The Make America Healthy Again (MAHA) movement is full of theories about how to transform the wellbeing of Americans. Its strategy report issued this fall has 128 of them, in fact, focusing specifically on how to improve the health of children through changing diet, chemical exposure, a lack of physical activity, and chronic stress. But this roadmap for children’s health largely ignores psychological influences and social contexts, which may be the most important drivers of poor health and which could be, if wisely addressed, the source of kids’ sustained wellbeing. Missing, too, is the input of outside experts—including the children these strategies are meant to serve.

Depression, anxiety, post-traumatic stress disorder (PTSD), autism, eating disorders, asthma, and prediabetes have all increased greatly in kids. All are directly caused or indirectly influenced or exacerbated by the mental and emotional state of children and the conditions under which children live and how they deal with them.

The closest MAHA comes to acknowledging this is to highlight chronic stress, but some of the most important sources of that stress—as determined by authoritative, peer-reviewed surveys of young people—are neglected. Perhaps the most glaring omission is poverty. Children living in poverty are far more likely to face health challenges. They have far less access to high quality education and healthy foods. They suffer from asthma, diabetes, and obesity, as well as cardiovascular and immune disorders, significantly more often than children from well-off families, and are two-to-three times more likely to develop mental-health conditions.

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Violence is also absent from the MAHA drivers. And violence, especially when it occurs within the family, is one of the most dramatic and impactful of the much-studied adverse childhood experiences (ACEs). These factors, especially when they are repeated, predispose children to adult psychological disorders, alcoholism, and acts of violence. And gun violence—also unmentioned in MAHA’s guiding document—is the No. 1 cause of death in children. 

Read More: We’ve Been Thinking About Gun Violence All Wrong

This excision of context narrows the recommendations for remediation. And this myopia has unfortunately been compounded by MAHA’s failure to consider children’s own understanding of which “environmental factors” and “stressors” trouble them, or, indeed, to seek guidance from the experience and preferred choices of young people.

There’s a big opportunity for MAHA to include real-world experts in future studies and analyses: mental-health professionals, teachers, and........

© Time