A New England community water fluoridation campaign: Using social marketing and community mobilization for policy change

Despite its proven effectiveness at promoting oral health in a cost-effective, equitable manner, community water fluoridation (CWF) is often thwarted, and de-fluoridation efforts are ramping up throughout the country. Largely due to a small but vocal and well organized minority that relies on junk science and appeals to fear-based messaging, fluoridation can no longer win on its scientific merits alone.

With support from the DentaQuest Foundation, Health Resources in Action (HRiA) is implementing a new approach to CWF that mobilizes community support via coalition building and grassroots organizing, and deploys a social marketing strategy to understand and leverage community values. These approaches have been applied with great success in the public health field, but have not been applied to oral health practice and policy.

During the initial phase of this multi-year project, we identified ready communities in New England via collaboration with statewide oral health coalitions. Statewide coalitions received mini-grants to identify a local coalition and hire a campaign coordinator. States chose a community coalition using a set of criteria including local fluoridation history, absence of a school dental program, and existence of a coalition with which to partner. We conducted a literature review to identify factors contributing to the success or failure of CWF, and focus groups and stakeholder interviews to gain rich insight into community norms. We will share findings and learnings thus as phase two of the project gets underway. This novel approach to CWF advancement will provide a rich learning experience to inform future campaigns nationally.