Risk Communication in Public Health: Lessons from a Historic Fluoridation Debate in Saskatchewan

Effective risk communication is critical to gain public support when implementing population-level health interventions. Analysis of previous public health campaigns can provide guidance for future efforts. This case study examined a successful community water fluoridation campaign in Saskatoon, Canada, during 1953/54. The key strategies and messaging used by both sides of the debate were assessed using two publicly available historic data sources: documents in the city archives and newspaper coverage. The anti-fluoridation campaign approaches (e.g. misinformation, innuendo, half-truths and scare words, requesting a plebescite) were similar to those used elsewhere by this movement as described in the literature. Key features of the effective pro-fluoridation campaign included extensive community outreach, involvement of local experts, dissemination of supporting evidence while aggressively addressing misinformation, highlighting the support of relevant health organizations, and ensuring key messages received media coverage. This study illustrates how misinformation and public opposition has posed a challenge to public health efforts long before the advent of social media and highlights strategies, consistent with current risk communication principles, that have stood the test of time.