Abstract
BACKGROUND
Despite supporting scientific evidence, community water fluoridation (CWF) often fails in public referenda. To understand why, the authors quantitatively analyzed text from news media coverage of CWF referenda.
METHODS
The authors analyzed text from 234 articles covering 11 CWF referenda conducted in 3 US cities from 1956 through 2013. The authors used cluster analysis to identify each article’s core rhetoric and classified it according to sentiment and tone. The authors used multilevel count regression models to measure the use of positive and negative words regarding CWF.
RESULTS
Media coverage more closely resembled core rhetoric used by fluoridation opponents than the rhetoric used by fluoridation proponents. Despite the scientific evidence, the media reports were balanced in tone and sentiment for and against CWF. However, in articles emphasizing children, greater negative sentiment was associated with CWF rejection.
CONCLUSIONS
Media coverage depicted an artificial balance of evidence and tone in favor of and against CWF. The focus on children was associated with more negative tone in cities where voters rejected CWF.
PRACTICAL IMPLICATIONS
When speaking to the media, advocates for CWF should emphasize benefits for children and use positive terms about dental health rather than negative terms about dental disease.
Key Words
Fluoridation; public health and community dentistry; drinking water; health promotion; public opinion
Abbreviation Key
ADA – American Dental Association
CWF – Community water fluoridation
FAN – Fluoride Action Network
AUTHORS
Mr. Curiel is a graduate research assistant, Odum Institute for Research in Social Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Dr. Sanders is an associate professor, Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Ms. Christian is an archivist, Odum Institute for Research in Social Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Ms. Lafferty-Hess is a research data manager, Odum Institute for Research in Social Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Dr. Carsey is a professor and director, Odum Institute for Research in Social Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Dr. Lampiris is an associate professor, Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Dr. Slade is a professor, Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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Research reported in this article was supported by award UH2DE025494 from the National Institute of Dental and Craniofacial Research, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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The underlying data, code, and other materials necessary to reproduce results presented in the article will be preserved and made publicly available online via the University of North Carolina at Chapel Hill Dataverse (https://dataverse.unc.edu/) hosted by the Odum Institute data archive at the University of North Carolina at Chapel Hill.
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Disclosure. None of the authors reported any disclosures.
*Original abstract online at https://www.sciencedirect.com/science/article/abs/pii/S0002817717309868
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