HHS Secretary RFK Jr.’s reversal on fluoride in water could worsen health disparities for Black Americans

U.S. Secretary of Health and Human Services, Robert F. Kennedy, Jr., has made a reversal on decades-long guidance from the CDC to recommend the fluoridation of water. The stance is concerning to public health experts who say the practice has reduced the occurrence of oral disease.

Kennedy, who has long been a skeptic of the safety of fluoride in water, announced on Monday that he will order the CDC (Centers for Disease Control and Prevention) to halt its advisory recommendation to states on water fluoridation, fulfilling a pledge he made after President Donald Trump’s election last November. That same day, the Environmental Protection Agency (EPA) announced that it would begin a review of “new scientific information” on the potential health risks of fluoride in drinking water, according to the Associated Press. The federal agency is responsible for setting the maximum allowed level of fluoride in public water systems.

As the nation’s top health secretary, Kennedy does not have the authority to force states to stop the fluoridation of their drinking water, however, taking the step to order the CDC’s reversal on the matter could have significant influence. The CDC has previously said that fluoride in drinking water strengthens teeth health and reduces cavities by replacing minerals lost over time to normal wear and tear.

The federal government has endorsed water fluoridation since 1950 and began setting guidelines for how much fluoride should be added to drinking water in 1962.

Public health experts have disputed that there are health risks to fluoride in drinking water, particularly given the level of fluoride allowed at  0.7 milligrams of fluoride per liter of water. Reversing decades of recommendation and potentially reducing or eliminating water fluoridation is particularly concerning for health advocates who fear Black and brown communities could be adversely affected.

“The evidence is clear. Fluoridation is one of the most significant public health interventions of our time. Undoubtedly, eliminating fluoride from public drinking water will disproportionately burden low-income Black and brown communities and exacerbate health disparities,” Christopher J. King, dean of Georgetown University’s School of Health, told theGrio in a statement.

King said eliminating the use of fluoride in drinking water, combined with a disproportionate lack of access to health care could prove to be harmful to Black and brown American children and adults.

“These populations are especially at risk due to limited to no dental coverage, and a dearth of accessible dental providers. An increased incidence of dental cavities and the occurrence of costly preventable conditions caused by delaying care is likely to be the outcome,” he explained.

Scientific data shows that oral health disparities among Black children have existed for years, despite the intervention of fluoridation of public drinking water in their communities. According to a study from the National Institutes of Health, “Although the availability of insurance has increased, research indicates that it remains underutilized by the African American community.”

There are also other factors that may be at play other than access to insurance and care. “Sociocultural factors also impact the way African Americans experience oral health, from the patient-provider relationship to the value placed on oral health,” the NIH study notes. “African Americans have a tenuous history with the medical community and at times display evidence of mistrust for medical professionals. This mistrust can lead to an avoidance of services by African Americans.”

Without the intervention of fluoridation, public health experts worry the oral health of Black Americans could exacerbate.

EPA Administrator Lee Zeldin praised Kennedy’s move on water fluoridation and said the agency’s new review will inform its “future steps.”

“Secretary Kennedy has long been at the forefront of this issue. His advocacy was instrumental in our decision to review fluoride exposure risks, and we are committed to working alongside him, utilizing sound science as we advance our mission of protecting human health and the environment,” he said.