Baseless fears about fluoride are going mainstream

Good morning! I’m taking some time off to retreat to the woods, so you’ll be hearing from some of my colleagues for a few days. I’ll see you back here later next week. Send news and notes to [email protected] for when I’m back.

A historic public health achievement is under threat

Adding fluoride to water is considered one of the great public health achievements of the 20th century. But as President-elect Donald Trump prepares to re-enter the White House, it may not be long for the 21st century. Last week, Robert F. Kennedy Jr. — who Trump has pledged to let “go wild” on public health — told NBC that “fluoride will disappear.”

Rumors about fluoride date all the way back to the 1960s, when a conservative group suggested it was a “communist plot” and a prime example of government overreach. But even then, there wasn’t popular support for the idea. That’s changed in recent months, evidenced by yesterday’s Washington Post opinion piece by emergency physician and former Baltimore health commissioner Leana Wen suggesting that removing fluoride is “not an entirely crazy idea.”

Read more from STAT’s Anil Oza, who breaks down all the science behind the controversy.

Doctors are rarely disciplined for spreading misinformation

Disseminating misinformation to the public is the least common reason for doctors to be disciplined by state medical boards, according to a study published yesterday in JAMA Network Open. Researchers analyzed more than 3,100 disciplinary meetings in the five most populous states between 2020 and mid-2023. Only six proceedings were focused on public misinformation, while 21 were for spreading misinformation directly to patients.

No governmental body tracks the prevalence of physician-spread misinformation. But a study published in the same journal last year found that in 2021 and 2022, 52 doctors spread misinformation on social media about Covid-19 vaccines, masks, and conspiracy theories.

“We allow the profession to police themselves. And when they fail to do that, even in the most egregious cases, what they are abetting is the erosion of trust and respect for doctors,” Wendy Parmet, director of Northeastern University’s Center for Health Policy and Law, told the Washington Post last year for an investigation that also found doctors are rarely punished for spreading misinformation. Experts have long called for doctors to be held more accountable for spreading misinformation, but others have questioned whether medical boards are equipped to fill that role.

STD epidemic slows in the U.S.

Some good news across the STD front: The syphilis epidemic in the U.S. slowed dramatically last year, while gonorrhea cases fell and chlamydia cases stayed below pre-pandemic levels, per federal data released yesterday. In particular, cases of the most infectious stages of syphilis fell 10% from the year before — the first substantial decline in more than two decades.

“I’m encouraged, and it’s been a long time since I felt that way” about the nation’s epidemic of sexually transmitted infections, said the CDC’s Jonathan Mermin. “Something is working.”  Read more.

Health policy experts on the once and future president

As the incoming Trump administration takes shape, STAT is staying on top of all the implications for health policy. Here’s what you should check out today:

• Yesterday, FDA Commissioner Robert Califf said he’s unsure about the future of the agency under the incoming Trump administration and “disappointed” about the election’s outcome. “I’m biased, but I feel like the FDA is at peak performance right now and we’ll just see what happens as the new team comes in,” Califf said. Read more from STAT’s Lizzy Lawrence.
• In today’s episode of the First Opinion Podcast, Torie Bosch talks with lawyer and health policy expert Carmel Shachar about her experience during the first Trump administration and what she expects to be different this time around. I was particularly intrigued by her thoughts on interstate regulations on abortion and telehealth. Shield laws protecting abortion providers and patients in progressive states haven’t really been tested yet, she said. And while telehealth rules were loosened during the pandemic so a provider in one state could often treat someone in another, those exceptions have ended. But “it’s not like an eyeball changes when it crosses over [from Massachusetts] into New Hampshire,” Shachar said. Take a listen to the conversation.

News you can use in a beer vs. wine debate

People who drink beer as their only alcoholic beverage of choice have worse diets, exercise less, and are more likely to smoke cigarettes than people who drink wine, liquor, or a combination, according to a new study that will be presented at the American Association for the Study of Liver Disease’s Liver Meeting later this week and simultaneously published in the journal Nutrients.

The findings are based on self-reported data from a nationally representative survey of more than 1,900 U.S. adults. Almost 39% of respondents drank beer only, while 22% drank wine only, 18% liquor only, and 21% drank a combination. Beer drinkers were more likely to be male, younger, and low-income — but the association persisted even after adjusting for relevant variables. The authors note that prospective studies could help to understand the connection.

More people are surviving congenital heart defects

Congenital heart defects are structural abnormalities in the heart or nearby blood vessels that develop before birth. Worldwide, they occur in 9 out of every 1,000 live births. About a quarter of these people need surgery or a catheter-based treatment during infancy, after which more than 90% (in developed countries) survive into adulthood. Progress in increasing survival rates has been decades in the making.

But as more people grow older, they may leave the care of pediatric cardiologists only to find doctors whose training has not have included care of adult survivors like them. “They are part of a group of patients that hadn’t really existed before,” researcher Anitha John told STAT’s Liz Cooney. Read more from Liz about the growing number of adult survivors of congenital heart defects and the inadequate care they receive.

What we’re reading

• 43 lab monkeys escaped in South Carolina. They have a legal claim to freedom, Vox

• Experts warn of ‘chilling’ effect of Texas attorney general suing doctors over gender-affirming care, Salon

• Buoyed by billion-dollar deals, its stock is up 50% this year. How did Boston Scientific get its mojo back? STAT
• Chronic brain trauma is extensive in Navy’s elite speedboat crews, New York Times
• How I addressed racial bias in my company’s AI algorithm, STAT