Catherine Rampell: Society is making you sick, GOP says. Too bad their plans will make you sicker.

The biggest threat to your health isn’t your inability to afford an inhaler or to get that weird mole checked, the GOP argues. It’s everything else about American society, from nutrition to neurotoxins.

Unfortunately, the party’s agenda would make those other societal problems worse, too.

Republicans desperately want to cut taxes this year, which will be expensive. So, they’re plotting to pay for the revenue loss (at least partly) by slashing the safety net. Among the biggest programs on the chopping block: Medicaid and Obamacare marketplace subsidies, which help low- to middle-income Americans purchase private-market insurance.

Of course, the last time Republican lawmakers tried to reduce health coverage, it didn’t go well. Their 2017 Obamacare repeal efforts failed spectacularly, leading to a drubbing in the subsequent midterm elections. But the party is more prepared this time. The GOP has begun a preemptive PR campaign, with the message: Actual medical care is kinda superfluous. Or at best, it’s insignificant.

For instance, health and human services secretary pick Robert F. Kennedy Jr. pledged to “Make America Healthy Again.” How? Not by helping more people get health coverage so they can see doctors. That’s not in Donald Trump’s agenda. Rather, Kennedy plans to undermine trust in childhood vaccines (or perhaps revoke their approvals); fire medical researchers and drug regulators; and encourage Americans to consume “healthier” foods (such as raw milk, bird flu be damned).

Republicans in Congress echo the message. In a Fox News interview on Sunday, Sen. Roger Marshall, R-Kan., explained that nonmedical issues are driving the country’s high rates of chronic diseases, such as diabetes or liver problems.

“Look, about 70% of your health outcomes are determined by you. It’s determined by what you eat and what you’re surrounded by,” said Marshall, who is a physician. “By the time you come to my office as a doctor, I can impact maybe 10 or 20% of your health outcomes.”

While Marshall’s exact percentages are debatable, he’s making a reasonable point. Health outcomes are related to economic, cultural and environmental factors. Doctors and researchers call these “social determinants of health.” They include adequate nutrition; financial security; safe, stable housing; and clean air and water. They’re why public health experts have lately experimented with unorthodox interventions to improve health outcomes, such as “prescribing” fruits and vegetables or even cash for poor babies to reduce nutritional and developmental problems associated with poverty.

Unfortunately, these are not the kinds of proposals Republicans are pursuing. Quite the opposite.

In that Fox News interview, Marshall said the plan is to make “healthy foods affordable, available as well.” Yet last congressional session, House Republicans tried to slash funding for a nutritional program for low-income moms and babies. (They did not succeed.) And now, to pay for their proposed tax cuts, Republicans are seeking to slash food stamps. Tax cuts for the rich, funded by hunger for the poor.

Meanwhile, Trump has threatened tariffs on all imports from Mexico, which would presumably include all the Mexican tomatoes, avocados, raspberries and other fresh produce Americans buy. His mass deportation plans would also hollow out the (largely undocumented) workforce that grows crops here in the United States. And Trump’s advisers want to dismantle the visa program that allows immigrant agricultural workers to come here legally.

These proposals would all raise the price of fruits and veggies, putting “healthy foods” further out of reach for low-income families.

Kennedy suggests Trump will reduce chronic illnesses by removing “toxins” from our water and air, a laudable goal. Unfortunately, that’s hard to square with Trump’s actual record, which involves dismantling environmental protections wholesale.

For instance, the first Trump administration relaxed toxic-waste rules for coal plants, allowing them to dump more arsenic, lead and mercury into public waterways and more fine particulate matter into the air. Trump also opened the door for a comeback in asbestos, a known carcinogen, in manufacturing. And he helped chlorpyrifos, a pesticide linked to pediatric brain damage, stay on the market.

Of course, if Republican politicians really want to tackle a uniquely American social determinant of health, there’s an obvious target: gun culture. Firearms are now involved in the deaths of more American children each year than any other injury or illness, including car crashes or cancer. The United States has one of the highest rates of firearm mortality among developed nations.

Alas, Republican officials have blocked modest (and popular) gun safety measures, such as universal background checks. They promise instead to expand access to firearms. They rationalize this stance by arguing that gun violence is caused not by excessive access to guns but – wait for it – inadequate access to health care!

Untreated mental illness, they say, is the real American killer. Which, somewhat inconveniently, suggests the solution is more programs to expand health coverage and care. What’s the GOP response to that? Start this column over, I guess. Second verse, same as the first.