The politics of fluoridation in seven California cities.

AS A HEALTH MEASURE, the fluoridation of community water supplies has 4 been approved and enthusiastically endorsed for over a decade by virtually L all the important health people and organizations in the country. Its value is being verified by an increasing number of experiments, urveys, and studies. Yet at the same time it is being rejected more and more consistently by voters at the local level. There are 11 communities in California which have voted favorably on fluoridation in referendums, while more than 25 others have considered the idea at the ballot box and rejected it. Since 1957 there have been at least 16 fluoridation referendums inthe state, and in all but two of these the measure was rejected. It is the purpose here to consider this curious phenomenon, to analyze its causes and effects, and to draw some conclusions about its implications for other issues in the political arena. Fluoridation, its proponents assert, is a safe, well-tested, economical procedure for markedly improving the dental health of children through the addition of fluoride salts to the water supply in the ratio of one part of fluoride per million. At higher concentrations a cosmetically undesirable stain appears on the teeth, a condition called "fluorosis," but this problem can be avoided if the concentration is carefully controlled. Several points hould be made about the political nature of this issue: 1. The health benefits of the measure are remote and statistical, and directly accrue to a segment of the population which is not included in the electorate. 2. Fluoridation itself, while it benefits only some, affects everybody in a most vital manner through the very water that is consumed. 3. The measure is chiefly sponsored by people who are not ordinarily active in the political arena health professionals. Thus the issue is not linked in the voter's mind with any particular political personality or party it is, in this sense, seen on its own merits.