President-elect Trump's decision to nominate Robert F. Kennedy Jr. as Secretary of Health and Human Services is sparking concern and criticism in the world of public health.

That's due in part to Kennedy's long-held beliefs against vaccines.

There are worries, too, about his history of false statements and beliefs in debunked conspiracy theories on subjects

like HIV and AIDS, antidepressants, and autism. At the same time, he's pushing hard on some

major problems that experts say are real, like nutrition, obesity, processed food, among them.

We're joined now by Caitlin Janalina, who works in public health and writes the

Substack newsletter, your local epidemiologist. Thanks for being with us. Thanks for having me.

So we should say HHS is a sprawling bureaucracy, 80,000 employees across 13 agencies. If

RFK Jr. is confirmed, what would it mean for all of the things that HHS oversees?

Things like drug approvals, food safety, disease surveillance, in addition to Medicaid and Medicare?

Yeah, I mean, these are our agencies that protect the health of Americans. Everything from, like you said,

in the introduction, nutrition, to vaccines,

to our data to see how the national health is going, where we can make improvements, where we

cannot, the support to local and public health departments. So it is a $3 trillion budget.

It's a massive job. And someone that has a lot of experience needs to be there.

He is one of the most prominent anti-vaccine activists in the country.

As you've pointed out in your writing, it's really the states that help determine vaccine policy

when it comes to things like school mandates or exemptions.

So help me understand what your worries are about his potential impact if he is confirmed.

Yeah, so that's right.

So vaccine policy, it's primarily governed by individual states rather than the federal government.

However, there certainly are places.

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