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MAHA REPORT 20  JUL / AUG 2025 I  HEALTHCARE JOURNAL OF NEW ORLEANS   https://doi.org/10.1016/j.jad.2023.05.011. 67 Alexander, G. C., Gallagher, S. A., Mascola, A., Moloney, R. M., & Stafford, R. S. (2011). Increasing off-label use of antipsychotic medications in the United States, 1995– 2008. Pharmacoepidemiology and Drug Safety, 20(2), 177–184. 68 Fleming-Dutra, K. E., Hersh, A. L., Shapiro, D. J., Bartoces, M., Enns, E. A., File, T. M., Finkelstein, J. A., Gerber, J. S., Hyun, D. Y., Linder, J. A., Lynfield, R., Margolis, D. J., May, L. S., Merenstein, D., Metlay, J. P., Newland, J. G., Piccirillo, J. F., Roberts, R. M., Sanchez, G. V., ... Hicks, L. A. (2016). Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA, 315(17), 1864- 1873. https://doi.org/10.1001/jama.2016.4151. 69 Aversa, Z., Atkinson, E. J., Schafer, M. J., Theiler, R. N., Rocca, W. A., Blaser, M. J., & LeBrasseur, N. K. (2021, January). 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The American journal of clinical nutrition, 112(3), 721-769. 74 Kearns, C. E., Schmidt, L. A., & Glantz, S. A. (2016). Sugar industry and coronary heart disease research: A historical analysis of internal industry documents. JAMA Internal Medicine, 176(11), 1680–1685. https://doi.org/10.1001/jamainternmed.2016.5394. 75 Mialon, M., Serodio, P., Crosbie, E., Teicholz, N., Naik, A., & Carriedo, A. (2022). Conflicts of interest for members of the U.S. 2020 Dietary Guidelines Advisory Committee. Public Health Nutrition, 27(1), e69. https://doi.org/10.1017/S136898002200035X. 76 OpenSecrets. (n.d.). Federal lobbying: Industries summary (N13, 2021 cycle). https://www.opensecrets.org/federal- lobbying/industries/summary?cycle=2021&id=N13. 77 U.S. Environmental Protection Agency. (2025, January 17). TSCA Chemical Substance Inventory. https://www.epa.gov/tsca-inventory. 78 Wouters, O. J. (2020). 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Science. https://www.science.org/content/ • Teens using social media over 3 hours daily face double the risk of anxiety and depression, with a 2022 meta-analysis showing each additional hour increases depression risk by 13%, and girls face nearly four times the risk of boys. 62 American children are highly medicated – and it’s not working The health system has aggressively responded to these increases in childhood chronic disease with increasing rates of pharmaceutical drug prescriptions which may cause further harm to the health of American children when used inappropriately. • Stimulant prescriptions for ADHD in the U.S. increased 250% from 2006 to 2016,63 despite evidence they did not improve outcomes long-term. 64 • Antidepressant prescription rates in teens increased by 1,400% 14-fold between 1987 and 2014, 65 even though a systematic overview shows that psychotherapy is just as effective as drugs in the short term, and potentially more effective in the long term. 66 • Antipsychotic prescriptions for children increased by 800% eight-fold between 1993 and 2009 1995 and 2005 , with most of these medications prescribed for conditions not approved by the FDA for use in children. 67 • Studies find that more than 35% (equivalent to more than 15 million prescriptions) of childhood antibiotics are unnecessary 68 and that infants exposed to antibiotics in the first 2 years of life are more likely to develop asthma, allergic rhinitis, atopic dermatitis, celiac disease, obesity, and ADHD. 69 Corporate Capture and the Revolving Door Although the U.S. health system has produced remarkable breakthroughs, we must face the troubling reality that the threats toAmerican childhood have been exacerbated by perverse incentives that impact the regulatory bodies and federal agencies tasked with overseeing them. While Congress is ultimately in charge of authorizing federal regulatory agency research budgets, government funding has been a small portion of the totality of research dollars being spent on chronic childhood disease. The majority is funded by the food, pharma- ceutical, and chemical, as well as special interest Non- Governmental Organizations (NGOs) and professional associations. The following examples illustrate how deep and widespread this influence has become across multiple sectors: • The food industry funds the bulk of research in the field. ABMJ analysis found that industry spent over $60 billion on drug, biotechnol- ogy, and device research in nutrition science; 70 by comparison, the government spends an estimated $1.5 billion on nutrition research. 71 Concerningly, industry-funded nutrition research may bias conclusions in favor of sponsors’ products. 72 Government funding for nutrition research through the NIH is only 4-5% of its total budget 73 and in some cases is subject to influence by food industry-aligned researchers. 74 Moreover, one analysis reported that 95% of the 2020 Dietary Guidelines Advisory Committee members had financial ties to food and pharmaceutical companies. 75 • The chemical-manufacturing industry spent roughly $77 million on federal lobbying activities in 2024, while 60% of their lobbyists previously held federal posts. 76 In addition, more than ten thousand chemicals listed on the EPA’s inventory are designated as confi- dential, and generic chemical names are used to identify them. 77 • The pharmaceutical industry, from 1999 to 2018, spent $4.7 billion on lobbying expenditures at the federal level, more than any other industry. 78 In addition, 9 out of the last 10 FDA commissioners 79 —and approximately 70% of the agency’s medical reviewers 80 —have gone on to work for the pharmaceutical industry. Over 80% of clinical departments and teaching hospitals at U.S. medical schools receive some degree of pharmaceutical funding, while half of the total costs for continuing medical education (CME) is funded by industry. 81 82 Between 2010 and 2022, industry provided $6 billion to over 20,000 patient advocacy organizations. 83