Why don't more people care about Donald Trump's health?

He isn't exactly young.

(Donald Trump and fast food, a love story)

Any time I write about Joe Biden’s age and health — as I did earlier this week — the comments section fills up with a unique type of whataboutism: Why aren’t you talking about Trump’s age and health????

Which is, on it face, a fair argument. After all, we know very little about Trump’s health. And what we do know suggests Trump isn’t exactly a fitness personified.

As a candidate for president, he broke with tradition and refused to release any detailed information about his medical history.

In December 2015, he released a much-mocked letter from his personal physical — Dr. Harold Bornstein — that asserted that, if elected, Trump would be “the healthiest individual ever elected to the presidency.”

Bornstein provided no evidence for such a wild claim and, before his death in 2021, told CNN that Trump had dictated the entire letter to him.

Unsurprisingly, that first letter did not satisfy people looking for some details about Trump’s medical past. So, in September 2016, he released ANOTHER letter from Bornstein, with limited details — including his height and weight (6’3”, 236 pounds) and the fact that he took a statin to regulate his cholesterol.

In an appearance around that time on the Dr. Oz(!) show, Trump said this about his health and the importance of good health more generally:

"When you're running for president, I think you have an obligation to be healthy. I just don't think you can do the work if you're not healthy. I don't think you can represent the country properly if you're not a healthy person.”

Which, ok.

While in the White House, Trump submitted to an annual physical. But, just like before he was elected president, the read-out on his health often felt larded with spin.

One example: In 2018, White House physician Ronny Jackson — yes that Ronny Jackson — took to the White House podium to deliver an update on Trump’s health.

It was, um glowing.

Jackson said that Trump did “exceedingly well” on his cognitive test and that his cardiac health was “excellent.”

“He has incredibly good genes, and it’s just the way God made him,” Jackson said in response to a question about Trump’s less than healthy diet. “I told the President that if he had a healthier diet over the last 20 years he might live to be 200 years old.”

Good genes! 200 years old!

A word about that diet while we’re at it. Trump has long preferred fast food — McDonalds in particular — both in and out of the White House.

There are a few reasons for that — among them that he thinks fast food is less likely to be poisoned and he believes fast food places are more sanitary because a single food poisoning outbreak could be hugely damaging for their business. (Yes those are the real reasons).

Trump has said his favorite meal at McDonalds is the “Fish Delight” (presumably he means the Filet O Fish) and there are even conflicting reports about what Trump’s favorite meal is at the Golden Arches.

Jared Kushner, the president’s son in law, said that Trump likes to order a “Big Mac, Filet-o-Fish, fries and a vanilla shake.” Corey Lewandowski, Trump’s erstwhile campaign manager in 2016, said the president’s favorite meal is “two Big Macs, two Filet-O-Fish and a chocolate malted.”

Trump’s exercise regimen — or lack thereof — certainly doesn’t make up for his diet.

In 2018, he told the press “I get exercise. I mean I walk, I this, I that. I run over to a building next door. I get more exercise than people think.”

But, the truth is that Trump eschews what we would describe as normal exercise. Not only does he not like it, he believes it is detrimental to one’s health.

This, from the brilliant book “Trump Revealed,” explains that nicely:

After college, after Trump mostly gave up his personal athletic interests, he came to view time spent playing sports as time wasted. Trump believed the human body was like a battery, with a finite amount of energy, which exercise only depleted. So he didn’t work out. When he learned that John O’Donnell, one of his top casino executives, was training for an Ironman triathlon, he admonished him, “You are going to die young because of this.”

Um, yeah.

ALL of that is to say that despite weighing in at a slim 215 pounds during his arraignment last week in Georgia (snort!), Trump is, at 77 years old, not exactly the picture of health.

Which, by the numbers alone, stands in relatively sharp contrast to Joe Biden who, while three years his senior, is significantly more active (he bikes etc.) than Trump and, generally speaking (ice cream accepted), seems to watch what he eats.

In February, White House physician Kevin O’Connor pronounced Biden “fit for duty, and fully executes all of his responsibilities without any exemptions or accommodation.”

So, purely on paper, you would think that the Biden-Trump age and health debate is effectively a wash. One is a little older, sure. But he also takes care of himself better.

And yet, poll after poll shows that that is simply not the case. The AP-NORC poll released earlier this week painted the situation in stark terms: 77% of people said Biden was too old to effectively serve another four year term. Just 51% said that of Trump.

Now 51% is not nothing. But, there’s clearly a gap between what how people think about Biden’s age and how they think about Trump’s.

How to explain that gap? Perception — and the eye test.

When you see Trump — usually playing golf or on the campaign trail — he looks overweight, yes, but not morbidly so. He holds campaign rallies that go on for hours with him serving as the ring master. He sends out social media posts in the middle of the night.

Trump does not, in short, act his age.

Biden, on the other hand, moves slowly. He speaks slowly. (This could well be, as his allies suggest, a function of the lingering effects of a childhood stutter.) As the New York Times described Biden recently:

[He is] a little slower, a little softer, a little harder of hearing, a little more tentative in his walk, a little more prone to occasional lapses of memory in ways that feel familiar to anyone who has reached their ninth decade or has a parent who has.

And, another Times piece from last year noted:

Mr. Biden looks older than just a few years ago, a political liability that cannot be solved by traditional White House stratagems like staff shake-ups or new communications plans. His energy level, while impressive for a man of his age, is not what it was, and some aides quietly watch out for him. He often shuffles when he walks, and aides worry he will trip on a wire. He stumbles over words during public events, and they hold their breath to see if he makes it to the end without a gaffe.

So, Biden looks old. And people perceive him to be old.

How do change perception? It’s a very tough thing. Because, as we’ve just detailed, they are so often not based on the facts as we know them.

But what I do know is that Biden and his team (and his supporters) can’t live in the world as they want it to be. They need to live in the world as it is. And in that world, Biden’s age and health are much bigger problems than Trump’s.

Which means, as I’ve suggested before, Biden needs to find ways to show he is physically active. He need, maybe, to give a speech on age and the presidency. He has to show a level of vitality that counteracts what is sure to be a vicious campaign from Republicans trying to suggest that he is not up to the job he is running for.

And he needs to start now.