Where public health meets public opinion: Understanding political support for fluoridation in Calgary, 2021.

Objectives: To understand variables associated with support for community water fluoridation among ordinary citizens during periods of heightened issue salience, with a particular focus on how support varies on the basis of demographic characteristics, attitudes toward public health science, and political variables such as ideology, populism, and issue salience.

Methods: Statistical analysis of individual-level data from a large-scale survey of eligible voters in the City of Calgary, Alberta in 2021, collected at the time of a community water fluoridation plebiscite.

Results: Survey data (N = 1130) reveal substantively important and statistically significant relationships with fluoridation support in each of our three analysis categories (demographics, public health expertise, and politics). Support for fluoridation tends to be higher among men, university-educated, higher-income; among those with trust in experts and knowledge of fluoride governance; and among those who consider the issue important and have low levels of populist attitudes. Two exceptions to findings in past studies are age and ideology: younger respondents were more likely than older respondents to support fluoridation in Calgary, as were those on the ideological left, as compared to the right.

Conclusion: Incorporating studies of the correlates of public attitudes related to public health policies is important for understanding public health policy failure and success, especially in instances involving public consultation mechanisms, such as plebiscites.