Trump’s surgeon general nominee is a public health risk – MSNBC News

Report on the Nomination of Dr. Casey Means for U.S. Surgeon General and its Implications for Sustainable Development Goals

This report analyzes the nomination of Dr. Casey Means for the position of United States Surgeon General, focusing on the potential impacts on public health and the nation’s commitment to the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 10 (Reduced Inequalities), and SDG 16 (Peace, Justice and Strong Institutions). The confirmation hearing, scheduled before the Senate Health, Education, Labor and Pensions (HELP) Committee, has been postponed as of October 30, 2025.

The Role of the Surgeon General in Advancing SDG 3: Good Health and Well-being

The Office of the Surgeon General is a critical institution for promoting public health, a mission that directly aligns with the core tenets of SDG 3. The role has historically involved:

• Providing trusted, evidence-based medical guidance to the public.
• Leading national health initiatives on topics such as disease prevention, mental health, and safety.
• Combating health misinformation, a significant barrier to achieving universal health coverage and well-being.
• Leading the U.S. Public Health Service Commissioned Corps in response to health crises like pandemics and the opioid epidemic.

An effective surgeon general is essential for translating complex scientific information into actionable public health strategies, thereby safeguarding and improving the health of the population.

Assessment of Nominee’s Profile Against Public Health Mandates

Concerns have been raised regarding the suitability of Dr. Casey Means for a role centered on evidence-based public health and science communication. An assessment of her professional background reveals several points of concern:

1. Professional Credentials: Dr. Means did not complete a medical residency and does not hold an active medical license, distinguishing her from predecessors who were board-certified physicians with extensive clinical and public health experience.
2. Commercial Interests: Her career is primarily defined by wellness entrepreneurship, including the marketing and sale of dietary supplements, creams, and teas. This commercial focus presents a potential conflict with the duty to provide objective, non-market-driven health guidance.
3. Public Health Philosophy: Dr. Means has promoted the view that most chronic health conditions are a result of individual lifestyle choices. This perspective is a significant departure from established public health science, which recognizes a complex interplay of factors.

Impact on SDG 10: Reduced Inequalities

The nominee’s philosophy, which oversimplifies the causes of disease by focusing on individual factors, directly conflicts with the objectives of SDG 10 (Reduced Inequalities). This approach fails to address the systemic and socioeconomic determinants of health that create significant disparities among different populations.

• Ignoring Systemic Inequities: Attributing poor health outcomes solely to diet and lifestyle dismisses critical factors such as access to healthcare, environmental conditions, and economic stability.
• Exacerbating Health Disparities: This viewpoint does not account for documented health inequities, such as the 40% higher death rate from breast cancer among Black women compared to white women, or the higher prevalence of diabetes and its complications among low-income individuals.

A surgeon general must champion policies that address these disparities to ensure equitable health outcomes for all, a cornerstone of SDG 10.

Threats to SDG 16: Peace, Justice and Strong Institutions

The appointment of a surgeon general lacking a foundation in rigorous public health science threatens the integrity and public trust in a key governmental health institution, undermining progress toward SDG 16.

• Erosion of Institutional Trust: In an era of widespread medical misinformation, the surgeon general’s office must be a bastion of scientific integrity. Appointing a nominee known for social media influence and marketing rather than scientific expertise risks eroding public trust in science and government health agencies.
• Prioritizing Ideology Over Evidence: The nomination signals a preference for branding and marketing ideologies over objective, evidence-based public health guidance. This precedent weakens the institution’s capacity to respond effectively to health crises.
• Consequences of Misinformation: The failure to communicate evidence-based facts can have fatal outcomes, as seen in recent measles deaths among unvaccinated children following the promotion of unconventional therapies over proven vaccines.

Conclusion

The nomination of Dr. Casey Means poses a significant risk to the advancement of national health objectives and the Sustainable Development Goals. The role of Surgeon General requires a leader with deep experience in public health, a commitment to addressing health inequities (SDG 10), and the ability to strengthen public trust in scientific institutions (SDG 16). Prioritizing scientific integrity and evidence-based practice is paramount to ensuring good health and well-being for all Americans (SDG 3) and maintaining the credibility of the nation’s public health leadership.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • The article’s central theme is public health in the United States. It discusses the role of the surgeon general in promoting health, preventing diseases, and providing evidence-based guidance. Specific health issues mentioned include chronic conditions like diabetes and cancer, mental health, gun violence, pandemics, opioid overdose spikes, and infectious diseases like measles.
2. SDG 10: Reduced Inequalities
   • The article explicitly addresses health disparities and systemic inequities. It points out that health problems cannot be attributed solely to individual choices, citing examples of how socioeconomic factors and race impact health outcomes. This directly connects to the goal of reducing inequalities within a country.
3. SDG 16: Peace, Justice and Strong Institutions
   • The article critiques the nomination for surgeon general, arguing it could undermine a crucial public health institution. It emphasizes the need for integrity, accountability, and evidence-based leadership to maintain “public trust in science.” The discussion about combating “medical misinformation” and the importance of a “moral and scientific voice” for the public relates to the goal of building effective and transparent institutions.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Under SDG 3: Good Health and Well-being
   • Target 3.4: “By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.” The article mentions the surgeon general’s historical focus on “disease prevention” and “mental health,” and discusses chronic conditions like “diabetes and cancer” which are major non-communicable diseases.
   • Target 3.8: “Achieve universal health coverage, including… access to safe, effective, quality and affordable essential medicines and vaccines for all.” The article highlights a failure in this area by stating, “innocent unvaccinated children died of measles in Texas,” directly linking the lack of vaccination to preventable deaths.
   • Target 3.d: “Strengthen the capacity of all countries… for early warning, risk reduction and management of national and global health risks.” The article notes that the surgeon general leads the U.S. Public Health Service Commissioned Corps, “a group of medical professionals who respond to crises like pandemics and opioid overdose spikes.”
2. Under SDG 10: Reduced Inequalities
   • Target 10.2: “By 2030, empower and promote the social, economic and political inclusion of all, irrespective of… race… or economic or other status.” The article argues that the nominee’s philosophy “dismisses systemic inequities,” and provides specific examples of health disparities that counter this view, such as why “Black women have a roughly 40% higher death rate than white woman from breast cancer” and why “low-income individuals face higher rates of diabetes.”
3. Under SDG 16: Peace, Justice and Strong Institutions
   • Target 16.6: “Develop effective, accountable and transparent institutions at all levels.” The entire article is an argument for protecting the integrity and effectiveness of the surgeon general’s office. It calls for a leader with “rigorous public health experience” who provides “objective public health guidance” rather than “marketing ideologies,” which speaks directly to the need for an effective and accountable institution.
   • Target 16.10: “Ensure public access to information…” The article stresses the surgeon general’s role in combating “medical misinformation” and the need to “communicate evidence-based facts to mitigate the nation’s health ailments.” This highlights the importance of providing the public with accurate and reliable information, a key component of this target.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For SDG 3 (Good Health and Well-being)
   • An indicator for Target 3.4 is directly implied. The article states, “Black women have a roughly 40% higher death rate than white woman from breast cancer.” This is a specific example of a mortality rate due to a non-communicable disease (Indicator 3.4.1), disaggregated by race.
   • An indicator for Target 3.8 is implied by the measles outbreak example. The statement that “unvaccinated children died of measles” points to gaps in vaccination coverage (part of Indicator 3.8.1) as a critical measure of health service access and effectiveness.
2. For SDG 10 (Reduced Inequalities)
   • The article provides qualitative indicators for Target 10.2 by citing specific disparities in health outcomes. The examples of higher breast cancer death rates for Black women and higher diabetes rates for low-income individuals serve as direct measures of health inequality that can be tracked over time.
3. For SDG 16 (Peace, Justice and Strong Institutions)
   • An indicator for Target 16.6 is implied through the discussion of trust. The article states that “public trust in science is fragile.” This suggests that the level of public trust and satisfaction with public health institutions and their guidance is a key, albeit qualitative, indicator of their effectiveness and accountability.

4. Summary Table of SDGs, Targets, and Indicators

Source: msnbc.com