The Four Biggest Public Health Trends of 2026: Part 1

Happy new year to each of you! I appreciate your taking time to join me here.

In the U.S., the biggest public health trends of 2026 won’t be new developments, like the manufacturing of penicillin or some viral TikTok challenge. Rather, I think we’ll be seeing an intensification of four existing trends:

1. Expansion of personalized medicine

2. Integration of AI into health care

3. Bipartisan resistance to MAHA

4. Increasing use of GLP-1 drugs

This is a short and admittedly subjective list. Much is missing, such as shifts in the landscape of recreational drug use (ongoing declines in opioid-related mortalities and alcohol intake, combined with increasing numbers of daily or near-daily marijuana users).

I chose these four trends because I believe they’ll affect the most Americans, not just in terms of health care options and individual behaviors, but also in how we talk about health. Even if you’re not interested in trying GLP-1s, for instance, their popularity is spurring broader conversations about medical ethics, health hacks, and the relative importance of lifestyle vs. treatment.

This two-part series will take the form of a countdown. This week I’ll discuss GLP-1 drugs and resistance to MAHA. Next week I’ll tackle AI and then the biggest health trend of 2026, personalized medicine, a label that can be stretched to include everything from gene editing to concierge care to health and longevity coaching.

4. GLP-1 drugs: More use, greater scrutiny.

A November survey found that approximately 12% of American adults are taking a GLP-1 drug such as Ozempic or Wegovy, roughly double the percentage reported this time last year. That’s about 1 in 8 of us.

In 2026 we can expect this trend to accelerate. Why? Simply put, greater convenience and lower cost:

• Ten days ago, Novo Nordisk announced that the FDA has approved its new Wegovy pill. For the first time, a GLP-1 drug can be taken orally rather than via injection. (You can purchase it now, or wait for Eli Lilly’s competing pill, expected to be on the market by mid-year.) This is good news for folks who dislike needles.

• The new Wegovy pills are being sold for $149 per month, much cheaper than injectable versions. (As of this morning, discounts are already available at some online pharmacies.) Even the price of injectables is declining, owing to a deal the Trump administration made with Novo Nordisk and Eli Lilly back in November. Low-cost microdosing options are increasingly available as well.

So, we can expect a sharp increase in the use of GLP-1s this year. Is that a good thing?

Causes for concern

Back in 2023, during his opening monologue at the Academy Awards, Jimmy Kimmel served up a now-famous zinger:

“Everybody looks so great. When I look around at this room I can’t help but wonder, ‘Is Ozempic right for me?’”

A funny line, but also a question that millions of Americans should be asking themselves.

On the one hand, GLP-1s clearly reduce weight, an important consideration given that nearly 40% of American adults are obese. In 2025, several studies confirmed that GLP-1s also lower the risk of cardiometabolic and kidney diseases, even apart from their impact on adiposity.

The economic impacts are worth mentioning too. Last month, Cornell researchers reported that households with at least one GLP-1 user spend 5.3% less on groceries, with the greatest reductions for calorie-dense processed foods (e.g., a 10.1% decline in savory snacks).

5.3% may not sound like much, but consider this crude, back-of-the-envelope calculation: On average, an American family of four can expect to spend about $1200 per month on groceries this year. 5.3% of that would be just over $63 in savings. Thus, if one person in that family starts taking the new Wegovy pill, the net cost of the pill would be $149 minus $63, or $86 per month. I suspect most people would find that affordable.

Still, I’m not persuaded that GLP-1s are a good thing, at least not for everyone – and perhaps not even for the majority of people who rely on them for weight loss. There are causes for concern:

• GLP-1s only help so long as a person takes them. Most people who quit regain what they lost, and in a few cases they end up exceeding their original weight. A meta-analysis published last month also confirmed rebound effects for systolic blood pressure and blood sugar. In the Cornell study, most people who stopped taking GLP-1s returned to their original diets and, in some cases, began spending even more on groceries.

• Discontinuation rates are high; over half of those taking the drugs for weight loss quit within a year. Some find the price too steep. Some believe they don’t need the support anymore. Many are put off by side effects such as nausea and diarrhea.

• Other, less noticeable side effects include loss of muscle along with fat. Anecdotally, psychological effects such as diminished motivation and enthusiasm are also being reported. (MedPage Today offers a nice summary of other pros and cons here.)

Bottom line: There’s no free lunch. Using GLP-1s may incur costs beyond the literal price of the drugs. The point is not that people should be discouraged from using them, but that they need to understand the likely tradeoffs.

In sum, we can expect increasing GLP-1 use in 2026, along with greater scrutiny as more people try out the drugs and more data on the pros and cons accumulate.

3. Bipartisan resistance to MAHA: The body politic responds to infection.

I don’t want to talk politics here – trust me, I really don’t – but it’s unavoidable, because public health in the U.S. has become so deeply politicized.

This is unfortunate. Concern for health should transcend political ideology.

For Republican-minded readers, I want to assure you that I don’t object to everything MAHA stands for. I appreciate RFK Jr.’s call for more exercise, healthier foods, and a cleaner environment. I admire the man for having spent the past four decades fighting pollution.

At the same time, I can’t help feeling that in 2025, MAHA infected American public health.

Is there a better word to describe what happened? An infection is defined as an invasion of the body with pathogens that cause disease. In this case, it’s the body politic that has been invaded, and the pathogens are ideas and practices that contradict established science and endanger public health.

For instance, by firing or driving out experts at the FDA and CDC and replacing them with ideologues, RFK Jr. has rapidly undermined U.S. vaccine policies. By the end of 2025, the CDC’s Advisory Committee on Immunization Practices (ACIP) had voted to rescind universal recommendations for the following vaccines:

• Hepatitis B (for newborns)

• MMRV (for children under 4)

• COVID-19 (for healthy adults under 65)

Each of these vaccines has been shown to be safe and effective. There’s no new evidence calling for changes to their recommended use. (ACIP also voted for discontinuation of flu shots containing thimerosal, an ingredient also repeatedly shown to be safe.)

The consequences of HHS-wide anti-vaccination efforts are already visible. Vaccine hesitancy continues to increase (particularly among adults who identify as Republican). Measles, whooping cough, and flu are on the rise, each far more prevalent among unvaccinated populations. Broadly, public trust in federal health agencies continues to erode.

Meanwhile, these agencies are increasingly unable to respond to problems their own policies are creating. Growing chaos has been documented at the NIH and CDC – unfilled positions, cancelled meetings, communication blackouts, flawed reports, lost data. Worst of all, from a long-term perspective, funding for health-related research is being slashed, including nearly half a billion dollars for mRNA vaccines alone.

I’ve barely scratched the surface here.

Fortunately, the body politic has a sort of immune system. Bipartisan resistance to the MAHA infection is increasing, and I expect this trend to shape public health dialogue and practices in 2026.

Part of what’s happening is declining popular support for almost all things Trump. Here a sinking tide lowers all boats, including those of RFK Jr. and other HHS agency leaders. (I’m glossing over some distinctions here between public attitudes toward MAGA, MAHA, HHS, and RFK Jr., according to survey data.)

Part of the resistance stems from internal conflict that’s likely to come to a head this year. For instance, as the New York Times reported in separate articles last month, the MAHA base is increasingly unhappy with the EPA over its easing of restrictions on toxic chemicals. In November, the EPA approved the use of two pesticides internationally classified as PFAS, or “forever chemicals”, arguing that they pose no health risks when used as intended – a claim contradicted by the EPA’s own data.

There’s a familiar pattern here. Whether it’s the FDA, the CDC, or the EPA, we find that the agency has already sponsored or created some of the scientific evidence that’s ignored or contradicted by the agency’s new, dangerous policies.

For vaccine safety – again, this is just one example – what RFK Jr. and his cronies are saying, in effect, is that you can’t trust established science, medical authority, or federal health agency data. You can only trust federal health agency leaders, beginning on whatever day in 2025 RFK Jr. replaced the experts who occupied those positions with ideologues and unqualified mouthpieces who dabble in pseudoscience.

Fortunately, MAHA activists and their fans are noticing. In spite of the tendency for the rest of us to demonize them, I assume that they are, for the most part, ordinary human beings who seek good health for themselves and their loved ones. They notice how Trump administration deregulations are increasing environmental pollution. They notice that measles and whooping cough are on the rise. They want fluoridated water for their children. A KFF poll conducted in October found that 30% of respondents who consider themselves MAHA supporters now disapprove of the way RFK Jr. is handling his role as HHS secretary.

In short, part of the growing resistance to MAHA comes from within.

Just as the immune system relies on a variety of strategies for handling pathogens, so resistance to MAHA is taking on many forms. As funding for health research is being gutted, private organizations and funders have begun to step up (though the gap is far from being closed). Mainstream scientists and scientific organizations continue to speak out against MAHA errors and excesses. And new data is playing a role. In 2025 we saw more evidence for vaccine safety, including a WHO analysis published last month confirming the absence of a link between vaccines and autism.

I was particularly intrigued by a November study in Nature Communications demonstrating a vastly improved method of restoring tooth enamel via remineralization. Given MAHA’s baseless, dangerous attacks on fluoridated water (I’ve written about the safety record here) – and given that over 170 communities, and now the state of Utah, have banned the fluoridation of public water – I began to wonder: If our water is no longer fluoridated, could the new remineralization technology save the teeth of future generations of American children?

Perhaps. But science can’t solve all of our problems. Nor should problems like this be cropping up in the first place. The CDC itself has described fluoridated water as one of the 10 great public health achievements of the 20th century (vaccination is another one), and we need to ensure that the MAHA infection doesn’t undermine these historically unprecedented successes.

What we can do

As you’ve probably noticed, I’ve shifted here from description to advocacy.

The remineralization study reminded me that we need to do more than just develop treatments for the sequelae of MAHA infection. We need to directly confront the source, and to promote greater trust in scientific and medical authority (with the understanding that they’re fallible, of course).

One way to do this is to leverage bipartisan dissatisfaction with RFK Jr. and other MAHA leaders. Concretely, this means contacting your elected representatives, pressing them to support evidence-based health policies, and, whenever possible, voting for candidates with a strong record of respect for science.

Another strategy is to support health organizations such as the American Medical Association, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists, all of which issued evidence-based recommendations last year that contradicted false, pseudoscientific health statements made by the Trump administration.

A third strategy is to promote critical thinking in preK-16 education, as these are the citizens of tomorrow who will be sifting through health-related claims that vary in credibility and scientific backing, and voting for political candidates who demonstrate respect (or disdain) for science.

Finally, I invite you to continue reading this newsletter. Most weeks (aside from this two-part series) I discuss new health research. One of my goals – always – is to figure out what kinds of practical guidance can be gleaned from the data.

Up next week: A look at how AI and personalized medicine will continue transforming public health in 2026.

Thanks for reading!