The Effectiveness of Community Water Fluoridation in the United States

1996 ◽  
Vol 56 (5) ◽  
pp. 253-258 ◽  
Author(s):  
Herschel S. Horowitz
Keyword(s):  
United States ◽  
The United States ◽  
Water Fluoridation ◽  
Community Water ◽  
Community Water Fluoridation

scholarly journals Emulation of Community Water Fluoridation Coverage Across US Counties

2019 ◽  
Vol 5 (4) ◽  
pp. 376-384
Author(s):  
J.A. Curiel ◽  
A.E. Sanders ◽  
G.D. Slade
Keyword(s):  
United States ◽  
Health Literacy ◽  
Explanatory Power ◽  
The United States ◽  
County Level ◽  
Water Fluoridation ◽  
Community Water ◽  
Percentage Points ◽  
Us Counties ◽  
Community Water Fluoridation

Introduction: Expansion of community water fluoridation has stalled in the United States, leaving 115 million Americans without fluoridated drinking water. Objective: This study used spatial regression methods to assess contributions of supply-side factors (neighboring counties’ fluoridation coverage) and demand-side factors (health literacy, education, and population density of the local county) in predicting the extent of fluoridation in US counties. Methods: For this cross-sectional ecological analysis, data from the 2014 Water Fluoridation Reporting System for all 3,135 US counties were merged with sociodemographic data from the 2014 American Community Survey and county-level estimates of health literacy based on the National Association of Adult Literacy Survey. We employed multilevel geographically weighted autoregressive models to predict fluoridation coverage of each county as a function of fluoridation coverage of neighboring counties and local-county covariates: either health literacy or sociodemographic characteristics. Akaike’s Information Criterion was used to distinguish the better model in terms of explanatory power and parsimony. Results: In the best-fit model, an increase from the first to third quartile of neighboring counties’ fluoridation coverage was associated with an increase of 27.76 percentage points (95% confidence limits [CI] = 27.71, 27.81) in a local county’s fluoridation coverage, while an increase from the first to third quartile of local county’s health literacy was associated with an increase of 2.8 percentage points (95% CL = 2.68, 2.89). The results are consistent with a process of emulation, in which counties implement fluoridation based upon their population’s health literacy and the extent of fluoridation practiced in neighboring counties. Conclusion: These results suggest that demand for community water fluoridation will increase as health literacy increases within a county. Furthermore, when considering expansion of fluoridation, non-fluoridated communities can benefit from precedents from nearby communities that are fluoridated. Knowledge Transfer Statement: Expanded coverage of community water fluoridation has stalled in the United States. The economic theory of diffusion describes how, over time and space, policy enacted in one community can influence public opinion in a neighboring community. This study applies geospatial analysis of county-level data and the theory of policy diffusion to demonstrate that fluoridated counties can promote the implementation of community water fluoridation in their neighboring, non-fluoridated communities.

scholarly journals Community water fluoridation perceptions and practice in the United States: challenges in governance and implementation

Water Policy ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 365-375 ◽  
Author(s):  
Thomas Walker ◽  
Lori Dickes ◽  
Elizabeth Crouch
Keyword(s):  
United States ◽  
Water System ◽  
The United States ◽  
Water Systems ◽  
Primary Objective ◽  
Water Fluoridation ◽  
Sample Mean ◽  
Community Water ◽  
Large Water ◽  
Community Water Fluoridation

Abstract The primary objective of this research is to reveal potential challenges in achieving the finalized water fluoridation recommendation made by the Federal Water Fluoridation Panel in the United States (U.S.) with data extracted from consumer confidence reports. A secondary objective is to understand community water system manager's perceptions of and ability to meet this new standard using a survey instrument. Mean fluoridation levels are above the recommended level. The confidence interval does not capture the nationally recommended 0.7 mg/L. The t-test revealed two statistically significant results: that the sample mean is not equal to 0.7 mg/L and that the sample mean is higher than 0.7 mg/L. Respondents felt engaged in the policy process, but preferred state over federal policymaking. There is evidence that the optimal fluoridation level may not have been reached by water systems and that some water systems are under-fluoridating, while others are over-fluoridating. Several large water systems and pockets across the U.S. are not practicing artificial water fluoridation which reduces the effectiveness of this policy. Regular engagement by states with water system managers and feedback from water management professionals could be encouraged to better understand local constraints in meeting the federal recommendation.

Costs And Savings Associated With Community Water Fluoridation In The United States

2016 ◽  
Vol 35 (12) ◽  
pp. 2224-2232 ◽  
Author(s):  
Joan O’Connell ◽  
Jennifer Rockell ◽  
Judith Ouellet ◽  
Scott L. Tomar ◽  
William Maas
Keyword(s):  
United States ◽  
The United States ◽  
Water Fluoridation ◽  
Community Water ◽  
Community Water Fluoridation

scholarly journals Community water fluoridation predicts increase in age-adjusted incidence and prevalence of diabetes in 22 states from 2005 and 2010

2016 ◽  
Vol 14 (5) ◽  
pp. 864-877 ◽  
Author(s):  
Kyle Fluegge
Keyword(s):  
Tap Water ◽  
Fluoride Concentration ◽  
The United States ◽  
Sensitivity Analyses ◽  
Diabetes Incidence ◽  
County Level ◽  
Water Fluoridation ◽  
Community Water ◽  
Added Water ◽  
Community Water Fluoridation

Community water fluoridation is considered a significant public health achievement of the 20th century. In this paper, the hypothesis that added water fluoridation has contributed to diabetes incidence and prevalence in the United States was investigated. Panel data from publicly available sources were used with population-averaged models to test the associations of added and natural fluoride on the outcomes at the county level in 22 states for the years 2005 and 2010. The findings suggest that a 1 mg increase in the county mean added fluoride significantly positively predicts a 0.23 per 1,000 person increase in age-adjusted diabetes incidence (P < 0.001), and a 0.17% increase in age-adjusted diabetes prevalence percent (P < 0.001), while natural fluoride concentration is significantly protective. For counties using fluorosilicic acid as the chemical additive, both outcomes were lower: by 0.45 per 1,000 persons (P < 0.001) and 0.33% (P < 0.001), respectively. These findings are adjusted for county-level and time-varying changes in per capita tap water consumption, poverty, year, population density, age-adjusted obesity and physical inactivity, and mean number of years since water fluoridation started. Sensitivity analyses revealed robust effects for both types of fluoride. Community water fluoridation is associated with epidemiological outcomes for diabetes.

scholarly journals A Case-Control Study of Fluoridation and Osteosarcoma

2020 ◽  
Vol 99 (10) ◽  
pp. 1157-1164
Author(s):  
F.M. Kim ◽  
C. Hayes ◽  
S.L. Burgard ◽  
H.D. Kim ◽  
R.N. Hoover ◽  
...  
Keyword(s):  
Case Control Study ◽  
Phase 1 ◽  
The United States ◽  
Case Control ◽  
Bottled Water ◽  
Phase 2 ◽  
Water Fluoridation ◽  
Community Water ◽  
Community Water Fluoridation ◽  
Control Study

Public health policy decisions in the United States have resulted in 62.4% of the population having access to fluoridated water. The purpose of this study was to examine the association between community water fluoridation and osteosarcoma. A secondary data analysis was performed with data collected from 2 separate but linked studies. Patients for phase 1 and phase 2 were selected from US hospitals via a matched case-control study design. For both phases, cases included patients diagnosed with osteosarcoma, and controls were patients diagnosed with other bone tumors or nonneoplastic conditions. In phase 1, cases ( n = 209) and controls ( n = 440) were patients of record in the participating orthopedic departments from 1989 to 1993. In phase 2, cases ( n = 108) and controls ( n = 296) were incident patients who were identified and treated by orthopedic physicians from 1994 to 2000. This analysis included all patients who met eligibility criteria on whom we had complete data on covariates, exposures, and outcome. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% CIs for the association of community water fluoridation with osteosarcoma. A modestly significant interaction existed between fluoridation living status and bottled water use ( P = 0.047). The adjusted OR for osteosarcoma and ever having lived in a fluoridated area for nonbottled water drinkers was 0.51 (95% CI, 0.31 to 0.84; P = 0.008). In the same comparison, the adjusted OR for bottled water drinkers was 1.86 (95% CI, 0.54 to 6.41; P = 0.326). Findings from this study demonstrated that community water fluoridation is not associated with an increased risk for osteosarcoma.

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