Barnett Pauline, Penny Melanie, Brunton Cheryl, Begg Annabel
Department of Public Health and General Practice, University of Otago, Christchurch.
N Z Dent J. 2008 Dec;104(4):139-43.
The paper aims to analyse recent campaigns for water fluoridation in the South Island and to identify lessons to be learned from the outcomes.
The research uses a systematic case study analysis based on a public policy framework, drawing on key informants, public documents and participant observation of campaigns in five separate communities.
Over a four-year period in five specific communities (Gore and Southland in 2004; Ashburton in 2002 and 2006; and Grey and Westland in 2005), the opportunity to introduce or retain fluoridation was rejected by local Councils. The extent of community understanding of the issues, the processes of engagement on the part of the health systems and the approaches to decision-making by Councils varied widely, but the main inputs to decisions were the rejection of expert health advice and a reliance on binding referenda or other assessments of the strength of community feeling.
More evidence-based decision-making on fluoridation is required. Options at local level include tribunals and other mechanisms to support Councils, but it is likely that stronger national policy leadership and the application of robust health impact assessment may be necessary to ensure improved oral health and the reduction of inequalities.
