and an important target for prevention. Healthy food availability and affordability, safe walking and cycling infrastructure or sports facilities, cultural norms or traditions, media influence and regulatory environment—all contribute to the obesogenic environment. For children, school-level factors also have a role, including peer influence, limited dedicated physical education time, unhealthy school meals, and academic stress.”

Here is the intersection of Secretary Kennedy’s long history battling pollutants with his current MAHA agenda against the contaminants of food dye, emulsifiers, and ultra-processed foods. It will be informative to see how much of the Lancet’s agenda of government regulations and policies, taxes, and advertising bans on “unhealthy foods,” as well as a multiplicity of labels, is ultimately suggested and implemented by Secretary Kennedy and Department of Agriculture Secretary Rollins. Will they, in the words of the Lancet, “… encourage and promote healthy lifestyles, such as providing free or affordable healthy school lunches and safe spaces and infrastructure for physical activity.” Will they find a means for our food environment to “take responsibility for the quality, marketing, and price of the food they produce and sell, create and promote healthier choices, and take initiative?”

MAHA’s Modern Miasma

Secretary Kennedy’s MAHA initiative is not a natural evolution of his decades-long campaign against environmental pollutants, industrial toxins, and contaminated ecosystems, but rather a worldview that reframes chronic illness not solely as a biological accident, but as the outcome of environmental degradation, industrialized nutrition, and regulatory neglect.

What critics often mock as a misapplication of 19th-century science is, in fact, a continuation of Kennedy’s legal and environmental logic. His narrative has consistently argued that health, be it planetary or individual, depends on the purity of our air, water, and food. His campaign against “modern miasmas” seeks to shift the chronic disease paradigm from individualized blame or genetic fate to systemic, environmental causation.

Secretary Kennedy is repurposing miasma for the 21st century. It is no longer the stench of sewage that signals danger—it is the invisible haze of food additives and corporate influence. Like the miasmatic reformers of the 19th century, Kennedy’s policies may have practical effects even if their scientific framing invites debate. The question is not whether we should return to miasma, but whether we’ve been blind to its modern forms all along.