The Health Foundation of Central Mass

66 I n 2000, the U.S. Surgeon General deemed dental disease a "neglected" epidemic across the country. e best tool to fight dental disease is fluoridation, according to experts at the Centers for Disease Control and Prevention and the American Dental Association, among others. More than 145 million Americans have community water fluoridation programs, but in Massachusetts, Worcester remains one of a handful of municipalities without fluoridation in its public water supply. e Health Foundation of Central Mas- sachusetts was determined to change that in 2001 as an extension of its oral health investments in Central Massachusetts. e local statistics were alarming. More than half the children in Worcester had cavities, nearly half of all adults had lost a tooth to dental disease, and more than 20% of seniors had lost all their teeth. Dental disease has been identified as a precursor to other serious, life-threatening conditions such as diabetes and cancer. Despite research, expert opinion, and scientific findings that confirm the benefits of fluoridated water, voters in Worcester rejected the ballot question three times since 1963, most recently in 1996. e Health Foundation began investing in oral health in 2000 when it awarded a Synergy Initiative planning grant to fund the Central Massachusetts Oral Health Initiative (CMOHI). is initiative used a three-pronged approach of treatment, pre- vention, and education to combat the oral health crisis, first in Worcester and then in North Central Massachusetts. Another important element of CMOHI involved a fluoride education campaign designed to teach the public about the benefits of ensuring optimal fluoride levels in the city's public water system. Drinking fluoridated water benefits all members of a community, regardless of in- come, education level, or ethnicity, and the cost is minimal. At approximately 50 cents per person annually, water fluoridation saves millions of dollars each year from fewer dental visits and lower dental insur- ance costs for employers and employees. Taxpayers could save just over a million dollars a year in dental treatment costs for MassHealth patients in Worcester alone. Dr. Jan Yost, e Health Foundation's founding president and CEO, served as chairwoman of the Oral Health Advocacy Task Force steering committee, a task force that was created to support the advocacy efforts of CMOHI and other oral health initiatives. She led the 2001 campaign to add fluoride to Worcester's public water supply with a subcommittee that included dentist Dr. Abe Haddad, local and state officials, representatives from the Massa- chusetts Department of Health, UMass Memorial Health, the Worcester District Medical Society, and the Massachusetts Coalition for Oral Health. e task force included more than 400 stakeholders from across the state and represented three dental schools, dental researchers and providers, and organizations such as the Massachusetts School Nurse Orga- nization and the Massachusetts Alliance for Families, as well as concerned citizens. During the 2001 ballot referendum, e Health Foundation contributed $400,000 for pro-fluoridation ads and public edu- cation efforts and referred to the majority opinion of medical, scientific, public health, and the social services communities for consensus. Unfortunately, this referendum also failed to pass. Having previously failed to gain approv- al for elevating the fluoridation level in the city's water, the task force determined that the best alternative to a local referendum would be to support "An Act to Improve Oral Health of Children and Other Residents in the Commonwealth." e bill asked for authorization of a statewide community water fluoridation program in all cities and towns with more than 5,000 residents on a public water supply. e bill also called for a requirement that the state pay for the engineering and imple- mentation costs. e task force introduced the bill in a legislative hearing in October 2005; unfortunately, it was referred to study and did not move forward that leg- islative session. In the years that followed, the task force continued to advocate with the legislature and the administration to address the issue. Unfortunately, to this day, community wa- ter fluoridation is still not available for most residents in Worcester, to the detriment of many who experience the negative impacts on oral health and physical health. n Fluoridation: Improving More Than Dental Health Dental health of poor at risk Groups unite in a cause

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