--:-- [Theme music fades out]
--:-- Noelle King: Welcome to Today Explained. I'm Noelle King.
--:-- Noelle King: Karen, did you ever do any, like, theater as a young person?
--:-- Karen Landman: I did. Good! Yes, I knew it!
--:-- Noelle King: 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 would 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?
--:-- Noelle King: 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.
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--:-- Noelle King: Hey, I'm Dr. Boyd. I'm going to listen to your heartbeat real quick. today. Explained. 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 Landman: Karen, what is this job, Secretary of the Department of Health and Human Services?
--:-- Noelle King: 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.
--:-- Karen Landman: And we're told that RFK is an unorthodox pick for this job. What makes him so unorthodox?
--:-- Noelle King: He has a lot of beliefs about health-related issues. that are based in conspiracy theory lore.
--:-- Karen Landman: 2006 marks the day when suddenly these gluten allergies began exploding. Interesting. The celiac disease is putting in 5G to harvest our data and control our behavior.
--:-- Noelle King: 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.
--:-- Karen Landman: 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.
--:-- Noelle King: And science really drives a lot of the way America's health agencies function. And he fundamentally distrusts the process that makes science.
--:-- Karen Landman: So this is a person deeply at odds with the way that these organizations function.
--:-- Noelle King: 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?
--:-- Karen Landman: 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.
--:-- Noelle King: 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, it's also a lie.
--:-- Karen Landman: A group of people with the World Mercury Project reached out to him to see if he would help them push back against vaccines. 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.
--:-- Noelle King: 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.
--:-- Karen Landman: 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.
--:-- Noelle King: 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.
--:-- Karen Landman: 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.
--:-- Noelle King: 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.
--:-- Karen Landman: 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.
--:-- Noelle King: What are some of his other ideas that don't overlap with the scientific consensus?
--:-- Karen Landman: 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
--:-- Noelle King: He has linked chemicals in water with sexual dysphoria in children, not based in evidence.
--:-- Karen Landman: If you expose frogs to atrazine, male frogs, it changes their sex and they can actually bear young. And so the capacity for these chemicals that we are just raining down on our children right now.
--:-- Noelle King: He has linked antidepressant use with mass shootings not founded in evidence.
--:-- Karen Landman: 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.
--:-- Noelle King: 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.
--:-- Karen Landman: 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, am I in that camp? Perhaps.
--:-- Noelle King: Where does he overlap with the scientific consensus?
--:-- Karen Landman: 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.
--:-- Noelle King: You know, he fundamentally distrusts big institutions. And I think a lot of Americans across the political spectrum also distrust big institutions.
--:-- Karen Landman: 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.
--:-- Noelle King: 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.
--:-- Karen Landman: 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.
--:-- Noelle King: And they all have an interest in subsidies and then in mass poisoning the American public.
--:-- Karen Landman: 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.
--:-- Noelle King: He's not wrong. I mean, it's, you know, we have a really unhealthy food system in this country.
--:-- Karen Landman: 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 percent of health experts in this country.
--:-- Noelle King: 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.
--:-- Karen Landman: If he is confirmed, if RFK Jr. is confirmed, what are likely to be his priorities?
--:-- Noelle King: 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 health care providers all over the country rely on to determine who should get vaccinated and when.
--:-- Karen Landman: 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.
--:-- Noelle King: 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.
--:-- Karen Landman: And that could theoretically happen.
--:-- Noelle King: 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.
--:-- Karen Landman: 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.
--:-- Noelle King: So there's a lot of damage to be done on vaccines.
--:-- Karen Landman: 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.
--:-- Noelle King: 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,
--:-- Karen Landman: 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 the dental health of hundreds of millions of Americans.
--:-- Noelle King: What does RFK's rise say about the way Americans now think about science and about public health?
--:-- Karen Landman: There does seem to be something bigger afoot here, and he seems to be representative of that bigger thing.
--:-- Noelle King: Yeah, I think, you know, somebody pointed out to me the other day that he speaks the same anti-intellectual language that Trump does.
--:-- Karen Landman: And he also, he seems like a vengeance pick, right? Like he has a list of grievances that he moves through life with.
--:-- Noelle King: 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.
--:-- Karen Landman: 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.
--:-- Noelle King: So I think he seems like a really sympathetic character to a lot of Americans for a lot of those reasons.
--:-- Karen Landman: Vox senior reporter Karen Landman. She's also a doctor.
--:-- Noelle King: Coming up why are so many Americans skeptical about fluoride And we going to come right out and ask it do they have a point
--:-- Noelle King: Support for Today Explained comes from Chime. Nobody likes fees and complicated banking, says Chime. And Chime gets that, says Chime. Chime is a financial technology company that says they understand that every dollar counts. So when you set up direct deposit through Chime, they say you get access to fee-free features, such as free overdraft coverage, getting paid up to two days early with direct deposit, so much more.
--:-- Noelle King: Chime says with qualifying direct deposits, you can be eligible for free overdraft, up to $200 on debit card purchases and cash withdrawals. Plus, they say you don't need to worry about monthly fees or maintenance fees.
--:-- Noelle King: You can work on your financial goals through Chime today. You can open an account in two minutes at chime.com slash explained. That's chime.com slash explained.
--:-- Noelle King: Chime feels like progress. Chime is a financial technology company, not a bank. Banking services and debit card provided by the Bank or Bank N.A. Or Stride Bank N.A. Members FDIC.
--:-- Noelle King: Every day, millions of customers engage with AI agents like me. We resolve queries fast. We work 24-7 and we're helpful, knowledgeable, and empathetic. We're built to be the voice of the brands we serve. Sierra is the platform for building better, more human customer experiences with AI. No hold music, no generic answers, no frustration. Visit sierra.ai to learn more.
--:-- Noelle King: Support for the show today comes from LifeKit, the podcast from NPR. What's in your life kit? I'm asking. They didn't ask that. Every day you have to make choices that might shape the direction of your life, but you can't flip to the back of the book to find an answer key. Instead, you can listen to the Life Kit podcast from NPR.
--:-- Noelle King: Life Kit offers real stories about common issues like relationships, finances, parenting, and your career. If you're looking to move with more intention or just need thoughtful guidance on living better, Life Kit delivers strategies to help you make meaningful, sustainable change From fitness routines to mental resilience, navigating personal goals to tackling burnout, each episode is full of relevant insights and clear takeaways about things we all could use a little help with.
--:-- Noelle King: LifeKit wants to help you approach your own life with confidence and clarity and walk away with a game plan you can implement right away. Enough from me. Go listen to the show, LifeKit. It's a podcast from NPR.
--:-- Noelle King: 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 Schulzen: 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.
--:-- Noelle King: 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.
--:-- Michael Schulzen: 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.
--:-- Noelle King: Grand Rapids' fight against tooth decay started in January 1945 when fluoride was added to the water supply.
--:-- Michael Schulzen: 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.
--:-- Noelle King: 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.
--:-- Michael Schulzen: Where and when do the conspiracies about fluoride in the water start?
--:-- Noelle King: 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.
--:-- Michael Schulzen: 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.
--:-- Noelle King: And then in secret, the city council decided to add fluoride to the water anyway and did so before that process had finished.
--:-- Michael Schulzen: 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.
--:-- Noelle King: Elected officials in their community were going behind their back to do something that they had concerns about.
--:-- Michael Schulzen: How does the mistrust about fluoride develop in the ensuing years?
--:-- Noelle King: 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.
--:-- Michael Schulzen: You're not going to shove fluoridization down our throats. What right has a politician got to tamper with our drinking water?
--:-- Noelle King: The John Birch Society the kind of right organization famously takes up fluoride as one cause There are concerns about fluoride being in some ways a communist plot related to brain control
--:-- Michael Schulzen: If you were to try to design something that would become a locus of these fears you almost couldn do it better It's invisible. It's in the water. It comes out of your tap. It's very difficult to avoid.
--:-- Noelle King: 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.
--:-- Michael Schulzen: And fluoride has, over the years, inspired a tremendous amount of fear and concern.
--:-- Noelle King: What is the attitude of science toward fluoride in the water, and how does that evolve?
--:-- Michael Schulzen: 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.
--:-- Noelle King: The question is whether the much, much lower doses of fluoride that are appearing in water actually have some effect.
--:-- Michael Schulzen: 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.
--:-- Noelle King: But this is really by no means a kind of anywhere near even a consensus or non-fringe position during this period.
--:-- Michael Schulzen: 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.
--:-- Noelle King: 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.
--:-- Michael Schulzen: 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?
--:-- Noelle King: Huh. And then do they? They do, although it happens slowly.
--:-- Michael Schulzen: 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.
--:-- Noelle King: And that begins in particular to trigger some studies, some initial research within the National Toxicology Program, which is housed within the National Institutes of Health.
--:-- Michael Schulzen: 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.
--:-- Noelle King: Where is the science on this today? What do we know we know and what do we know we don't know yet?
--:-- Michael Schulzen: 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.
--:-- Noelle King: 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.
--:-- Michael Schulzen: 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.
--:-- Noelle King: So the sort of typical fluoridated water that most Americans get out of their taps.
--:-- Michael Schulzen: I wouldn't say that there is by any means a scientific consensus around that at this point.
--:-- Noelle King: 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.
--:-- Michael Schulzen: 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.
--:-- Noelle King: And you have other people outside the dental health world as well who are also raising some concerns about this research.
--:-- Michael Schulzen: 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.
--:-- Noelle King: 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 kid's teeth than it is to fix my kid's brain if fluoride does something to their development.
--:-- Michael Schulzen: 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 backfire, right, for people who have public health in mind.
--:-- Noelle King: I think, as I said before, it is not a fringe position right now within the world of environmental epidemiology and toxicology that there may at least be some signal here that researchers should be paying attention to.
--:-- Michael Schulzen: 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?
--:-- Noelle King: And answering that is well above my pay grade, but I think it's something that we all do well to wrestle with.
--:-- Michael Schulzen: Michael Shulson of Undark magazine.
--:-- Noelle King: Amanda Llewellyn produced today's show. Jolie Myers edited. Patrick Boyd and Rob Byers engineered. Laura Bullard aggressively checked the facts.
--:-- Noelle King: Special thanks to Michael Shank out walking the streets and asking the questions.
--:-- Noelle King: I'm Noelle King. It's Today Explained. Thank you.
