A Citations Needed Live Show Beg-a-thon: MAHA, TikTok and the Rise of Health-Branded Fascism
Citations Needed | October 31, 2025 | Transcript
[Music]
Nima Shirazi: Welcome to Citations Needed, a podcast on the media, power, PR, and the history of bullshit. And welcome as well to our latest Beg-a-thon, our periodic virtual live show fundraiser. I am Nima Shirazi.
Adam Johnson: I’m Adam Johnson.
Nima: And thank you, everyone, for joining us as we stream live. Of course, you can follow the show on Twitter and Bluesky @citationspod, Facebook Citations Needed, and become a supporter of the show if you’re not already through Patreon.com/CitationsNeededPodcast. All your support through Patreon is so incredibly appreciated, as we are 100% listener-funded.
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Nima: That’s right. Now tonight, on Citations Needed, we’ll be talking about what we’re calling the Granola-to-Fascist Pipeline, how decades of pseudoscientific notions of health and wellness have helped usher in the so-called Make America Healthy Again movement, not really a movement, but the movement led, of course, by none other than–weird to even say this–current Health and Human Services Secretary, and also vehement Tylenol opponent, Robert F. Kennedy, Jr.
Adam: Yeah, we thought this was kind of a perfect, very much in our wheelhouse, because it combines a recurring trend we talk about on the Right, which is this kind of false, anti-corporate, anti-establishment narrative that ultimately comes out the end of the sausage machine, ultimately serving power, serving corporate America and the like. And it also combines, of course, a very intense social media aspect, which we’re excited to get into. And so we’ll be looking at the cottage industry of wellness. This is, we’re going to be somewhat painting with a very broad brush, so please indulge us. We know that this current that we’re talking about, by design, and one of the reasons it’s so effective, is that it does kind of encapsulate so many different currents. We’re going to do our best to sort of be fair in how we represent those, and talk about the differences within that world with our guest. So we’re really excited to talk about how this really kind of got turbocharged during Covid and manifested with this daily horror we see on our television screens where RFK Jr. says the most batshit thing imaginable in the least coherent way possible. And so we’re excited to talk about the anti-vax elements, the seed oils, supplements, the unpasteurized milk, some of which is funny, some of which is not, and a lot of which is very much in the middle of being both simultaneously very funny but also very serious.
Nima: Yeah. We’ll be joined in a little bit by our guest tonight, Justin Feldman, a social epidemiologist who researches health, racism, economic inequality, and state violence. Previously a professor of epidemiology at the NYU School of Medicine, Justin is now Principal Research Scientist at the Center for Policing Equity at Yale University Lab. Justin will join us in just a moment, and I’m really excited to get to that conversation, but first, as we do, let’s note part of why we’re doing this Beg-a-thon as we call it tonight.
Citations Needed takes a team to produce each and every show and to keep everything up, and it takes a ton of work. Not many shows do the type of research we do at the pace we do it. And since we started the show back in July of 2017, we’ve released nearly 230 episodes, over 180 News Briefs, we’ve welcomed more than 300 guests. We love doing this show, and we’re very grateful for every listener, every download, every review, every like, every share. Tens of thousands of you wonderful people listen to the show every week, and we cannot thank you enough, but only a tiny fraction of you actually support the show and our team through Patreon.
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Nima: [Laughs]
Adam: But if you can, please do, because it helps keep the show sustainable, which is, again, why we’re here literally begging you during our Beg-a-thon, because that’s what we do. We beg.
Nima: That’s right. So head on over, if you are not already a supporter, and go to Patreon.com/CitationsNeededPodcast. As Adam said, if you have the means, if you are able, please do sign up to support the show. When we do these live shows, we also have some goodies to give away to our amazing supporters and listeners. And so you know, if the warm, fuzzy feeling of being a Citations Needed patron isn’t quite enough, we’re sweetening the pot with some giveaways for new subscribers or anyone who joins at a higher member tier. So if you’re already a supporter, amazing. Thank you. If you are able to, if you care to, you could go up a tier in your support and be eligible for some merch giveaways. So by signing up, you will be automatically put into the giveaway raffle, as it were, and we’re going to keep that open. Yes, we’re doing this live show on Monday, October 13, but we’re going to keep this open until Friday, November 14. So yeah, please do head over to Patreon. If you’re able to do that, that would be amazing. We will announce winners and email you all if you are a winner on Friday, November 14, or shortly thereafter, maybe early the following week. Sign up. You could win some wonderful merch. But that is all for our groveling. Let’s get to the show. How’s that, Adam?
Adam: Yeah, let’s do it. Let’s get to the content they crave.
Nima: [Laughs] We’re going to be focusing on the so-called Make America Healthy Again and Health Freedom movements, or as we prefer to call it, the Granola-to-Fascist Pipeline. We’ll explore how understandable distrust of Big Pharma and Big Ag and food conglomerates have been exploited, twisted, and translated into more fascist politics, thanks in no small part to anti-vaccine movements, which have historically aligned themselves with these faux-countercultural political tendencies. Now this, of course, has been particularly visible under the current presidential administration, as the former environmental lawyer and now current Trump-appointed Secretary of Health and Human Services, Robert F. Kennedy, Jr., increasingly imposes this ideology upon the entire American public.
Adam: Now there’s a lot to laugh and gawk at, which–have no fear–we will be doing but the stakes are very high. As our guest Justin Feldman has noted, since RFK Jr. was confirmed as Secretary of Health and Human Services, he has attempted to significantly cut federal funding to health research, fire hundreds of scientists at major public health institutions like the National Institute of Health and the Centers for Disease Control and Prevention, and threaten vaccine development recommendations and availability, severely undermining public health in ways that we will probably not know the full picture of until decades from now.
Nima: And to quote Justin directly from his article in Current Affairs from March of this year, 2025, quote,
RFK Jr.’s first weeks on the job coincided with a move by the administration to end an ad campaign that has proven effective at promoting seasonal flu vaccination followed by the cancellation of an advisory committee meeting, which puts next season’s flu vaccine in jeopardy.
Adam: Now, before we dive into the RFK Jr.-addled era of the present, let’s take a brief look at some of the foundations for this, for rightwing notions of superficial environmentalism and so-called health freedom. A lot of what we’re seeing today can be traced back to, unfortunately, like a lot of bad things, 19th-century Germany.
Nima: In the 1995 book Ecofascism: Lessons from the German Experience, historian and social ecologist Peter Staudenmaier highlights two German nationalists, Ernst Moritz Arndt and his student, Wilhelm Heinrich Riehl, both of whom advocated for environmental causes like forest conservation, but solely for the protection of white, non-Jewish Germans. Staudenmaier writes that Arndt’s environmentalism was quote,
couched always in terms of the well-being of the German soil and the German people, and his repeated lunatic polemics against miscegenation, demands for teutonic racial purity, and epithets against the French, Slavs, and Jews marked every aspect of his thought.
End quote.
Adam: And in 1853, Riehl, a student of Arndt, wrote an essay entitled “Field and Forest,” in which he argued, via antisemitic glorification of rural life and wholesale condemnation of modernity in cities that, quote,
We must save the forest, not only so that our ovens do not become cold in winter, but also so that the pulse of life of the people continues to beat warm and joyfully, so that Germany remains German.
Unquote. Now these writings would give way to the Volkisch movement, which similarly conflated environmentalism and vehement racist German nationalism, and was influential in the development, of course, of Nazi ideology, particularly the so-called “green wing” of the Nazi Party.
Nima: Now around the same time of the rise of this strain of ecofascism, anti-vaccine movements were arising in Europe as well. Throughout the 19th century, in the years following the 1796 introduction of the smallpox vaccine, the UK instituted laws making the smallpox vaccine for children free and later compulsory. But opponents of vaccination mandates formed so called anti-vaccination leagues, which published tracts, pamphlets, and periodicals with titles like The Anti-Vaccinator from 1869 or The Vaccination Inquirer from 1879. According to a 2025 BBC report, these groups appealed, in large part to, quote, “concerns about bodily autonomy and individual freedom.” End quote.
Adam: And by the late 19th century, this sentiment had reached the United States, with groups like the New England Anti-Compulsory Vaccination League and the Anti-Vaccination League of New York City lobbying through similar fear mongering literature and corporate battles to repeal compulsory vaccination laws in the United States.
Nima: But the case of Bernarr Macfadden, and I say Bernarr, I know you’d think I was going to say Bernard. He was actually born Bernard, but changed his name to Bernarr because he thought it sounded cooler, more masculine. The case of Bernarr Macfadden is an instructive one. An early 20th-century American wrestler, bodybuilder, wellness culture promoter, and public personality. In other words, the influencer of his era. Macfadden launched the magazine Physical Culture in 1899, opened a chain of health-food restaurants, and eventually authored more than 100 self-help books. In a 2022 profile of Macfadden, Dr. Michelle Cohen described his notions of health as, quote, “a regimen of fasting, fitness and hostility to medical science.” End quote.
Now, Macfadden often printed the admonition, quote, “Weakness a crime, don’t be a sinner!,” end quote, on his magazine covers, and in 1902 wrote of his opposition to the smallpox vaccine that the disease only affects those who quote, “eat very heartily and exercise rarely,” end quote. Now, side note here. Macfadden himself almost died as a child, when he was an orphan, after an inoculation against smallpox went wrong and gave him blood poisoning. So it was kind of a personal vendetta against vaccines themselves.
Now, in 1911 Macfadden published his own Encyclopedia of Physical Culture, writing in it this quote,
Disease has not come upon you because you have been attacked by a germ of some kind, it has not come because you have breathed some extraordinary microbe, it has appeared because you are ready for it, in most cases because you have deserved it as a penalty for violating Nature’s health laws.
End quote. He claimed that the 1918 Spanish flu pandemic, for instance, was caused by a poor diet, and that the American Medical Association, kind of his number-one enemy, was actually an evil cult out to control our lives. He even opened a number of lifestyle resorts called Healthatoriums, or sometimes sanitariums, on Long Island and upstate New York all the way to Chicago and even in Battle Creek, Michigan, right across the road from John Harvey Kellogg’s own creepy Sanitarium. And though their techniques and approaches often differed, they both preached a form of ableism, social Darwinism and eugenics, advocating for a, quote-unquote, “new aristocracy” of, quote, “Apollos and Venuses and their fortunate progeny,” end quote, to, as Kellogg wrote, quote, “save the human race, or at least the white portion of it,” end quote.
Now, Macfadden often published pro-eugenicist tracts in his magazines, and in 1927, printed a glowing interview with Benito Mussolini, in which Mussolini told the magazine, quote, “Fascism is a muscular creed,” end quote. Macfadden gave Mussolini dietary advice and personally trained up to 40 Italian Fascist cadets in his ‘psychultopathy’ techniques. Now, according to writer Jules Evans, Macfadden said in an interview at the time, quote, “There are times when I believe that America needs a Mussolini, as never before.”
Now, saying those types of things did not, I guess, take him out of the good graces of those, you know, powerful Americans all the way up to FDR, who he actually had a photo op with. He was, you know, a celebrity of his time. And we can see how that works in these kinds of people’s favors still today.
Adam: Yeah, so this sets the stage for the rightwing political currents we see before us today. Again, I’m sure all this sounds very familiar. This is what we see today, from the pseudoscientific kind of supposedly pre-agricultural, more normative Paleo diet in the 1970s, to the renewed anti-vaccination vigor of the late 1990s and early 2000s, to the bizarre social-media-powered hostility to ill-defined toxins of more recent years. The throughline from the yesteryear health celebrities like McFadden to the TikTok grifters today is clear. As Jessica Grose wrote in the New York Times last February, quote,
It is impossible to read about Mr. Macfadden — who was using the term “medical freedom” in 1920 — without thinking about Robert F. Kennedy Jr., our new secretary of health and human services, and the raw-milk-drinking, vaccine-skeptical, psychedelic-loving Make America Healthy Again movement that has coalesced around him.
Unquote.
Nima: So with all of that, let’s get to our guest. One more reminder, folks, if you haven’t already, head over to Patreon.com/CitationsNeededPodcast. Join up if you have not already, move up a tier if you’re already a supporter, and thank you so much for being so. Between whenever you’re hearing this and Friday, November 14, you’ll be eligible to win free Citations Needed merch. Keep an eye on your email, the email that you use for your Patreon account. You’ll hear from us if you win, and I hope that you all do.
Now, finally, the unbelievably patient guest tonight, Justin Feldman, is going to join us now to dissect the perils and absurdity of the Make America Healthy Again and Health Freedom movements. We are so glad that he’s joining us. He’s a social epidemiologist and Principal Research Scientist at the Center for Policing Equity at Yale University Lab. Justin, thank you so much for joining us today on Citations Needed.
Justin Feldman: Thank you so much for having me. Really happy to be here, and not that happy that this issue is so timely and relevant. But here we are.
Adam: Yeah, because I want to dive into it here, because you’ve written about it. You thought a lot about this. Now, we kind of went into the origins of MAHA, for want of a better term. And obviously that was a very brief introduction, but I think that kind of got to some of the core elements, the core themes, which do kind of, again, play into genuine concerns about the health movement. Because I think some people listening to this, even some people on the Left, would think, Okay, yeah, those guys are kind of cranks. And yeah, there’s some dicey stuff around eugenics and fascism. But what are you guys? Just pro-corporate health food, pro-corporate medicine? You bring in Justin Feldman from the Egghead University to come tell, you know. So there’s kind of this, we obviously traffic very much in establishment skepticism. It’s a huge part of what we do. But I think when it comes to healthcare and medicine in general, what you want to do is you want to differentiate between genuine skepticism or healthy skepticism, or healthy critiques of power versus what we see in this current.
And again, there’s a reason why it’s in the current White House and why it’s supported by the Republican Party. If it was genuinely subversive, it wouldn’t be. Which is a kind of bizarre, and this is again, a key element of all fascism, which is a pseudo-populism, a bizarre, warped, inverted populism. So if you could, I want to sort of begin by talking about how you see its current formation went from, I think it’s fair to say, sort of not really existent in the first Trump administration, to a sort of so-called post-Covid, or early Covid kind of morphing into this genuine force of politics that now runs public policy, much to the shock and chagrin of many a liberal.
Justin Feldman: Yeah, absolutely. So yeah, as you said, the first Trump administration did not really embrace the Health Freedom organizers, organizations. Trump did gesture towards allowing RFK Jr. in the first administration to do some kind of panel on vaccine safety, and ultimately it was canceled. He didn’t go ahead with it. These people organized a lot, particularly during the pandemic, and they put together some political action committees, so they revealed themselves to be a fundraising force in politics. A lot of politicians in the Republican Party saw a kind of opportunism, an opportunity they could seize, and eventually Trump, the candidate for the second administration, saw potential opportunity to broaden his electoral coalition.
I think there is a danger in overstating how popular the appeal of this movement is, however. A lot of the politicians, almost entirely Republican politicians, that Health Freedom organizations endorsed in their primaries, did not win those primaries, and the policies that RFK Jr. is pursuing right now, or the Trump administration is pursuing, under the guise, under the banner of Health Freedom or MAHA, poll really poorly. Vaccination is still really popular, including among Republicans. Not as much the Covid vaccine, but vaccination in general. There’s still, 92.5% of children being sent into kindergartens have their required vaccination. So this is from a political and electoral standpoint, still pretty niche and fringe. From a public-health standpoint, dangerous.
Adam: And of course, Trump just got his flu and Covid vaccine last week, to be clear.
Justin Feldman: Of course, and it was Trump’s inclination to run for his second term by touting his achievement in developing the Covid vaccine, and he was booed in Alabama at a rally when he wanted to take credit for that. So this is pure opportunism, not something he’s deeply committed to in any way.
Nima: Shocking that Trump would be opportunistic in that way. Now, Justin, before we get any further into this, can you explain what the worldview is of this Health Freedom, medical freedom, Make America Healthy Again? And, you know, maybe there are different variants within there. How would you describe what is driving this? Now, you know, I say that knowing [chuckles] it’s a bit of a trick question, there’s very little consistency. There’s a lot of picking and choosing what gets touted as True Scotsman Health Freedom advocacy. But if you could kind of summarize the basic tenets of it for those listening, who hopefully are blissfully less aware of this than you are, that would be great. What kind of makes up this worldview and this, quote-unquote, “movement?”
Justin Feldman: Yeah, this is really confusing to a lot of people. And I think your typical article about this in the New York Times, for example, is just going to get it pretty wrong. And I was confused when I first started looking into this, and it took me a while to figure out the core of it. First, what it’s not. I think it’s tempting to see the Health Freedom movement as a libertarian movement, as a government hands off of my body kind of movement, but that is very clearly not the case. Many of these organizations of the Health Freedom movement are either fully anti-abortion or have endorsed candidates that are anti-abortion. They also believe in sort of nanny-state policies that a libertarian wouldn’t like, like restricting SNAP benefits to exclude certain foods they deem unhealthy.
What is unifying, you know, one week they’re about beef tallow, another raw milk, etc. Avoiding seed oils. It’s hard to keep up with what the trends are. But beyond that, the thing that brings them all together and that allows you to draw a throughline from Bernarr Macfadden to RFK Jr. today is this idea of what health is. So someone like me, who’s leftwing and in public health, sees health through a collective lens, through a lens of solidarity. They do not. They see health as highly individual. And if someone is healthy, it means they are more worthy as a person. They have gone through a transformative path of self-discipline to attain some kind of health. And if you are not healthy, it is because you are an inferior person, you are not self-disciplined, and you need to go on the same kind of path that they themselves went on and do that kind of transformation. And if that doesn’t work, it’s kind of underneath everything. Maybe there’s something wrong with you, constitutionally, in your genes, and that’s a way in which you aren’t valuable. And that’s where you get a lot of this weird 19th-century racism that RFK is so fond of.
Nima: Well, actually, about that, can you explain how that weirdo kind of 19th-century Road to Wellville style, individualistic health mantras, right? Like, make sure you’re only ingesting, you know, spring water and you are doing calisthenics from this time to this time. What is the throughline there, to the kind of influencer on TikTok or YouTube trend? It may be just a straight line. [Laughs]
Adam: And talk, if you could, as well about some of the bigger social-media influencers, because I think some people may not be familiar with those. So talk about those trends, what is hot, and who’s kind of pushing it for those unedified.
Justin Feldman: Yeah, this is really history repeating itself over and over. You brought in some of this in the intro, but I would point to even earlier, or in the US, in the 1850s you have what was called the Popular Health Movement. That’s where you have the invention of the graham cracker, which was created to stop people from masturbating. That was part of this Popular Health Movement where you have people like Graham or later Kellogg, bring in these new foods–granola, in the case of Kellogg brothers–that could be, either food or practices like water therapy, that could be used to bring your health away from the authority of the medical establishment and into your own hands.
But of course, there were a lot of entrepreneurs in this space who were becoming wealthy or sought to become wealthy as a result. And that has just repeated itself again and again and now is with social media and direct marketing. You just see the form this really often takes is multi-level marketing, perhaps pyramid schemes. Whether or not it meets the legal definition depends on the particular person. But you’ve just seen a really wide range of practices, people promoting consumption of mud from a particular lake in Canada that poisoned people because it was contaminated with heavy metals.
One of the most popular influencers in this world is Joe Mercola. He has earned tens, if not hundreds, of millions of dollars on supplements, has a huge influence, is one of the most influential figures in this world. His face probably does not appear in your feed because he’s higher towards the top of the pyramid, and you just find, as in the case of Bernarr Macfadden you mentioned before, just kind of very strange people. So Mercola has reportedly come under the influence of a psychic who is channeling a centuries-old spirit and helping him with his business decisions. [Laughs] So, yeah, you just have people who are into really esoteric spirituality, really rightwing world views. And then often they’re just highly narcissistic in ways that blind them from the kind of morality or self-doubt that a normal person like you or me might feel if we were encouraging people to consume products that were potentially dangerous.
Adam: Let’s talk a bit about the sort of material conditions that lead to this. Because, you know, again, as leftists, we don’t believe these things emerge from discrete moral failures, but they have antecedents. Specifically, now, I think a lot of this was supercharged by the kind of social disruptions of Covid and the paranoid conspiracies that emerged around that, with respect to, sort of grafted on a lot of the Alex Jones, you know, Agenda 21, eat seed oil people and eat bugs, whatever, we can get into that, because, again, there’s so much there. And again, if you’re not familiar with this, I envy you.
But I want to talk a little bit about the ways in which the kind of scienceism, the sort of smug scienceism, and perhaps we’re guilty of that as well, which is, although, again, we’ve criticized capitalist science from a leftwing perspective, but there’s this liberal tendency to be like, Well, it’s the science. And there’s not a lot of argumentation. And this combined with a failure to support things like Medicare for All or to sort of be perceived as being part of the establishment. And one thing I think we’ve really seen over the last 10 years, more than anything, is that a lot of these things don’t break down along left/right, as much as they break down upon the perception of being establishment or anti-establishment, even though you and I would perceive someone like RFK as being very establishment, aside from the fact that he’s just a rich, you know, heir to a bunch of money and doesn’t really work, that he is perceived as being anti-establishment. And the liberal intelligentsia, the kind of, you know, scolds and the medical professionals, are viewed as being the establishment.
Now, again, the establishment also tells me not to eat lead. The establishment also tells me not to walk into traffic. The establishment is sometimes right about things. Part of being a leftist is being able to distinguish between good and bad science, or knowing the motivations of certain, quote-unquote, “science” versus others. But this wholesale rejection of establishment science, it comes from this, again, it sort of emerges from, I think, some of the social disruptions around Covid in terms of supercharging it. But it obviously predates it. You have a lot of the Alex Jones, pseudo-libertarian distrust of authority. People take a vaccine, they get sick for two days, and they think, Well, this doesn’t seem right, you know what I mean?
Or this idea that everybody’s their own Ubermensch. That vaccines are for the weak. I don’t need it. And there is this hyper-atomization, hyper-individualism in our culture. So I want to ask about what are those material sort of antecedents that you see failures of liberals? Because you talk a lot about the kind of scienceism scolding, you talk about handing over, letting Big Pharma write legislation for decades, as Democrats did, taking money from Big Pharma, as a lot of Democrats do, taking money from privatized health insurance. Because, again, people interface with the medical establishment largely through their insurer. They view it as the establishment. And this is something, again, through Obamacare, we kind of institutionalized and touted as good. So talk about the liberal failures if you could. Because I do think that we, being sort of the liberal Left, got viewed as being The Man, in a way that I think opened up this grift economy to grow so much. And in many ways it was true, just in sort of all the wrong ways that they that they mean.
Justin Feldman: Yeah, I mean, this gets a little complicated, but I’m going to try to break it down. It’s no secret that the health system in the US sucks, especially if you’re someone with a chronic illness or a rare illness, autistic person with high support needs or their parents, it can be a real struggle to get the care you need, to get the answers you need. Some people who have struggled with the conventional healthcare system are among those who have been organized into this movement. So that’s kind of one strand of this. I don’t think they necessarily constitute the majority, but it’s certainly worth thinking about. I think for people who are asking questions about medical authority, and that is one of the medical and public-health authority, one of the major forms of professional authority that people experience directly in their lives, in terms of interpersonal interactions, or they live through a pandemic, whose lives are shaped by public-health policy. In those cases, it can be tempting for liberals, especially to say, Hey, you’re a crackpot. You just need to trust the experts and the people in charge. And it’s just not always that simple.
It is true that, yes, all the vaccines out there have been tested through a really transparent process and are good, and if they’re been recommended for you, you should get them. It’s also true that we have a regulatory state that have been really weakened over time, over the last several decades, to the extent that it was ever strong at all. And you have a kind of regulatory capture by major industries that have made it so that it’s easier to put pollutants into the world, to you know, put it bluntly, and yeah, if you’re a regular person trying to navigate all of this, it can be really difficult to know, where do you draw the line between healthy skepticism and crankishness?
Nima: That actually leads me to one of the things I wanted to ask about. It’s very closely connected. And actually, you wrote about this really, really nicely in your piece from March, Justin. So let me quote you to you, and then ask a question. You’ve written that, quote,
For the left, therefore, the necessity to fight for maintaining basic public health infrastructure is somewhat new territory and is complicated by a need to fight not only economic elites but also reactionary cultural forces that have been remarkably successful at leveraging the broad social appeal of “personal choice.”
End quote. So digging just a little bit deeper into what you were just getting into, can you please explain how fighting to maintain basic public-health infrastructure, and that is, I mean, sanitation services, normal vaccine mandates, food safety regulations–
Adam: Not getting cholera, which killed a lot of people.
Nima: [Laughs] Right. Not getting cholera, not getting measles, which is now back, right? Things that traditionally used to be givens in a normal, functioning society, fighting to maintain those basic public infrastructure ideas, policies, regulations, is not only more dire now, but how do you see that being even more difficult based on the new movements that are now coming to the fore?
Justin Feldman: Yeah, I mean, just historically, you know, against all odds, the US Left has, I think, achieved a lot, and I think you could argue public-health programs, policies like Medicare, Medicaid, OSHA, EPA, were to at least to some extent, an achievement of leftwing organizing and demands. But when it comes to things like, yeah, basic sanitation, vaccination, basic public-health infrastructure, that was essentially elites realizing that it was in their best interest to have a generally orderly society where people wouldn’t just die because they were drinking their own sewage.
It is really hard to politically organize around that stuff. Immediately you bump into opponents who are framing things in terms of personal choice, where it’s not just the big corporations that want to protect their profits. Those certainly are allies of these Health Freedom people. But it gets more complicated, and we haven’t really been able to do that very well. I mean, look at the Covid pandemic and the peeling away of all of the, not just policies to prevent transmission of disease, but social welfare policies that were in place to help and protect people. It proved nearly impossible to organize around it for, at least for the mainstream US Left and instead, we focused on other issues, like Medicare for All, etc.
Adam: Yeah. Because I think part of this efficacy is that everybody, I think everybody has, like, 5% woo. Everyone has some skepticism of the medical establishment. Just a little bit, right? And I think they kind of use that as a wedge to open up this whole world of just mindless contrarianism that really does take back progress that was hundreds of years in the making. That, by the way, again, this has happened with the Covid vaccine, where it’s like, when people talk about, in the United States, of being this conspiracy and this and that, and it’s this, you know, Agenda 21 and it’s like, literally, Hamas hands out Covid vaccines. Iran hands out Covid vaccines. Israel hands out Covid vaccines. If this is a conspiracy, it’s sort of, communist countries, socialist countries, Democrat–it doesn’t matter, right? If this is a conspiracy, it’s quite elaborate, because that means they would have had to have had Israel and Iran and North Korea and Russia. I mean, they all basically did the same thing.
And I think you see this when you think, talk about development. Again, sanitation, cleanliness, basic vaccines. This was not, this was something both capitalist and communist countries did. This is something that, quote-unquote, “democratic” countries did. These are kind of fairly banal, universal things. Now, again, we can have skepticism around the margins about what age or what this, but this idea that that became coded as The Man, I find it very strange, because it seems very historical, and it used to be the people on the Left would support these things as so-called development. This is how you could have increased the standard of your living, because you’re not having your kids die of preventable illness or dying of cholera or living in slums. And now it seems like, you know, you make the same argument in your piece, basically, sort of how people argue that reason why abortion was able to be taken away is because people, a whole generation lived with it being legal. They kind of took for granted that it was eternal. And it’s like, these things are not eternal. People died all the time. And you see this–
Nima: They were often fought for and won.
Adam: Right.
Nima: Against odds, against those working against them.
Adam: Yeah, again, I think it’s true even for some on the so-called Left, or people who are Left-adjacent. I don’t want to hippie-punch here. It becomes establishment-coded to be for fairly banal public-health things now.
Justin Feldman: Yeah, I mean, I’m still struggling exactly what to do with that politically. It’s, yeah, it’s just not, not entirely clear.
Nima: Before we get to our next question, Justin, let me cut in and be a little uncouth by reminding our wonderful listeners, please do sign up or move up a tier on Patreon between now, when you’re hearing this, and November 14, hopefully sooner rather than later. You can go right to Patreon.com/CitationsNeededPodcast. As we have said on every show, but we’ll continue to say, we are 100% listener-funded. We don’t run ads. There are no commercials on Citations Needed. There never have been. We don’t get foundation grants. We don’t get corporate money. We’re able to stay completely independent because of the ongoing support of listeners like you, and so, please, if you like the show, and you’re able to, of course, only if you’re able to–
Adam: Remember, if you can get at least 10 of your friends and family to sign up for Patreon, you get access to our special third tier. Wait, no.
Nima: [Laughs] Yeah, exactly. And then you get, you know, some Citations Needed Tupperware.
Adam: I do want to talk about the pyramid scheme aspect of it, because I do think it’s like, I’m looking at this going, Man, there really isn’t a franchise model or multi-level marketing parallel for public health. That really supercharges things. Can you talk about the ways in which the grifter is not necessarily parasitic or kind of adjacent to this movement, but is actually the thing that charges it as a kind of force?
Justin Feldman: Yeah, exactly. So for people who are living in the US have health problems, health concerns, not getting the answers they want from the medical establishment, as they see it, an alternative voice can come in and sell them something. And not only can they sell them something, they can give them a job in terms of selling that thing to others. There’s a fusion of a method, a message, philosophy of, Health Freedom philosophy, particular crank-ish beliefs about the medical establishment that may be combined with legitimate concerns and then promoting a product. And they’re advertising at once the product and a social message, and it’s hard to compete with that, because if you are doing something that the Left has traditionally done in terms of answering people’s health struggles, setting up a free clinic or some kind of health solidarity group, support group, etc., people aren’t making money off of that stuff.
Adam: No. And also, especially because things like Medicare for All, or free universal healthcare, maybe especially now, they seem so far away. They seem sort of impossible, whereas these more individualistic solutions provide people with more immediate, again, it’s, I don’t want to always go back to this, but because it seems like, Oh, it’s another leftist who says the problem is we don’t have universal healthcare, but it does seem like if we did have free at the point of access healthcare, this would solve a lot of these problems in terms of the sort of raw conditions for this type of grifter economy.
Nima: Because it also feels like there’s a gap that needs to be filled for–
Adam: Yes.
Nima: Feeling like you have a lack of agency.
Adam: And it’s being filled by fucking supplements.
Justin Feldman: Yeah, no, exactly. Same thing for health research. That even feels more distant and abstract in a way. That’s something that, you know, the US is the largest funder of health research in the world through the National Institutes of Health, that has just dramatically transformed the lives of not only people in this country, but all over the world, and by messing with NIH funding, it’s causing almost unknowable harm, sometimes into the distant future. And how do you make an argument around that when it feels so remote from people’s daily struggles?
Nima: Yeah, I want to get back to, you know, stuff that we were talking about in the intro and that you also brought up, but I feel like we can dig down a little more into it, and it’s the eugenicist undertones of all of this, sometimes overt overtones, I want to be clear, but that, you know, really do overlap with, as we’ve been discussing this kind of rise-and-grind hustle culture that actually we’ve done a whole other live show about. So if you haven’t checked that out, folks, check that out. But you know, something we’ve seen even more of lately with RFK is how he talks about people with autism. And you’ve written that, quote,
The contempt for the unfit and inferior has eugenic undertones to it, meaning that the lives of certain undesirables — whether they be poor, chronically ill, disabled, and so forth — are implied to be less valuable than those who are ‘healthy.’
End quote. So, Justin, I’d love for you to just expand on that a bit, talk about the ways in which this, you know, extreme health obsession and fitness directly drives headlong into more kind of misanthropic politics. Often, I think what we’ve seen lately kind of manifesting as overt fascism, which kind of gets us to this health, wellness, fitness, granola style, into, as we’ve said, the kind of fascist pipeline. Talk a little bit about how that happens and how it’s connected to this kind of TikTok influencer, It’s all about you, You control your own destiny, your own health, this kind of individualistic thing that then has everything to do with that some people are made for the future and some have to be kind of discarded.
Justin Feldman: Yeah. I mean, I think it really often starts with fatphobia and just really horrific statements by a lot of these grifters around fat people dying of essentially, of their own decisions and behaviors. That especially during Covid, I think this is super understated, especially during the height of the pandemic, we saw that like, Okay, this many people are dying, but they have preexisting conditions, often that’s framed around what they see as poor lifestyle choices around diet and exercise. And that, yeah, very quickly slips into this sort of biological determinism, where some people are maybe just not cut out to be protected in this life from government policy, and they can either undergo some arc of transformation, arc of self-discipline, or they can die. And you see RFK Jr. especially, really obsessed with this idea that different racial groups are biologically distinct and have different disease susceptibility, famously talking about Covid engineered as a bioweapon that could harm Black and white people but spare Chinese and Jewish people, essentially implying that this is the Chinese government conspiring with Jews to kill us ordinary Americans. And I guess he includes Black people in that, in that particular case, but then he thinks Black people should have a different vaccine schedule.
Nima: Right, because their immune systems are different, right?
Justin Feldman: Yeah.
Nima: There’s this, yeah, very, very strange race science that kind of enters into his–
Justin Feldman: Yeah, and there’s, there’s long, long been ideas in the US around, Black people are susceptible to infectious disease, but not susceptible to more advanced, quote-unquote, “lifestyle illnesses” like cancer and heart disease. More than a century old. And yeah, it’s just remarkable how clearly, overtly, he’s reintroducing that.
Adam: I want to expand on the eugenicist aspect of it, because I do think it’s, when we talk about, it’s a recurring theme on the show, which is this idea that one must expand this the circle of solidarity, that’s kind of the broader meta-theme of our entire podcast, in key ways. Because the opposite of that is atomization, individualism, and individualism and sowing individualism obviously serves capital so well, which is why, again, RFK can just find a place in the Republican Party. No one seems to give a shit. Because it’s not a genuinely subversive worldview. It is a smattering of mishmash, half-assed ideas mixed with deregulation. They talk about environmental pollution and environment meanwhile, again, Trump has gutted the EPA. I mean, it’s just, in a typical kind of fascist way, just a kettle logic of bullshit, and none of it makes any consistent sense. It’s internally inconsistent. And of course, it’s only concerned with kind of high-profile, superficial opposition to the establishment or whatever. But there is this hyper-atomization.
And I guess what I really want to ask is, we ask this a lot of our guests, if you were the dictator of the Left or the liberal Left tomorrow, what would you do differently? What would your messaging be? Now we’ve talked about pivoting this conversation of mistrust on the medical establishment towards a universal healthcare system that’s free, free at the point of usage, which has a lot of appeal. It polls well when framed a certain way. What would your approach be to kind of win back this narrative? Because I do think it’s fair to say that these people have won a lot of, I think the policies themselves aren’t popular, but the general vibe, I think, has won over a lot of more, quote-unquote, “normal” people, people who are not necessarily in that world, and I’m sort of curious what your counter messaging would be if you were in charge.
Justin Feldman: Yeah, and I developed this more in the Current Affairs piece, which anyone can check out. But my suggestion is, and it’s not, I didn’t come up with this, but I am repeating this, is to think about health as a collective right. We as society, as people, have a right to have conditions that allow us to be healthy, and that includes a whole lot of things. It includes a right to a safe and healthy workplace, directly tied into struggles over capital versus workers, and are they spending appropriate money on safety measures? It relates to environmental pollution. You know, you have a major, really major source of cardiovascular disease and related mortality is air pollution, and that’s coming from industry burning stuff and manufacturing things and that sort of thing. That is directly a people-versus-profit issue. You have issues like, Okay, if someone’s not getting exercise, active transport, being able to walk around or bike around your community, or roll a wheelchair around your community, directly tied into issues of urban planning, of property values, maybe on a different scale, but still a struggle for economic justice.
Nima: Yeah. I think this idea of health as communal, rather than consumer, which is something that you talk about in your piece and elsewhere, is really critical here, right? Just that kind of framework shift, because with so much of what we see from this kind of Health Freedom movement, it’s basically like the freedom to be able to harm others without any consequence, or the freedom to assume that our future lies in consuming new products, not being told what to do by the government, or getting, let’s say, free vaccines that will ensure that maybe most of us don’t die. But it seems like the freedom always goes in the direction of faking that you care about big corporate greed, but just turning back into kind of individualistic greed. And so the reframe of consumer to communal, I think, is really, really key here.
Adam: It’s just how contradictory most people are. If, again, you poll people, you see this all the time, that will give you completely contradictory statements about individual freedom versus collective, and it just seems like if you’re not going to provide a meaningful, robust alternative to an actual collective health policy and instead rely on this kind of, you know, Obamacare, insurance-focused, egghead, kind of scolding approach, yeah, you’re going to lose that battle nine times out of 10. But it’s not like people aren’t open to things like universal healthcare, or aren’t open to things like public health. It’s really how you frame it. It’s what day you sort of find them on. And whether or not you have this, I keep going back to this, because I think it’s true, whether or not you have this aura of genuinely looking out for the average person and opposing the establishment, or whether you’re just going around and finger-wagging people. And I just think for so long, the approach was to finger-wag while shoveling money into these parasitic insurance companies, while letting Big Pharma write our legislation while diabetes medicine spiraled out of control. And so there was this perfect opportunity for these grifters to come along and take that anti-establishment mantle. I don’t want to blame everything on that, but I think that’s a large part of it. And people are just so malleable, they can change on a fucking dime. The same polling question, you know what I mean? So I don’t think, as you say, I don’t think these things are really in principle that popular. I think they’re kind of filling a niche more than anything.
Justin Feldman: Yeah, exactly. Again, the polling, to the extent there has been any, on what RFK Jr. has been doing on public health or on cuts to Medicaid, for example, shows the agenda is really unpopular. People don’t want to get sick, generally. They don’t want to die, generally. And what I worry about is, on top of everything that’s happening now, if a Democratic administration gets in the White House, there’s going to be a lot of work that needs to be done to even get back to the pretty sad state we were at before the second Trump administration. And I’m not sure that a Democratic administration is going to be up to doing that work, because it was, these institutions were built in a time that was very different politically.
Nima: Right, where there was a different kind of assumption that sanitation services were normal and good, right? [Laughs] I mean, just some of the basics, which now kind of, you know, take healthy, reasonable skepticism to its loony conspiracy end, that just has put us into really dire straits here. As we’ve said, it makes even advocating for even just basic liberal reform, getting-back-to-zero stuff, normal vaccine mandates, stuff like food regulation, makes that even harder.
Adam: I think you can’t just advocate for the status quo, the kind of pre-Trump status quo. I think you have to argue for something more robust.
Nima: Yeah.
Adam: Something that is based on solidarity and universalism and genuine, you know, universal healthcare. Because I do think you need to have a populist countermessage. You can’t just do the, We’re going to go back to the pre-Trump days when everything was, quote-unquote, “normal,” because people fucking hated that. Their premiums were high, their healthcare was shitty, their insurances were gouging them. That’s the problem. You’ve got to stop framing the countermessage as an institutionalist or a status-quo message, because people fucking hate that status quo as well. So if some, you know, some MLM guy is going to offer an alternative, they’re going to take it because the status quo is so shitty.
Nima: So with that, Justin, before we let you go, I’m first going to remind folks that they can sign up to become Patreon supporters of Citations Needed [laughs] through Patreon.com/CitationsNeededPodcast. Again, we are 100% listener funded. No pyramid schemes here, although kind of, if you switch tiers, you’ll be eligible to get free merch. A drawing is going to happen on or after November 14, you have between now and November 14 to sign up for the Citations Needed Patreon. Please do, again, that’s Patreon.com/CitationsNeededPodcast. We are able to continue to do this show because of the amazing support of listeners like you.
Also, if you don’t want to wait around to see about the free merch giveaway, you can just head right on over to our Bonfire merch stores, Bonfire.com/store/Citations-Needed. Feel free to use the 10% off discount code, that is CNLIVE10. That is the discount code. You can use that on Bonfire for all your Citations Needed swag needs. Holidays are coming up, folks. Get on it.
But, Justin, before we let you go, please do tell us and our amazing viewers and listeners what you are up to these days at the Center for Policing Equity and elsewhere, and what we can look out for your incredible research and writing moving forward.
Justin Feldman: Thanks. So I’m doing some research. I put out some work around police violence in the US. I have a study coming out soon looking at trends in how much police violence has been used over the Black Lives Matter era, finding that there has not been much progress. And yeah, we’re working on some projects around police funding versus social services, and eventually, I hope to write a bit more about something adjacent to Health Freedom, sort of looking at Trump II as a war on the professional class.
Nima: Well, we will definitely look out for that. Been speaking, of course, with Justin Feldman, social epidemiologist who researches health, racism, economic inequality, and state violence. Previously a professor of epidemiology at NYU School of Medicine, he is now Principal Research Scientist at the Center for Policing Equity at Yale University Lab. Justin, thank you so much for joining us tonight on Citations Needed.
Justin Feldman: Thanks so much for having me.
Nima: And that will do it for our Citations Needed Beg-a-thon. Citations Needed now in its ninth season, we’ve been doing this since July of 2017, if you can believe it, Adam, can you?
Adam: You really don’t have to keep reminding people how old we are, Nima.
Nima: [Chuckles] That’s right. Well, but we just keep looking younger and younger.
Adam: True.
Nima: At least there’s that. But folks, thank you all for continuing to support the show. We cannot do this show without you. We are so grateful to your support for every share, every like, every conversation that you have about the show. Really, we are so grateful. We cannot do it without you. And also, we are incredibly grateful to our Patreon supporters who allow us to keep doing the show. And if you are not already a Patreon supporter, guess what I’m going to do? I’m going to urge you to become a Patreon supporter. You can just go to Patreon.com/CitationsNeededPodcast. Sign up there for whatever tier makes sense to you. Anything you’re able to do, that would be amazing. If you are already a supporter through Patreon and you want to change tiers, feel free. You can do that. You also can decide to give any amount you want. You don’t just have to stick with the strict tiers. If you give above whatever the tier amount kind of is, you will automatically be in that tier. So feel free to do that.
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But that will do it for this Citations Needed Beg-a-thon. Thank you all for listening. Of course, you can follow the show if you don’t already on Twitter and Bluesky @citationspod, Facebook Citations Needed, and become a supporter of the show through Patreon.com/CitationsNeededPodcast. Thank you all for listening and joining us for the livestream. I’m Nima Shirazi.
Adam: I’m Adam Johnson.
Nima: Citations Needed’s senior producer is Florence Barrau-Adams. Our producer is Julianne Tveten. Production assistant is Trendel Lightburn. The newsletter is by Marco Cartolano. The music is by Grandaddy. Thanks again, everyone. We’ll catch you next time.
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This Citations Needed live Beg-a-thon was recorded with a virtual audience on Monday, October 13, 2025, and released on Friday, October 31, 2025.
