The Involvement of Health Professionals and Local Officials in Fluoridation Controversies

Abstract

MASSACHUSETTS has had its share of colorful fluoridation battles. In the first years of the promotion of fluoridation in the commonwealth, 26 communities adopted it, while 27 rejected it.5 At this time, the decision to fluoridate was reached in the city council or town meetings, but in April, 1958, the State Assembly voted to require a public referendum before any local community could install fluoridation. The Social Science Research Program at the Harvard School of Public Health began the study of the fluoridation issue in June, 1957, at a time when no referendum was yet required. At first, two social anthropologists studied the controversy in six communities,2'4 while making statistical analyses of the variables associated with the favorable adoption of fluoridation.1'3 Because the findings from the six communities revealed the important roles that dentists were playing in every case, a study in much greater detail of dentists' involvement was undertaken in ten communities, including the original Six.7 This proved so enlightening that a third wave of interviewing investigated the involvement of a set of other statuses in these same communities.8 These statuses were those that by their very nature would seem inevitably to be involved one way or another in the fluoridation controversy when it arose. The study did not focus on issue leaders, the protagonists or the antagonists, but explored the behavior, information, and opinions of those connected with the health field (physicians, nurses, pharmacists) as well as certain officials (members of the Board of Health, water commissioners and superintendents, and selectmen).6