Today, Explained - Robert Fluoride Kennedy Jr.

Episode Date: November 21, 2024

If RFK Jr. leads the Department of Health and Human Services, he could radically reshape public health priorities in America, from vaccines to fluoride in the water. This episode was produced by Amanda Lewellyn, edited by Jolie Myers, fact-checked by Laura Bullard, engineered by Patrick Boyd and Rob Byers, and hosted by Noel King. Transcript at vox.com/today-explained-podcast Support Today, Explained by becoming a Vox Member today: http://www.vox.com/members Robert F. Kennedy Jr. during a UFC event at Madison Square Garden in New York City. Photo by Jeff Bottari/Zuffa LLC. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Karen, did you ever do any, like, theater as a young person? I did. Good! Yes, I knew it! Okay, guys, I have pulled a section from your piece. It is two lines, and I'm going to have you read those lines with feeling and with nuance. This will come at the top of the show in the billboard. It's going to be your voice coming out. Amanda, can we get those lines to Karen? All right. No matter where a person stands on the political spectrum,

they can probably find something to agree with Kennedy on. He's the personification of the growing distrust of science and the public health establishment that many Americans have felt in the post-pandemic era. Robert F. Kennedy Jr., Health and Human Services Secretary. It's coming up on Today Explained. BetMGM, authorized gaming partner of the NBA, has your back all season long. From tip-off to the final buzzer, you're always taken care of with a sportsbook born in Vegas. That's a feeling you can only get with Bet MGM.

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Today, explain. I'm Noelle King. Dr. Karen Landman did not make it as an actor. Instead, she's a senior health and medicine reporter at Vox. She is also a physician and an epidemiologist. Karen, what is this job, Secretary of the Department of Health and Human Services. This job is overseeing a bunch of federal agencies that have a lot to do with health, including but not limited to the CDC, the FDA, the Food and Drug Administration, the Centers for Medicare and Medicaid, the Indian Health Service, lots and lots of important agencies that together really chart a course for the health of our nation. And we're told that RFK is an unorthodox pick for this job. What makes him so unorthodox? He has a lot of beliefs about health-related issues that are based in conspiracy theory lore.

2006 marks the date when suddenly these gluten allergies began exploding. Interesting. The celiac disease. They're putting in 5G to harvest our data and control our behavior. COVID-19 is targeted to attack Caucasians and Black people. And I think kind of at the heart of that is a distrust of the scientific process and of the people who do it

and a tendency to really confuse causation with association. You know, the fact that two things kind of happen at the same time in the same place, to him is proof that one caused the other, where the whole scientific process exists to disentangle those things from each other. And science really drives a lot of the way America's health agencies function, and he fundamentally distrusts the process that makes science.

So, this is a person deeply at odds with the way that these organizations function. You have not said the word vaccines yet, but I feel like that's what we're headed toward. Talk to me about this gentleman's history of vaccine skepticism. Where does it start? I mean, his involvement with it starts in the 2000s. He had been, prior to that, an environmental lawyer. He'd done a lot of work with cleaning up polluted water systems. You know, coal claims to be cheap and clean. When they say they're clean, we know that's a dirty lie. When they say they're cheap, we know that's a dirty lie. When they say they're cheap, it's also a lie. It's actually... A group of people with the World Mercury Project reached out to him to see if he would help them

push back against vaccines. Basically, they felt on the basis of some since disproven research purporting to link vaccines with the presence of a preservative in vaccines that did contain a little bit of mercury, not present in vaccines anymore. But they asked him to get involved in informing the public about the scourge, quote unquote, of thimerosal and of mercury in vaccines and its impacts on health. Again, not proven by science, not really rooted in reality. He got involved with this group, eventually became its head. It has now changed names to the Children's Health Defense, arguably has been one of the most influential groups in anti-vaccination advocacy worldwide. He became the face of it internationally and brought his platform, his fame, a lot of money, and a lot of attention to their cause. Science is so overwhelming on the link between vaccines and autism. It needs no further research. The research is out there, the CDC's own research.

I think he has seeded doubt in a million different ways on the utility and the life-saving nature of vaccines, which, you know, by the way, we should just say, have saved hundreds of millions of lives worldwide. So, you know, he's cast doubt on the process of creating them and the process of administering them and of recommending them for decades in so many different ways. What are some of his other ideas that don't overlap with the scientific consensus? Oh, gosh. You know, he said a lot of stuff about fluoride, which has also saved a lot of teeth. Hundreds of millions of teeth. Maybe billions. Who knows? Who can say? You can never be sure. I think fluoride is a poison. He has linked chemicals in water with sexual dysphoria in children, not based in evidence.

If you expose frogs to atrazine, male frogs, it changes their sex and they can actually, they are young. And so the capacity for these chemicals that we are just raining down on our children right now. He has linked antidepressant use with mass shootings not founded in evidence. NIH needs to be studying to see if there's connections to some of the SSRI and psychiatric drugs people are taking, whether there's connections to video games. There are a lot of non-scientific beliefs that he has espoused publicly and just cast doubt on how much we know about the causes of a whole bunch of health conditions.

So I feel like the most controversial thing you could say about RFK is not that he's totally right or, oh, he's totally wrong, but this guy has some good ideas. And truthfully, truthfully, am I in that camp? Perhaps. Where does he overlap with the scientific consensus? Yeah, it is funny. You know, when somebody is a shapeshifter the way he is, a lot of people can find a lot of things he said to agree with. You know, he fundamentally distrusts big institutions. And I think a lot of Americans across the political spectrum also distrust big institutions. One of the things that makes big institutions, big government institutions deserving of distrust, including in the eyes of a lot of scientists, is that they are to some degree under the influence of the lobbies for big business interests that they interact with a lot. Pharma and agriculture

have a lot of interactions with the FDA, and their lobbies do too. And so, they drive some of the policy that comes out of FDA that drives the way Americans eat, the drugs Americans have access to. So on that, he and a lot of legitimate scientists and members of the public in the United States agree. It's that the agency, the USDA, the FDA have been captured by the industries they're supposed to regulate. And they all have an interest in subsidies and then in mass poisoning the American public. I mean, he holds our agriculture system responsible for the high levels of chronic disease in this country, right? He says it's their fault that we're fat. It's their fault that we have such high rates of diabetes. It's their fault that we have such high rates of heart disease. He's not wrong. I mean, it's, you know, we have a really unhealthy food system in this country.

You know, his goals, you know, reducing chronic illness in this country, reducing our unhealthy weight epidemic and our epidemic of chronic disease is the same as the goals of, I would guess, probably more than 90% of health experts in this country. It's just the way that he wants to get there and the ground level causes of these things. He often has a lot of disagreement with those experts. If he is confirmed, if RFK Jr. is confirmed, what are likely to be his priorities? So there are several different ways that he could kind of attack vaccines. One of the ways is to simply weaken the recommendations or do away with the recommendations that the CDC makes and that states and healthcare providers all over the country rely on

to determine who should get vaccinated and when. He could influence how vaccines are paid for. So, there's a program called Vaccines for Children that pays for low-income kids nationwide to get vaccines for free. And he could simply direct or pressure whoever is appointed to run the centers for Medicare and Medicaid to do away with that program, to ask Congress to defund that program. And that could theoretically happen. And I think, you know, perhaps one of the biggest things he could do is just by having his enormous platform cause a lot of Americans to doubt vaccines more than they did before, and cause Americans that didn't really doubt the FDA or the CDC's authority before to really distrust it now.

So there's a lot of new distrust that he could bring to the system and that he could affirm amid people who already distrust these big institutions. So there's a lot of damage to be done on vaccines. Can he take fluoride out of the water? He cannot. That is something that's usually determined by municipalities. It's sometimes determined by voters. But in as much as he could lead a lot of people to distrust fluoride for the first time and to question the science that shows fluoride has done far, far more good than harm, he could cause a lot of people to lobby their elected officials or their municipalities or to even vote to remove fluoride from their water, which would harm, you know, the dental health of hundreds of millions

of Americans. What does RFK's rise say about the way Americans now think about science and about public health? There does seem to be something bigger afoot here. And he seems to be representative of that bigger thing. Yeah, I think, you know, somebody pointed out to me the other day that he speaks the same anti-intellectual language that Trump does. And he also, he seems like a vengeance pick, right? Like he has a list of grievances that he moves through life with. And even though they may come from a different place than Trump does, he ends up in the same place where he distrusts experts, he distrusts big institutions, he feels wronged by a lot of the world. I think a lot of Americans really are attracted to conspiracy theories as well, in part because of how excluded from society

they have felt over the past few decades. So I think he seems like a really sympathetic character to a lot of Americans for a lot of those reasons. Vox senior reporter Karen Landman, she's also a doctor. Coming up, why are so many Americans skeptical about fluoride? And we're going to come right out and ask it, do they have a point? Now, after years of fluoride research, Procter & Gamble proudly announces triumph over tooth decay for everyone, everywhere. It's Today Explained. We're back this time with Michael Schulzen of Undark Magazine. He's a reporter and editor there. And in general, I write a lot about scientific controversies and kind of debates over what science says and does not say. Michael's recent writing is about fluoride.

The science on fluoride is not settled. Many public health experts in the dental community love it. But a small number of experts in the toxicology community have been asking questions about negative effects on developing brains. This starts in the U.S. in the early 20th century, largely from kind of incidental observations, which is that people drinking water with naturally occurring levels of fluoride seem to have some lower rates of tooth decay. And by the 1940s, there were some public health researchers or some dental researchers who came to think that

it seemed like the evidence was actually fairly strong, that there was something about the exposure of teeth to a little bit of added fluoride that could help to slow or prevent the effects of tooth decay. Grand Rapids' fight against tooth decay started in January 1945 when fluoride was added to the water supply. So you start to see municipalities in the 1940s doing this. Wisconsin is a leader, Michigan is a leader,

and some of the initial evidence that comes back from some of these interventions suggests that it's been really helpful. It's really helping to reduce rates of tooth decay, especially in children, and to improve oral health in these communities. After six years of fluoridation, the study shows that the six-year-old children who drank the water from birth had 65% less tooth decay. All right, so it's wonderful news. The kids' teeth are getting better. Where and when do the conspiracies about fluoride in the water start?

You know, there's a specific story that I have been fascinated by for a long time, which is the story of Stevens Point, Wisconsin in the 1940s, where there was debate in the community about whether or not to add fluoride to the water. This was this exciting new possible intervention. Some local citizens felt some concerns about it. They were worried that fluoride could be poisonous, that it could have some toxic effects, and they pushed back and essentially were pushing for a referendum, seemed to have gotten the city council to stop. And then in secret, the city council decided to add fluoride to the water anyway

and did so before that process had finished. And so some of the specific concerns that those people were raising about toxicity may not have borne out, right? But at the same time, if they were feeling like there was something about fluoride that was conspiratorial, in that case, they were correct. Elected officials in their community were going behind their back to do something that they had concerns about. How does the mistrust about fluoride develop in the ensuing years? You know, it becomes this kind of issue that a lot of different groups that have some deep

distrust in public health or some deep distrust in government more broadly can kind of express some of those anxieties through or come to see through that lens, come to see this as being a threatening or dangerous intervention. You're not going to shove fluoridization down our throats. What right has a politician got to tamper with our drinking water? The John Birch Society, the kind of right-wing organization famously takes up fluoride as one cause. There are concerns about fluoride being in some ways a communist plot related to brain control. If you were to try to design something that would become a locus of these fears, you almost couldn't do it better. It's invisible. It's in the water.

It comes out of your tap. It's very difficult to avoid. You know, if you don't trust the people who are making that decision on your behalf, this is a way that their decision-making is coming directly into your home, directly into the stuff that you're putting in your body. And fluoride has, over the years, inspired a tremendous amount of fear and concern. What is the attitude of science toward fluoride in the water and how does that evolve? So, you know, I think one piece of context that's important to understand here is that, like many things, at higher doses, fluoride is toxic, right? And I don't think that that's been a controversial point during this period. The question is whether the much, much lower doses of fluoride that are appearing in water actually have some effect.

During this period in the 19, you know, going into the 1980s and 1990s, you have small numbers of scientists who express some concerns about potentially toxic effects from fluoride. But this is really by no means a kind of anywhere near even a consensus or non-fringe position during this period. In the 1980s, there's some people at EPA who raised some questions about fluoridation. And then in the 1990s, you start to see more research coming in particular from China and India, looking at communities that have high naturally occurring levels of fluoride in their water and starting to detect some potential link between higher levels of fluoride and lowered IQ in children. These studies are by all accounts very poorly done. There are a lot of other things that could be causing this effect besides the fluoride. But getting into the early 2000s,

especially, you start to see some researchers at least noting this and asking some questions about, okay, is there a pattern here that we need to investigate more? Huh. And then do they? They do. Although it happens slowly. In 2006, there's a kind of a panel of advisors commissioned on behalf of the federal government say some of this evidence about neurotoxicity is suggestive enough that we need to see more research. to trigger some studies, some initial research within the National Toxicology Program, which is housed within the National Institutes of Health by especially the mid-2010s. The National Toxicology Program is beginning to invest some considerable resources, both in funding research, funding epidemiological research on fluoride, and also commissioning a systematic review by some of their own scientists,

meaning an intensive, intensive, exhaustive look through the scientific literature to try to understand whether there's a pattern here that merits further attention or even warrants more serious concern. Where is the science on this today? What do we know we know, and what do we know we don't know yet? Yeah, you know, it's a tough question. And it's a question where depending on who you ask, you can get dramatically different answers. What I would say is that there is a small body of evidence that suggests that there may be some link between fluoride and neurodevelopmental effects, so especially sort of negative effects for fetuses or for young children at doses of fluoride that are not that

much higher or maybe actually are the same as what people are routinely encountering when drinking water that has been treated as part of a community water fluoridation program. So the sort of typical fluoridated water that most Americans get out of their taps. I wouldn't say that there is by any means a scientific consensus around that at this point. But at the same time, I don't think it's a fringe position within the worlds of environmental epidemiology or toxicology to say, we see a concerning signal here, and this is something that we need to be paying more attention to. At the same time, you have some folks who are really skeptical of this research. You have, especially in the world of dental public health, some researchers who say, we just don't think these studies are very good, and we don't think the

evidence is nearly strong enough to be making these kinds of changes to a public health program. And you have other people outside the dental health world as well, who are also raising some concerns about this research. We learned in the first half of the show that RFK can't just go and take the fluoride out of the water. Cities, municipalities have to make that decision. We also talked in the first half of the show about the problem of RFK being he does have some good points. And I'm not a conspiracy theorist, but I read a piece like yours and I found myself thinking, huh, if I were a parent where my brain might go is it is going to be easier to fix my kids teeth than it is to fix my kids brain. If fluoride does something to their development. Yeah, you know, I think this is one of those areas where dismissing even having the conversation as being not okay, right, or saying even considering this is engaging a conspiracy theory has the potential to back of environmental epidemiology and toxicology that there may at least be some signal here that needs to be, researchers should be paying attention to. But I think this brings us back to this really deep question in public health,

which is how do you communicate uncertainty and what does it look like to talk about uncertainty in public? And answering that is well above my pay grade, but I think it's something that we all do well to wrestle with. Michael Shulson of Undark Magazine, Amanda Llewellyn produced today's show, Jolie Myers edited, Patrick Boyd and Rob Byers engineered, Laura Bullard aggressively checked the facts. Special thanks to Michael Schenck out walking the streets and asking the questions. I'm Noelle King. It's Today Explained. you