Building public understanding and support on science-intensive public health issues. Case study: Community water fluoridation in San Diego

In the current climate of mistrust, public skepticism extends to nearly every social institution: from politics and government to business, academia, religion and science. This presents problems for public health engagement and outreach, because scientists and public health experts cannot count on receiving the benefit of the doubt when controversial issues are on the table. This presentation takes the findings of a series of public dialogues on Community Water Fluoridation (CWF) in San Diego as a case study. In a series of dialogues with randomly recruited representative samples of San Diegans, Viewpoint Learning (working with the Dental Health Foundation of California and funded by the Centers for Disease Control) examined which considerations are most important in forming and changing people's views on CWF, and more generally how the public form their attitudes and reach judgment on issues with a strong scientific component. We found that both traditional public education approaches and social marketing are insufficient to bring about public support for change on science-intensive issues – and can be counterproductive especially in a climate of mistrust. The research indicates that a different, dialogue-based approach that positions public health experts as advisors rather than advocates shows promise for more effectively building public understanding and support on science-intensive issues.