RFK Jr.’s absurd statistic on the spike in chronic diseases in the U.S.

 “We’ve got the highest chronic disease burden of any country in the world. When my uncle was president, 3 percent of Americans had chronic disease. Today, it’s 60 percent.”

This is a favorite line of Kennedy’s — which he repeated while pitching his plan to phase out petroleum-based synthetic dyes from the nation’s food supply. In the interview with Watters, he spoke broadly, about all Americans. During his confirmation hearings in January, he used a similar talking point about children: “When my uncle was president, 2 percent of American kids had chronic disease. Today, 66 percent have chronic disease.”

He’s said it enough that the figures have started to creep into search results of AI models on chronic diseases in the 1960s. Presumably that’s because Kennedy is now a Cabinet secretary and apparently is considered a voice of authority.

But this is one of those examples of how people (and computers) need to do some critical thinking when they hear statistics like this. John F. Kennedy was elected president 65 years ago. How were numbers collected back then? What were considered chronic diseases back then? Are they comparable to today?

Of course not. Kennedy should be ashamed of spreading misinformation, and interviewers should challenge him when he spouts stuff like this.

The Facts

Kennedy’s staff at HHS did not respond to our questions on his source for chronic diseases during his uncle’s presidency. It took some digging, but we finally found the National Health Interview Survey taken between July 1962 and June 1963. For all ages, the percentage of people (civilian, noninstitutional) reporting one or more chronic diseases was 44.5 percent.

That’s almost 15 times higher than 3 percent. For people 17 and under, the figure in the survey is 20.1 percent. That’s 10 times higher than the 2 percent Kennedy claimed in his confirmation hearings.

Still, you have to be careful with data so old. Standards and definitions change over time.

The Centers for Disease Control and Prevention today offers this definition: “Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.” While many conditions considered chronic today are similar — such as hypertension and cancer — in the 1960s, deafness and missing fingers were also considered chronic. That’s not the case now.

At the same time, this is self-reported data. Sixty years ago, people were less likely to know if they had high blood pressure or cancer. Early cancer detection has significantly improved over the decades. For instance, modern mammography methods for breast cancer did not exist in Kennedy’s presidency, and mammograms were not officially recommended by the American Cancer Society until 1976.

One study, written in 1986 by one of the leading figures in the field of hypertension, found that “in the 1960s, at least half of the individuals with hypertension were unaware of their disease, and the blood pressures of fewer than 20 percent were controlled at normotensive levels. In contrast, in the 1980s, only a small percentage, perhaps as few as 10 or 15 percent of hypertensive patients, are unaware of their disease and, in many parts of the country, more than 60 percent are being treated to [reach target] blood pressure levels.”

Doctors also have made significant progress in wiping out some deadly diseases, saving countless lives. In 1960, the death rate from tuberculosis (another chronic disease) was 6.1 per 100,000 people (down from 45.9 in 1940). Now, it’s 0.2 per 100,000 people.

That also means that people are living longer — and if you live longer, you develop more chronic diseases.

Kennedy’s statistic for today — 60 percent — appears to come from a 2017 Rand study, using the Medical Expenditure Panel Survey. The report found that, as of 2014, 60 percent of American adults had at least one chronic condition and 42 percent had more than one. (There appears to be no reliable source for Kennedy’s claim in his confirmation hearings that 66 percent of children today have chronic conditions. The 2022 National Survey of Children's Health found 41 percent of children had one or more of 25 “current or lifelong health conditions.”)

Christine Buttorff, a Rand policy researcher and co-author of the 2017 study, said that longer life leads to more chronic diseases in many ways.

“People live longer due to public health interventions such as vaccines, clean water and environment, and other advances that lower death rates from infectious diseases,” she said in an email. “Longer lifespans thus result in a higher prevalence of chronic diseases, though public health has contributed here too through things like tobacco cessation efforts and population safety measures like seat belts and air bags. Better detection raises the incidence of a disease which is also a factor, and improved medical technology has generated cures for some diseases or for people to live longer once diagnosed.”

As for why the United States has a higher level of chronic diseases than peer countries, she attributed that to factors such as education, income, lifestyle and the lack of access to preventative or primary health care.

“As life expectancy lengthens, we will generally see more people with chronic conditions,” said Larry Levitt, executive vice president at KFF, a nonprofit health-policy organization. “We unfortunately tend to collect chronic conditions as we age, so the longer we live, the more chronic conditions we’ll have.”

In other words, this is another example of Kennedy taking a success story — longer lives and better detection of chronic diseases — to argue that something is rotten. He’s long been a purveyor of the fiction that vaccines cause autism, and one of his key points of evidence is that the percentage of people with autism has increased. But the percentage of people diagnosed with autism spectrum disorder has gone up mainly because of expanded definitions and better detection. There is no blood test for autism, so a diagnosis is based on observations of a person’s behavior. Indeed, while autism diagnoses have increased, those of intellectual disability have decreased, indicating that previously, children may have been misdiagnosed with other conditions.

The Pinocchio Test

Contrary to Kennedy’s claim, the percentage of Americans with chronic diseases has not increased 20 times over the past six decades. A survey from 1962 puts the percentage of Americans with chronic diseases at 44.5 percent, not the absurdly low number of 3 percent touted by Kennedy.

Moreover, it’s foolhardy to make such comparisons over so many decades. The definition of chronic diseases has evolved. At the same time, detection has improved, so it’s also possible the 44.5 percent figure from the early 1960s is too low. Many people in the 1960s had undiagnosed cancer or high blood pressure that eventually killed them.