Flappin' Their Gums About Fluroide
Locals debate ballot measure
by Rob Pratt
Conspiracies abounded during the late '50s when the idea of fluoridating municipal water supplies first gained national attention. Though Minnesota Sen. Joe McCarthy's crusade against Communists had unraveled, generals at the Pentagon not-so-secretly scrambled to fill the "bomber gap" and schoolkids across the land performed duck-and-cover drills, preparing to ride out an imminent nuclear war.
Today, fluoridation of municipal water supplies still carries a paranoia charge that can instantly polarize a community. Clouded in confusion and rife with accusations of hidden motives verging on X-Files intensity, fluoridation draws passionate adherents sincere about promoting health as well as equally vocal and sincere detractors who decry it as a needless health risk.
Now Santa Cruz faces fluoridation as many communities across the nation have faced it -- deeply divided. Backed by a 1995 law requiring fluoridation and recent state funding to make it happen, the city stands ready to fluoridate municipal water supplies that serve upwards of 23,000 area homes and businesses. But not if residents pass Measure N, an anti-fluoridation initiative that city voters will decide in a special election March 2.
On one side of the issue, health officials like Betsy McCarty, the county's chief of public health administration, dozens of dentists and a handful of elected officials promote fluoridation as an unqualified public health boon. They cite a vast list of official endorsements from prominent individuals and groups like the U.S. Surgeon General, the American Dental Association and Kaiser Permanente Medical Centers, concluding that fluoridated water both prevents tooth decay and saves public health dollars.
On the other side, locals have teamed up with statewide activists like Jeff Green of Citizens for Safe Drinking Water, an anti-fluoride activist organization based in San Diego, to protest the "forced medication" of municipal water users. They too provide a long list of endorsements and they present a study that suggests the phosphate fertilizer industry might support fluoridation as a way to sell off a by-product that otherwise requires costly hazardous waste treatment. At the very least, they say, fluoridation represents a needless governmental intrusion into people's private affairs.
Both sides agree on one point: There's plenty of misinformation and factual distortion to go around. What's more, the measure alone adds to the confusion since it is written in the negative.
For fluoridation proponents, the issue requires a campaign that not only outlines the benefits of fluoridation but also one that informs voters about the specific ballot language. Jay Balzer, head of Dientes Community Dental Clinic and a spokesman for the pro-fluoridation Citizens for a Healthy Future, explains that the group has to let people know that a "yes" vote on Measure N is really a "no" vote for fluoridation.
"It's confusing to the voters, and that's unfortunate," Balzer says. "I think a lot of people are going to read the language on the ballot in the voting booth, and you're going to have people voting in a manner they don't intend."
Even more frustrating, Balzer explains, the pro-Measure N (anti-fluoridation) groups have relied on professional activists to spearhead much of the campaign even though a long list of health professionals publicly opposes fluoridation. The anti-Measure N (pro-fluoride) Citizens for a Healthy Future, also endorsed by a long list of local health professionals, relies for leadership on volunteers who don't make a living campaigning about fluoride, who don't frequently make public presentations and who don't usually talk to the media.
"I don't know why there aren't any local people who oppose fluoride who will come out and publicly debate fluoridation," Balzer says of meeting Green in public forums on the issue. "We don't deal with this professionally -- we clean teeth -- and it's very difficult to gear up to respond to people like Jeff Green."
When public health officials noted a correlation between naturally occurring fluoride in certain water supplies and demonstrably stronger teeth in the people who drink from them, the movement to add synthetic fluoride to public water took off. But it stalled somewhere in the Midwest.
"The farther you go west, the less likely it is to be fluoridated," explains McCarty. "That's why California is ranked 48th out of 50 states in the number of fluoridated water systems."
The March 2 ballot measure started with a City Council debate touched off in early 1998. A statewide fluoridation program launched by an Assembly bill passed in 1995 mandated the addition of fluoride to all water systems with at least 10,000 hook-ups. In late 1997, Santa Cruz had ranked 12th on the state Department of Health Service's list of priority cities earmarked for fluoridation, a list compiled after a departmental review of the issue.
Working with then-Mayor Celia Scott, Theodora Kerry, who with Lois Kirby co-founded the anti-fluoridation Santa Cruz Citizens for Safe Drinking Water, organized a grassroots campaign. Soon they recruited help from Green and took their case to the City Council.
"I heard Lois on a radio show call-in, and she brought up the point about fluoride," Kerry explains. "At that point, we started pulling in people we knew to work on it, and we made our first presentation to the City Council on Feb. 10."
Six weeks later, after sponsoring City Council presentations by Green and anti-fluoridation expert witness Dr. David Kennedy, the Santa Cruz Citizens for Safe Drinking Water convinced the City Council to pass the "right to vote" ordinance.
"They realized that it was an issue," Kerry explains. "And without taking a stand on fluoridation, they voted 6-to-1 -- only Cynthia Matthews voted against it -- to not fluoridate without having the people of Santa Cruz vote on it."
Scott, who wrote the council ordinance, explains that it means fluoridation cannot begin in Santa Cruz unless voters pass a measure specifically in favor of it. Even if a majority votes against Measure N, the water department only can start fluoridation if an additional ballot measure passes that directly affirms it.
"The ordinance says that fluoridation can't start unless there's a positive vote on it," Scott says. "Measure N, if it passes, only repeals the existing ordinance and substitutes a flat prohibition against fluoridation."
After the March 24, 1998 council vote, fluoridation opponents again got busy. City Clerk Emma Solden reports that Measure N organizing began in April 1998 with a public notice of the intended initiative. Then, Kerry says, the Santa Cruz Citizens for Safe Drinking Water collected upwards of 10,000 signatures from city residents through October. The city clerk's office certified 5,500 of them, and the City Council on Nov. 24 approved the special election. Gail Pellerin of the County Elections Department estimates the cost at $3 per registered city voter, or roughly $111,000.
But the resulting ballot measure didn't simply call for a "yes" or "no" vote on fluoridation. Again with Green's help, Kerry says, the Santa Cruz Citizens for Safe Drinking Water crafted language that doesn't even mention fluoride in the ballot text. Instead, it prohibits "the use of (the) City's water supply to deliver products or substances intended to affect the physical or mental functions of persons consuming such water."
"We were not really sure the council wouldn't change with the election coming and all," Kerry says. "We said that the only thing you can count on is a ballot. Jeff Green, though, learned from experience that a yes-or-no vote could be overturned.... If we put it in a direct prohibition, it would still be holding. The council would be legally stymied if the measure prohibited the practice of fluoridation."
Local arguments for and against fluoridation have both employed well-honed messages developed during four decades of debate. Proponents point to the benefits of fluoridation, saying in the argument against Measure N, "hundreds of scientific studies have confirmed its safety." And, McCarty adds, no reputable study has ever identified a health risk from fluoridated water.
"I think that the anti-fluoridation movement is really a result of scare tactics and bad science," she says. "There's no responsible scientific organization that questions the effectiveness and safety of fluoridation of water."
Opponents cite studies that do indicate a health risk. Fluoridated communities have a documented higher instance of hip fracture, explains Kennedy, pointing to a study published in the Journal of the American Medical Association.
And fluorosis, or a discoloration of the teeth, is a widely known side effect of chronic excessive fluoride ingestion, says Kennedy, an expert-witness dentist whom local pro-fluoridation activists identify as working with Green on anti-fluoridation campaigns in other California communities.
Kerry accuses pro-fluoridation groups of concealed motives. She cites evidence that water fluoridation efforts are sponsored by the phosphate fertilizer industry, which produces a fluoride compound as a by-product -- a hazardous and expensive substance to treat if it can't be sold as a fluoridating agent for water.
"When you really look at where it's coming from, you understand that it's not a concern for children's teeth," she says. "It's a concern for industry. We're not John Birchers, we're not right-wingers or left-wingers. We're just health-conscious people, and that's the link we have in common."
For pro-fluoridation groups, the phosphate fertilizer connection smells like a red herring.
"I don't think there is support from the phosphate fertilizer industry to influence the vote," Balzer says. "I would like to see evidence that that industry is paying for fluoridation campaigns like this one."
Recent efforts to fluoridate municipal water systems stem from Assembly Bill 733, which the state legislature passed in 1995. Authored by then-Assemblywoman Jackie Spierer (now a state senator representing San Mateo), the bill directed the state Department of Health Services to require fluoridation of public water systems which serve more than 10,000 customers.
As a first step to implementation, Health Services in late 1997 published a priority ranking of water systems set for fluoridation. Highest on the list were systems like the one in Santa Cruz, which are the least costly to fluoridate. As funding came available -- which the bill says must come from "other sources than ratepayers, shareholders, local taxpayers or bondholders of the public water system" -- the state would require fluoridation of water systems according to the rank order of the priority list.
With a $10 million fluoridation grant made last month by the California Endowment, Santa Cruz stands in line to receive fluoridation funding in the near term. Other water systems in Santa Cruz County -- which McCarty says draw from wells and have other technical issues making them more expensive to fluoridate -- may have to wait a few years. The Department of Health Service's list placed Watsonville's municipal water system at 97 and the Soquel Creek Water District at 107.
©1999 Central Valley Publishing, Inc.