198636 Winning the fluoride war, one battle at a time: How one Canadian city resisted an intense lobby effort to stop community water fluoridation

Tuesday, November 10, 2009: 9:45 AM

Christopher O. Mackie, MD, MHSc, FRCPC , Public Health Services Department, City of Hamilton, Hamilton, ON, Canada
Peter Wiebe , Public Health Services, City of Hamilton, Hamilton, ON, Canada
In 2006, local anti-fluoride lobbyists, supported by an international network, began a concerted attempt to convince the council of a mid-sized Canadian city to discontinue community water fluoridation. The individuals involved were well acquainted with municipal issues and processes, having successfully lobbied for a municipal anti-pesticide bylaw against the advice local public health leaders.

Our public health department decided to develop a strategy to ensure that any decision about community water fluoridation was based on sound science as well as a strong understanding of the ethical issues. We researched the information needs of the city councillors, the arguments being used to criticize fluoridation, and the viewpoints of community stakeholders. We assessed the relevant evidence on the safety, effectiveness, ethics, economics, occupational health and environmental aspects of community water fluoridation. We then developed a strategy to translate this evidence into the type of information needed to create an environment where evidence-informed decision making was both possible and politically feasible. The strategy was successful, and the city council voted to maintain community water fluoridation.

Critical components of this success included: significant research into the historical, interpersonal, and rhetorical contexts of the issue; engagement with and support from stakeholders; messaging content tailored to the information needs of the individual city councillors; and messaging style tailored to the political context of the various environments in which these discussions occurred.

Learning Objectives:
1. Describe how local public health practitioners helped political decision makers to understand the ethical and scientific basis for community water fluoridation. 2. Identify the key tactics and arguments used by the anti-fluoridation lobbyists. 3. Differentiate between the various risk communication approaches that are successful in one-to-one meetings, media encounters and public meetings. 4. Demonstrate how scientific evidence can be transformed into convincing rhetoric to support appropriate community water fluoridation.

Keywords: Water, Oral Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted a portion of the research that informed this presentation and also collaborated in the devleopment of the concepts and arguments presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.