When fake news and spiritual beliefs erode public health advances

Measles were eradicated 19 years ago in the U.S., yet there were 387 cases of them between January and March. That’s primarily because people who never were vaccinated traveled abroad, contracted the disease and brought it back, where it spread among others who were never vaccinated. A major reason they weren’t vaccinated, more than 50 years after the measles vaccine became available, is because of their religious beliefs.

None of these reported cases was in Iowa. However, in 2017-18, 8,740 religious exemptions from vaccinations were granted in the state, more than three times the 2,572 granted in the 2006-07 school year. That’s cause for concern.

On a parallel issue, Americans stopped losing their teeth to decay after communities began adding fluoride to their drinking water in the late 1940s. In the 1900s, the No. 1 reason for admission to Mayo Clinic was tooth infection, says an Iowa health department official; everyone had dental decay or lost teeth.

But due to an amalgam of conspiracy theories, some by promoters of alternative, unregulated health products, some people are turning against fluoridation.  The latest to do so publicly is the Northwest Iowa city of Ida Grove, whose city council voted to stop fluoridating the water after a majority of residents surveyed indicated that’s what they wanted.

A 2018 report from the federal Centers for Disease Control listed more than 400 non-fluoridated Iowa water systems, each relied upon by anywhere from 30 to over 2,500 people. Often in these small water districts, they remove fluoridation without  notifying the state, says Bob Russell, director of the dental division at the Iowa Department of Public Health. All of those water systems had below the recommended level of 7 parts per million of fluoride, according to the CDC report.  

The anti-fluoridation movement isn’t religion-based, but like vaccine opponents, some of its most visible advocates approach the issue from an individual rights perspective, believing that government should not dictate what individuals or families do. The leader of the most prominent anti-fluoride group, Paul Connett at the New York-based Fluoride Action Network (FAN), is linked to conspiracy theorists like Info Wars’ Alex Jones, who promotes 9/11 conspiracy theories and calls global warming a hoax. Connett has partnered with anti-vaccine forces.

It’s cyclical, says Russell, observing that most people in their 40s, 50s and younger have had the benefit of fluoridated water and don’t realize how bad it was before.  “We are the victims of our successes,” he quipped, telling stories of the pre-fluoridation 1920s, when women getting married might get dentures as gifts, and men couldn’t attend religious services because they didn’t have six functioning teeth.

“When it’s removed, we do see a stark increase in decay,” he said. Then the health department works with the Iowa Department of Natural Resources to notify those communities, whose water operators may have stopped fluoridating without informing city elected officials. Then a dental hygienist may start noticing the results.

Why are communities revisiting debunked theories after the scientific community has exhaustively documented the health benefits of fluoride and vaccines? Before the measles vaccine became available in 1963, the disease infected 3 million to 4 million people and caused 450  deaths and 4,000 cases of encephalitis a year in the U.S.

Iowa state government requires certificates of vaccinations in order for families to register their children at public and private schools, licensed child care centers and preschools, though exemptions can be granted for medical and religious reasons. There were no reported cases of measles in Iowa in 2018. But as U.S. Education Secretary Betsy DeVos pushes for public funding to go to home schoolers, we can expect a growth in the population not vaccinating their kids.

How can we have come this far in rejecting myth and superstition in favor of science yet remain so susceptible to baseless fear-mongering? Though there has always been some resistance to fluoride, says Russell, it tends to peak during periods of high distrust of government. The resurgence of fake science accompanies the proliferation of politically motivated websites spreading fake news. Emotion substitutes for facts, he said.

Some fluoridation opponents promote and sell so-called natural health alternative products and services that were not scientifically reviewed or proven, according to health advocacy organizations. Russell points out that fluoride is a mineral found typically in rocks and herbs, that appears naturally in bodies of water. Ensuring the proper level of it in drinking water supplies helps level the playing field for people who may not get regular preventive dental care, Russell said.

“The scientific consensus over fluoridation’s health benefits, safety, social justice, and economies has been firmly established over six decades of widespread use in the United States and elsewhere,” says a health policy organization, Science in Medicine, which issued a paper slamming anti-fluoridation conspiracy theorists. “Nevertheless, anti-science critics have never relented in their opposition — recycling previously disproven charges of harm, inventing new ones out of whole cloth, misrepresenting scientific facts and research, exaggerating risks, understating benefits, inappropriately invoking the precautionary principle, and accusing public health officials of corruption, conspiracy, and ‘mass medication’ of whole populations.”

As an engaged public, we should all hold our government and institutions accountable and be skeptical when there are legitimate indications of wrongdoing. But we need to be discerning, and base judgments on evidence, not on fabricated theories stemming from some ideological agenda or promoting someone’s snake-oil sales. The people most likely to suffer when fluoridation is removed or vaccines are withheld are typically those who can least afford to compensate for those lacks, and may be most susceptible to factual fabrications. Public officials must keep fighting back to protect their health. 

Rekha Basu is an opinion columnist for The Des Moines Register. Contact: rbasu@dmreg.com Follow her on Twitter @rekhabasu and at Facebook.com/rekha.basu1106. Her book, “Finding Her Voice: A collection of Des Moines Register columns about women’s struggles and triumphs in the Midwest,” is available at ShopDMRegister.com/FindingHerVoice