Washington, February 26, Dr. Casey Means, Donald Trump's nominee for US Surgeon General, told senators that America is "the most chronically ill, high-income nation in the world," promoting a prevention-first approach that mirrors growing concerns in India over diabetes, obesity, and ultra-processed foods.
Appearing before the Senate Health, Education, Labor, and Pensions Committee on Wednesday (local time), Means described a nation burdened by chronic disease. "We live shorter, sicker lives than other high-income nations," she said. "Today's children are projected to live shorter, sicker lives than their parents."
She argued that public health leaders must address "ultra-processed foods, exposure to industrial chemicals, lack of physical activity, chronic stress and loneliness, and overmedication."
Her testimony resonated beyond Washington. India, like the United States, is grappling with a surge in non-communicable diseases, including diabetes, cardiovascular disease, and obesity – conditions increasingly linked to dietary and lifestyle changes.
Means framed her mission as shifting the US system from "reactive sick care to proactive health care."
"My goal in this role is to help our healthcare system focus on the root causes of illness," she told lawmakers.
She pointed to metabolic dysfunction as a central driver of illness. "Ninety-three percent of American adults have at least one marker of metabolic dysfunction," she said, arguing that chronic disease stems from deeper systemic causes rather than isolated conditions.
Republican senators largely welcomed her emphasis on prevention. Senator Roger Marshall said that nearly eight in 10 adults live with at least one chronic disease and urged reforms to medical education that prioritizes nutrition.
Democratic lawmakers, however, pressed Means on vaccines and her past financial ties to health-related companies.
"I believe vaccines save lives," Means said repeatedly, adding that they are "a key part of any public health strategy for infectious diseases."
When questioned about influenza vaccines, she said, "At the population level, I certainly think that they do" reduce serious illness.
For India, the discussion on chronic diseases is particularly relevant. Both countries face rising healthcare costs linked to lifestyle-driven illnesses. Urbanization, processed food consumption, and sedentary habits have fueled similar health trajectories.
India is also expanding policy conversations around food labeling, sugar consumption, and preventive care – themes central to Means' testimony.
If confirmed, Means would serve as America's chief public health spokesperson at a time when non-communicable diseases are rising globally.