With candidates and voters focused on the economy, immigration and abortion, the 2024 presidential election has been unusually light on health policy. But former President Donald J. Trump’s recent pledge to let Robert F. Kennedy Jr. “go wild on health” has put the issue front and center in the final days of the campaign.
With an assist from Mr. Kennedy — an environmental lawyer who has no medical or public health degrees — Mr. Trump put the spotlight on a trifecta of health policies: fluoridated water, vaccines and the Affordable Care Act, the program popularly known as Obamacare, which has provided health coverage to nearly 50 million Americans over the last 10 years.
As president, Mr. Trump would have only limited authority to make changes in these areas, even if Republicans won control of both houses of Congress. But he would have the bully pulpit. Here’s what you need to know about the three issues:
FLUORIDEOver the weekend, Mr. Kennedy declared on social media that, if elected president, Mr. Trump would advise communities to stop adding fluoride to drinking water. Mr. Kennedy described the compound as “an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders and thyroid disease.” In an interview with NBC News on Sunday, Mr. Trump said the idea of doing away with fluoridation “sounds OK to me.”
What is fluoride and why is it in our drinking water? Fluoride is a mineral that occurs naturally in water, although it can also be a byproduct of industry. Adding fluoride to public water systems began as an experiment in Grand Rapids, Mich., in 1945, after a dentist at the National Institutes of Health theorized that it might prevent cavities in teeth. Over the next 11 years, tooth decay in Grand Rapids dropped by 60 percent.
Other communities quickly followed suit. As of 2022, more than 209 million people, or 72.3 percent of the U.S. population served by public water supplies, had access to fluoridated water, according to the Centers for Disease Control and Prevention, which lists fluoridation as one of the “10 great public health achievements of the 20th century.”
What do health experts say about fluoride? Experts agree that excessive exposure to fluoride over a long period of time can cause health problems. The risks include dental fluorosis, a condition that leaves the teeth looking pitted or brown; skeletal fluorosis, which can cause joint pain or osteoporosis; and lower I.Q. in children.
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