The Problem with the "Chronic Disease Epidemic"
On the ableist, othering sensationalism of the phrase
The sensational language that RFK Jr uses to describe a rise in chronic illnesses ignores the reality of the human condition. We have always been vulnerable to sickness, chronic illness, disability. This is a fact that humans historically, and within the modern wellness culture, try to fervently deny. They believe they can resist the vulnerability that others experience by eating “right,” exercising, taking supplements, and engaging in other wellness practices. This is not a new phenomenon, and it has never been remotely close to the truth. While you may experience benefits by dietary changes and exercising, you will never escape the reality that every human will at some point get a chronic illness or disability – unless they die unexpectedly before this happens. The reason aging is so vilified in our society is partially because of its association with disability and a decline in health. And many, many people experience chronic health issues long before growing old. This has always been the case. Chronic health conditions are not new, no matter how much RFK Jr wants to talk about the supposed “lack of chronic health conditions” when he was growing up.
In Illness as Metaphor, Susan Sontag wrote “Illness is the night side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.” She wrote this in 1978. In 1926, Virginia Woolf published an essay called “On Being Ill,” which opens with a discussion on how common illness is. Woolf’s essay criticized the silence around illness, particularly in literature. As Anne Jurecic puts it in Illness as Narrative, Woolf “encouraged writers to turn their attention to the hidden drama of the sickroom, which she believed held more literary promise than the military detritus of war.” The silence Woolf described, as someone who had lived with chronic health issues herself, was profound because illness has never been a rare experience.
To have a chronic illness is to already be “othered” and “pathologized.” I was eleven when a classmate referred to me as “diseased” because I had a chronic illness. As with any kind of disability, people feel entitled to make rude comments. They say we’re not trying hard enough, we need to push ourselves more, we’re using our illness as an excuse. Sometimes they believe their comments are benign and full of good intentions, such as when they give unsolicited advice, but they’re still assuming they know more about our bodies and our health than we do. Sometimes they decide we’re actually just “faking,” which is a cruel accusation that still assumes they know anything about our health. RFK Jr’s rhetoric, and the rhetoric of wellness influencers, further others and pathologizes us. Suddenly we are the topic of a conversation that we haven’t even been invited to.
RFK Jr’s goal is to prevent more of us. In his hearing, he says “A healthy person has a thousand dreams. A sick person only has one.” It’s one thing if someone who is chronically ill wants to talk about how their only dream is to get better, but this was someone speaking for us and deciding that all of us with chronic illnesses have no dreams besides being healthy. He does this to get people to pity us, to fear becoming us, to sensationalize our existence. Even worse, the executive order on establishing a “Make America Healthy Again” commission says that our very existence poses “a dire threat to the American people and our way of life.” We are discussed as “burdens” who are “unable to join the military.” Disabled people, throughout history, have been described as burdens quite often. It has been used to justify our eradication.
Americans already know so little about the history of eugenics. They believe it only happened in Nazi Germany, despite the fact that German eugenicists learned from and worked with American eugenicists. They believe it only involves actions like sterilization and forced euthanasia, despite how much of it involves propaganda. And that’s what this executive order is: propaganda. It gets you to see us as a threat to American life, as burdens, as weak. As Nazis would put it, “life unworthy of life.” In the book In Reckless Hands: Skinner V. Oklahoma and the Near-Triumph of American Eugenics, Victoria F. Nourse writes “By the 1930s, degeneration was no longer merely a theoretical preoccupation; it was a daily worry about whether democracy or life had spent itself, whether the world was spiraling into self-destruction.” This fear of “degeneration” sounds very similar to the language RFK Jr uses when discussing the “chronic disease epidemic.”
The inability of Americans to recognize eugenic propaganda is dangerous, even deadly. Since the beginning of the pandemic, disabled people have been warning everyone about how comments like “don’t worry, COVID only impacts disabled people” gets people to see us as acceptable losses. Throughout the pandemic, people treated the deaths of disabled people as an inevitability rather than something we should try harder to prevent. Immunocompromised people who have experienced some of the most distress since 2020 are rarely empathized with. When disabled people have requested that people wear masks to make going out in public safer for us, some people have responded by saying we should be at home if we feel unsafe. Because as a society we have downplayed the risk that COVID poses to everyone, people rarely care about the number of disabled people who are still dying. Healthy people are dying or getting Long COVID too, but people assume it won’t happen to them. Because they eat right, and exercise, and take expensive supplements. They assume the “just world theory” that tells them bad things won’t happen to them applies to their health too. All of this is because of the eugenic propaganda that continues to this day. Contrary to what many may believe, eugenics are not a thing of the past.
Instead of having empathy for chronically ill people and asking what we actually need, we are seen as people who have no place in American society if we can’t meet the socially constructed ideal of a “healthy person.” Because of the history of eugenics and the harm that our wellness culture has caused, we should be willing to scrutinize our attitudes about “health” and “illness.” My hope is that people will start to realize that certain aspects of RFK Jr’s slogan may only sound appealing because many of us have internalized the belief that lack of health is a moral failing or a state of inferiority. While he may be a bit more subtle than eugenicists of the past, it is clear from the language RFK Jr uses that “Make America Healthy Again” means our health determines our value. Many marginalized people know where this rhetoric leads. In this moment, everyone has a choice: listen to those who are sounding the alarm about RFK Jr, or follow a dangerous charlatan who will harm us all.
References
Jurecic, A. (2012). Illness as narrative. University of Pittsburgh Press.
Nourse, V. F. (2008). In reckless hands: Skinner v. Oklahoma and the near triumph of American eugenics. New York, W.W. Norton & Co.
Sontag, S. (2002). Illness as metaphor. Penguin Books.
Woolf, V. (1930). On being ill. Reprint, Renard Press, 2023.