Influencing Municipal Water Fluoridation Policies: Identifying key policy hurdles

Pennsylvania ranks below average in levels of residents receiving fluoridated water. While in half the states, 77% of residents have properly fluoridated water, in Pennsylvania only 54.0% of the population is served by public water supplies that optimize fluoride.

For decades oral health advocates have been battling anti-fluoridationists. During the last decade the opposition to fluoride has significantly broadened. In Pennsylvania this has meant that the percent of residents having fluoridated water actually dropped by .2% from 2000 to 2006. It is therefore critical that efforts to promote fluoridation policies cannot only use science, but must use education and strategic advocacy to engage both residents and elected officials at the municipal level.

The purpose of this study is to identify the key policy hurdles within the municipal policy-making process that may be the most important to target for future pro-fluoridation advocacy efforts.

This study surveyed elected officials in over 100 municipalities in Pennsylvania using a web-based instrument. The survey collected data on three constructs: i) elected officials' level of knowledge about fluoridation; ii) elected officials' perceptions about sources of support and opposition to fluoridation; and iii) their current positions on fluoridation policies.

Preliminary results show that : i) 40% of respondents do not view the pro-fluoridation science as being reliable; ii) 52% of respondents do not perceive fluoridation as being beneficial; iii) 67% perceive that residents don't believe that fluoridation is necessary and, iv) 40% of respondents perceive municipal governments as being the source of greatest opposition.