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New Fluoridation Challenges,The Internet and Social Media
Myron Allukian Jr DDS MPHPresident, Massachusetts Coalition for Oral Health
Past President, American Public Health Association
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PREVALENCE OF TOOTH DECAY AND MEAN NUMBER OF PERMANENT TOOTH SURFACES AFFECTED BY AGE GROUP, US, 1999 -2004
Age Group % Prevalence Mean Number Affected Tooth Surfaces
6 – 8 10.16 0.33
9 – 11 31.36 1.32
12 – 15 50.67 2.8516 – 19 67.49 5.79
20 – 34 85.58 13.39
35 – 49 94.30 31.46
50 – 64 95.62 53.8765 – 74 93.25 69.88
75 + 92.70 74.08
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COMMUNITY WATER FLUORIDATION (CWF)
210 million Americans, 74.6% of US public water supplies
The foundation for better oral healthOne of the 10 greatest public health
achievements, 20th Century, CDC
Safe, effective and economicalColorless, tasteless, odorless at 1 ppm
Healthy People 2020 Goal: 79.6%
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NUMBER OF PEOPLE IN THE US WHO HAD ACCESS TO ADJUSTED WATER FLUORIDATION 1945-2012
Year Number of People
1945 231,9301950 1,578,5781955 26,278,8201960 41,179,6941965 58,369,3551970 83,725,7711975 94,627,2941980 106,170,1491985 120,100,100 (est.)2008 195,545,1092010 204,283,5542012 210,655,401
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Whack – A – Mole Strategy
FDA – EPA – CDC – IOM – APHA – Cities – Towns
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WE NEED A PLAN
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I. EVERY COMMUNITY IS DIFFERENT
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II. Know Your Community
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III. Know Your Opposition
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ANTIS ARE EVERYWHERE
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III. KNOW YOUR OPPOSITION A. Nature of Opposition
* Origin of anti-fluoridation movement * Hard core opposition * Soft core opposition
B. How are they organized? * Local, or state or nationally linked
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C. Communication Network * Internet * Social Media * Newsletters and brochures * Letters to the editor * Local meetings and presentations * Signs * Mailings
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D. Supporters and leaders
E. Avoid debates if possible
F. Tactics
* Petitions * Media* Town meetings * City Council * Bills and legislature
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FLUORIDATION CHALLENGES Opposition since 1950, despite be ing
a proven e ffective public hea lth mea sure
Since 2010, ~ 90 US communities ha ve re jected or discontinued fluorida tion
Public policy deba te ha s cha nged since 1950 Ma ss Media
Television
Inte rne t
Socia l Media
Anti-fluorida tion website
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87% of US adults Used by over 75% of all races, ages (except 65+), education, income, and
location
95% of US teens
97% of ages 18-29
72% of Internet users looked for health information in 2012
Internet Usage
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% OF AMERICAN ADULTS USING THE INTERNET1995-2014
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Baby Boomers
Generation X Generation YMillennials
Generation Z
Years Born 1946-1964 1965-1976 1977-1994 1995-2012
Popula tion 76 M 51 M 83 M 82 M, growing ra pidly, $ 44 billion in purcha sing power
Fa mous people
Bill Clinton, Meryl Streep
Barak Obama, Jennifer Lopez
Miley Cyrus, Serena Williams
Malala Yousafzai
Changing Generations
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INTERNET SEARCH ENGINES
77% of online hea lth informa tion seekers begin by using a sea rch engine
Top 6 sea rch engines: Google
Bing
Ya hoo
AOL
Ask
Wow
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Websites through which users create online communities to share information, ideas, messages and other content
As of January 2014, used by 74% of online adults
66% of social media users use the platform for civic or political activities
Post thoughts React to others Press friends to act on issues and
vote 50% of social media users share
news Stories, images or videos
46% have discussed a news issue or event
Social Media
Anti - Picture Shared on social media
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FACEBOOK Users crea te profiles to sha re persona l inte rests
1.35 billion monthly a ctive users in Q3 2014
71% of Inte rne t users, 58% of US a dult popula tion
Importa nt source of website re fe rra ls through sha ring from posts
Groups
Sha re thoughts with people with simila r inte rests
Pa ges
Used by orga niza tions a s a wa y to a dvertise
A tool to expa nd business, bra nd or orga niza tion
Events
Inform people of upcoming events, eg. town ha ll mee tings with CWF votes
Above: Anti-CWF ima ges from socia l media
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Distribution of the 15 Most Common Anti-Fluorida tion Tweet Arguments
Ma rch 1-14 a nd April 1-14, 2012, N=1815
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ACTUAL TWEET EXAMPLES
Fluoride in wa te r ca uses hypertension. We ha ve a n epidemic of this in Ire la nd tha nks la rge ly to fluorida tion
#Fluorida tion vic tories continue a s Wa shington town ba nishes toxic chemica l from wa te r supply
Ma yor sa ys 3 dentists priva te ly expressed concern re fluorida tion but won’t spea k public ly 4 fea r of losing license
During WW2 the NAZIS used FLUORIDE in the wa te r to do mind control on the c itie s tha t they ha d ta ken over.
FLUORIDE is found in 25% of ma jor tra nquillize rs a nd is often ca lled “The Chemica l Lobotomy”
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Fluoridation Information Website Tra fficJ une 2011-Ma y 2012
FluorideAction
Network (FAN)
CDC Fluoridation Section
Wikipedia "Water Fluoridation”
ADA Fluoridation Webpage
All ADA Webpages –Fluoridation
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12
Num
ber o
f Pa
ge V
iew
s
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MOST COMMON TWITTER & SOCIAL MEDIA ANTI-FLUORIDATION ARGUMENTS 2012 &2014 Social Media
2014Twitter2012
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Anti Pro
2012 2014 2012 2014
Facebook 100%(193)
96%(109)
0%(0)
4% (5)
Twitter 94.5%(343)
82% (850)
5.5% (20)
8%(188)
YouTube 100%(3,645)
99% (527)
0%(0)
1% (4)
Social Media Search Result Using The Keywords: Fluoride, Fluoridation, Water Fluoridation, and
CWF
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Social Media2014
Twitter2012
Cancer 41% Cancer 13%
Toxicity 32% Useless 12%
Brain Damage 11% Poison 10%
Calcified Pineal Gland 7% IQ/Cost 8%
Fluorosis/Bone Deformation 3% Criminal 7%
Decrease Fertility 2% Fluorosis/Industrial Waste 6%
IQ 1% Endocrine/Environ’t/Pacify 5%
Most Common Twitter and Social Media Anti-Fluoridation Arguments
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CDC CWF Website Traffic2011-2012 & 2014-2015
27,040
42,754
2011-2012 2014-2015
The number increased by15,714 (58%)
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Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15
ADA.org/Fluoride Page Views 7,216 7,578 6,296 5,014 5,517 7,517 8,881 10,763 12,869
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Discussion
● The public views most fluoridation information on anti-CWF websites
● The majority of search engine results are anti-CWF
● Most search results on social media were anti-CWF
● Anti-fluoridationists have a much better Internet and social media presence than pro-fluoridationists
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PERCEPTION- REALITY- CREDIBILITY
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VS
Public Interest
Scientific
consensus and
credibility
Junk science EmotionConfusion
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IV. KNOW YOUR RESOURCES
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Digital Promotion Toolkit
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Social Media Messages Specific to Preventing Tooth Decay
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WE SUPPORT COMMUNITY WATER FLUORIDATION AS A SAFE AND EFFECTIVE PUBLIC HEALTH MEASURE
Massachusetts Agencies and Organizations:
Massachusetts Department of Public HealthMassachusetts Coalition for Oral HealthMassachusetts Department of Environmental ProtectionMassachusetts Public Health AssociationMassachusetts Health CouncilMassachusetts Hospital AssociationMassachusetts Medical SocietyMassachusetts Dental SocietyMassachusetts Dental Hygienists’ AssociationMassachusetts League of Community Health CentersMassachusetts Coalition of School-Based Health CentersMassachusetts Chapter, American Academy of PediatricsMassachusetts Association For Mental Health
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V. DEVELOP BROAD BASED COMMUNITY SUPPORT
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Action Alert
Sa y NO to Ed Begley J r., a n Anti-F spea ker a t the APHA Opening Session, November 4
Conta ct APHA Executive Boa rd Members
Pa mela Aa ltonen, PhD, RN Cha ir, Executive Boa rd a a ltonen@purdue .edu(Director of Nursing Progra m, Purdue University, India na )
Shiriki Kuma nyika , PhD, MPH President, APHA skuma nyi@ma il.med.upenn.edu(Emeritus Professor of Epidemiology , Univ. of Penn. School of Medicine)
Ca ma ra P. J ones, MD, PhD, MPH President-e lect, APHA [email protected](Adult a nd Community hea lth, Na tiona l Ctr for chronic disea se prevention a nd hea lth promotion)
Georges Benja nmin, MD, Executive Director, APHA georges.benja min@a pha .org
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VI. ALWAYS BE READY
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THANKS TO FLUORIDATION OUR NATION HAS BETTER ORAL HEALTH!
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