Abstract
Objectives
Increasingly, support for water fluoridation has come under attack. We seek an explanation, focusing on the case of Waterloo, Ontario, where a 2010 referendum overturned its water fluoridation program. In particular, we test whether individuals perceive the risks of water fluoridation based not on ‘hard’ scientific evidence but on heuristics and cultural norms.
Methods
A sample of 376 residents in Waterloo were surveyed in June 2012 using random digit dialing. We use factor analysis, OLS regression, as well as t-tests to evaluate a survey experiment to test the credibility hypothesis.
Results
Perceptions of fluoride as a risk are lower among those who perceive fluoride’s benefits (B =.473, p < 0.001) and those whose cultural view is ‘egalitarian’ (B =.156, p < 0.05). The experiment shows a lower level of perception of fluoride’s benefits among respondents who are told that water fluoridation is opposed by a national advocacy group (Group A) compared to those who are told that the government and the World Health Organization support fluoridation (Group B) (t = 1.6547, p < 0.05), as well as compared to the control group (t = 1.891 3, p < 0.05). There is no difference between Group B and the control, possibly because people’s already general support for fluoridation is less prone to change when told that other public organizations also support fluoridation.
Conclusion
Public health officials should take into account cultural norms and perceptions when individuals in a community appear to rise up against water fluoridation, with implications for other public health controversies.
Key words: Fluoridation, public opinion, public policy
Résumé
Objectifs
On s’attaque de plus en plus à la fluoration de l’eau. Nous cherchonsune explication, à partir du cas de Waterloo, Ontario, où un référendum a renversé le programme de fluoration de son eau en 2010. Plus particulièrement, nous tentons de savoir si les gens perçoivent les risques de la fluoration de l’eau non pas selon des „faits” scientifiques, mais selon des normes heuristiques et culturelles.
Méthodes
On a étudié un échantillon aléatoire de 376 résidants de Waterloo en juin 2012 au moyen de la composition téléphonique aléatoire. Nous avons recours à l’analyse factorielle, à la régression par les moindres carrés ordinaires (MCO) et à des tests pour évaluer une expérience de sondage afin de tester l’hypothèse de crédibilité.
Résultats
La perception que le fluor constitue un risque est plus faible chez ceux qui connaissent ses avantages (B = -.473, p < 0,001 ) et ceux dont la perspective culturelle est égalitaire (B = -.156, p < 0,05). L’expérience montre une perception moins favorable des avantages du fluor chez les répondants à qui on affirme qu’un groupe de pression national s’oppose à la fluoration de l’eau (groupe A) comparée à ceux à qui on affirme que le gouvernement et l’Organisation mondiale de la santé appuient la fluoration de l’eau (groupe B) (t = -1,6547, p < 0,05), ainsi qu’au groupe témoin (t = -1,891 3, p < 0,05). Il n’y a aucune différence entre le groupe B et le groupe témoin, peut-être parce que les gens qui appuient déjà généralement la fluoration sont moins susceptibles de changer d’avis lorsqu’on leur dit que d’autres organismes publics l’appuient également.
Conclusion
Les représentants en santé publique doivent tenir compte des normes culturelles et des perceptions lorsque des membres d’une collectivité s’opposent publiquement à la fluoration avec les autres controverses possibles en santé publique.
Mots Clés: fluoration, opinion publique, jpolitique publique
Footnotes
Acknowledgements: We thank Wilfrid Laurier University’s Office of Research Services for financial support.
Conflict of Interest: None to declare.
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