MAHA Report: Autoimmune Disease Claims – IBD trends

A May 2025 report from the White House, Make Our Children Healthy Again: Assessment, highlights concerning trends in childhood chronic illness, including an increase in autoimmune diseases.

While the report cites peer-reviewed research to support its claims, many of the referenced studies are behind paywalls, limiting public access. This lack of transparency raises concerns, especially given that the report itself states its purpose is to “inform the American people regarding the childhood chronic disease crisis, using transparent and clear facts” (MAHA Report, p. 2).

In several cases, statements made in the report were not fully supported by the sources cited. This doesn’t mean the overall concerns raised are unfounded, but when it comes to research and medical topics, accuracy and clarity matter. Even well-intentioned messages can lose credibility if the supporting details aren’t carefully conveyed. This makes it even more important for readers to have the ability to verify the original evidence for themselves.

Building public trust requires public access to the raw evidence backing the claims being made.

Of the five sources cited in the autoimmune-related sections, only one was freely available; purchasing the remaining four would cost around $160. Nonetheless, the Global Autoimmune Institute has independently reviewed each cited study to evaluate the strength and validity of the claims presented.

Claim 2: Inflammatory Bowel Disease Trends

The MAHA report states on page 15:

“Rates of Inflammatory Bowel Disease (IBD), including Crohn’s, have increased by 25% over the last decade.”

To support this, the report cites:

‘Prevalence of pediatric inflammatory bowel disease in the United States: Pooled estimates from three administrative claims data sources‘, published in Gastroenterology by Kappelman et al in 2025.

What the Research Says

The study pooled insurance claims from more than 2.7 million U.S. children and teens under age 20. Among them, about 100,000 youth were estimated to be living with IBD (58,733 with Crohn’s disease and 36,270 with ulcerative colitis). The researchers also examined trends in the commercially insured population, which had data across multiple years.

This represents an increase of ~14% from 2011 to 2020, not the 25% cited in the MAHA report.

How Reliable Are These Numbers?

Because the U.S. has no national registry for IBD, prevalence estimates depend on insurance claims. Misclassification is a risk, but Kappelman’s team built on prior validation work (Dawwas et al., 2023), which showed that requiring multiple diagnosis codes plus supporting procedures or prescriptions yields a positive predictive value of ~91–94%. The numbers are robust, though not exact.

Placing U.S. Pediatric IBD in Context

• National burden: A related study (Lewis et al., 2023) found that about 0.7% of the entire U.S. population (children + adults) lives with IBD. Pediatric cases are part of this broader, rising burden.
• Disparities: Barnes et al. (2022) reported lower diagnosis rates among Black and Hispanic children compared to White children, which may reflect both real differences in risk and inequities in access to gastroenterology care.
• Global perspective: Kuenzig et al. (2022) documented rising pediatric IBD worldwide, with the steepest increases in North America and Europe, and growing incidence in Asia, the Middle East, and South America.

Bottom Line

The MAHA report is correct that pediatric IBD prevalence has risen, but its claim of a “25% increase over the last decade” is not supported by the cited study. The actual increase documented between 2011 and 2020 is closer to 14–15%.

If the report intended “the last decade” to mean 2015–2025, the cited study still does not substantiate that interpretation. Scientific publications typically state timeframes explicitly, and the report would have been more precise and more accurate had it followed that standard.

What Can Be Done?

Recognizing the burden of pediatric IBD is an essential first step. But beyond simply reporting numbers, action is needed to support children and families affected by Crohn’s disease and ulcerative colitis. Policymakers could:

• Fund pediatric gastroenterology clinics and research centers, ensuring timely access to specialists trained in childhood-onset IBD.
• Expand insurance coverage for essential diagnostic tests, medications, and nutrition therapy to reduce financial barriers.
• Support school accommodations, including training for school nurses, teachers, and cafeteria staff on IBD-related needs.
• Promote diverse representation in IBD research to close gaps in understanding of racial and ethnic disparities.
• Invest in public awareness campaigns that help families recognize symptoms early, reducing diagnostic delays.

The data is already here. What we need now is action.

Citations

MAHA Report (May 2025). The White House.

Kappelman, M. D., Brensinger, C., Parlett, L. E., Hurtado-Lorenzo, A., & Lewis, J. D. (2025). Prevalence of Pediatric Inflammatory Bowel Disease in the United States: Pooled Estimates From Three Administrative Claims Data Sources. Gastroenterology, 168(5), 980–982.e2. https://doi.org/10.1053/j.gastro.2024.11.004

Molodecky, N. A., et al. (2012). Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology, 142(1), 46–e30. https://doi.org/10.1053/j.gastro.2011.10.001

Ng, S. C., et al. (2017). Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet (London, England), 390(10114), 2769–2778. https://doi.org/10.1016/S0140-6736(17)32448-0

Kuenzig, M. E., et al. (2022). Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic Review. Gastroenterology, 162(4), 1147–1159.e4. https://doi.org/10.1053/j.gastro.2021.12.282

Barnes, E. L., et al. (2022). Racial and Ethnic Distribution of Inflammatory Bowel Disease in the United States. Inflammatory bowel diseases, 28(7), 983–987. https://doi.org/10.1093/ibd/izab219

Lewis, J. D., et al. (2023). Incidence, Prevalence, and Racial and Ethnic Distribution of Inflammatory Bowel Disease in the United States. Gastroenterology, 165(5), 1197–1205.e2. https://doi.org/10.1053/j.gastro.2023.07.003

Dawwas, G. K., et al. (2023). Development and Validation of Claims-Based Definitions to Identify Incident and Prevalent Inflammatory Bowel Disease in Administrative Healthcare Databases. Inflammatory bowel diseases, 29(12), 1993–1996. https://doi.org/10.1093/ibd/izad053

Kappelman, M. D., Moore, K. R., Allen, J. K., & Cook, S. F. (2013). Recent trends in the prevalence of Crohn’s disease and ulcerative colitis in a commercially insured US population. Digestive diseases and sciences, 58(2), 519–525. https://doi.org/10.1007/s10620-012-2371-5

Dhaliwal, J., et al. (2020). Phenotypic Variation in Paediatric Inflammatory Bowel Disease by Age: A Multicentre Prospective Inception Cohort Study of the Canadian Children IBD Network. Journal of Crohn’s & colitis, 14(4), 445–454. https://doi.org/10.1093/ecco-jcc/jjz106

Tolbert J, et al. KFF. The Uninsured Population and Health Coverage. https://www.kff.org/health-policy-101-the-uninsured-population-and-health-coverage/. Published May 28, 2024.

Nead, K. T., Hinkston, C. L., & Wehner, M. R. (2022). Cautions When Using Race and Ethnicity in Administrative Claims Data Sets. JAMA health forum, 3(7), e221812. https://doi.org/10.1001/jamahealthforum.2022.1812