0:00

Karen, did you ever do any theater as

0:02

a young person? I did.

0:04

Good. Yes, I knew it.

0:09

Okay, guys, I have pulled

0:11

a section from your piece. It is

0:13

two lines, and I'm going to

0:16

have you read those lines with feeling and with

0:18

nuance. This will come at the top of the

0:20

show in the billboard. It's going to be your

0:22

voice coming out. Amanda, can we get those lines

0:24

to Karen? All right. No

0:28

matter where a person stands on the political

0:31

spectrum, they can probably find something to agree

0:33

with Kennedy on. He's

0:35

the personification of the growing distrust

0:37

of science and the public

0:39

health establishment that many Americans have

0:41

felt in the post-pandemic era. Robert

0:47

F. Kennedy Jr., Health and Human Services

0:49

Secretary, it's coming up on Today Explained.

0:58

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2:19

Hey, I'm Dr. Boyd. I'm gonna listen to your heartbeat

2:21

real quick. Today,

2:24

explain. I'm Noel King.

2:26

Dr. Karen Landman did not make it

2:28

as an actor. Instead, she's a senior

2:31

health and medicine reporter at Vox. She

2:33

is also a physician and an epidemiologist.

2:35

Karen, what is this job? Secretary of

2:37

the Department of Health and Human Services?

2:40

This job is overseeing a bunch of

2:42

federal agencies that have a lot to

2:44

do with health, including

2:46

but not limited to the CDC, the

2:49

FDA or the Food and Drug Administration,

2:51

the Centers for Medicare and Medicaid, the

2:54

Indian Health Service, lots and

2:57

lots of important agencies

2:59

that together really chart

3:02

a course for the health of our nation. And

3:04

we're told that RFK is an unorthodox

3:06

pick for this job. What makes him

3:09

so unorthodox? He

3:11

has a lot of beliefs

3:13

about health related issues that

3:16

are based in conspiracy

3:18

theory lore. 2006

3:21

marks the day when suddenly

3:23

these gluten allergies began exploding.

3:25

The CELI Act is in

3:27

all. COVID-19 is

3:29

targeted to attack quotations and

3:32

black people. And

3:44

I think kind of at the heart of

3:46

that is a distrust of the scientific process

3:48

and of the people who do it. And

3:51

a tendency to really confuse causation with

3:53

association. You know, the fact that two

3:55

things kind of happen at the same

3:57

time in the same place to him

3:59

is proof that one caused the other,

4:01

where the whole scientific process exists to

4:04

disentangle those things from each other. And

4:06

science really drives a lot of the

4:08

way America's health agencies function and he

4:10

fundamentally distrusts the process that makes science.

4:12

So this is a person deeply at

4:14

odds with the way that these organizations

4:16

function. You have not

4:18

said the word vaccines yet, but I

4:20

feel like that's what we're headed toward.

4:24

Talk to me about this gentleman's history of

4:27

vaccine skepticism. Where does it start? I

4:29

mean, his involvement with it starts in the

4:32

2000s. He had been prior to that

4:34

an environmental lawyer. He'd done a lot

4:36

of work with cleaning up polluted water

4:38

systems. You know, coal claims to be

4:40

cheap and clean when they say they're clean. We

4:42

know that's a dirty lie. When

4:44

they say they're cheap, it's also a lie.

4:47

It's actually a group of people with the

4:49

World Mercury Project reached out to

4:51

him to see if he would help them push back

4:54

against vaccines. Basically they felt

4:56

on the basis of some

4:59

since disproven research purporting

5:01

to link vaccines

5:03

with the presence of a

5:06

preservative in vaccines that

5:08

did contain a little bit of mercury,

5:11

not present in vaccines anymore. But they

5:14

asked him to get involved

5:16

in informing the public about

5:18

the scourge, quote unquote, of

5:20

thimerosal and of mercury in

5:22

vaccines and its impacts on health. Again, not

5:25

proven by science, not really rooted in

5:27

reality. He got involved with this group, eventually

5:30

became its head. It has now changed

5:33

names to the children's health defense, arguably

5:35

has been one of the most influential

5:37

groups in anti-vaccination

5:41

advocacy worldwide. He became the face

5:43

of it internationally and brought his

5:45

platform, his, you know, his fame,

5:48

a lot of money and a

5:50

lot of attention to their cause. CDC's

6:00

own research. I think he

6:02

has seeded doubt in a million different

6:04

ways on the utility

6:07

and the life-saving nature of vaccines, which, by

6:10

the way, we should just say, have saved

6:12

hundreds of millions of lives worldwide.

6:16

So he's cast doubt on the

6:18

process of creating them and the process of

6:20

administering them and of recommending them for decades

6:22

in so many different ways. What

6:25

are some of his other ideas that don't

6:27

overlap with the scientific

6:29

consensus? Oh, gosh. You

6:32

know, he said a lot of stuff about fluoride, which

6:35

has also saved a lot of teeth. Hundreds

6:38

of millions of teeth. Maybe billions. Who

6:41

knows? Who can say? You could never be sure.

6:44

I think fluoride is a

6:46

poison. He has linked chemicals

6:49

in water with sexual dysphoria

6:51

in children, not based

6:53

in evidence. If you expose frogs

6:57

to actress named male frogs,

7:00

it changes their sex and

7:03

they can actually bear young.

7:06

And so the capacity for these

7:08

chemicals that we are just raining

7:11

down on our children right now. He

7:14

has linked antidepressant use

7:16

with mass shootings, not found it

7:18

in evidence. NIH needs to be

7:20

studying to see if there's connections

7:23

to some of the SSRI

7:26

and psychiatric drug drugs people are

7:28

taking, whether there's connections to video

7:30

games. There are a lot of

7:32

non-scientific beliefs that he has espoused

7:35

publicly and just cast doubt on

7:38

how much we know about the

7:41

causes of a whole bunch of health

7:43

conditions. So I feel

7:45

like the most controversial thing you could say

7:47

about RFK is not that he's totally right

7:49

or he's totally wrong, but this

7:52

guy has some good ideas. And

7:57

truthfully, am I in that camp

7:59

perhaps? more

10:00

than 90% of health experts

10:02

in this country. It's just the way

10:04

that he wants to get there and

10:07

the ground level causes of

10:09

these things. He often

10:11

has a lot of disagreement

10:13

with those experts. If

10:16

he is confirmed, if RFK Junior is confirmed,

10:18

what are likely to be his priorities? So

10:21

there are several different ways that he

10:23

could kind of attack vaccines. One

10:27

of the ways is to simply weaken

10:30

the recommendations or

10:32

do away with the recommendations that the

10:34

CDC makes and that states and healthcare

10:36

providers all over the country rely on

10:38

to determine who should get vaccinated and

10:41

when. He could influence

10:43

how vaccines are paid for. So

10:46

there's a program called Vaccines for

10:48

Children that pays for low income

10:50

kids nationwide to get vaccines

10:52

for free. And he could simply

10:55

direct or pressure whoever is appointed to

10:57

run the Centers for Medicare and Medicaid

10:59

to do away with that program, to

11:01

ask Congress to defund that program. And

11:03

that could theoretically happen. And

11:06

I think perhaps one of the

11:08

biggest things he could do is

11:10

just by having his enormous platform

11:12

cause a lot of Americans

11:15

to doubt vaccines more than they

11:17

did before and cause

11:19

Americans that didn't really doubt

11:21

the FDA or the CDC's

11:23

authority before to really

11:25

distrust it now. So there's a lot

11:27

of new distrust that he could bring

11:30

to the system and that he could

11:32

affirm amid people who already distrust these

11:34

big institutions. So there's a

11:36

lot of damage to be done on vaccines. Can he take

11:38

fluoride out of the water? He cannot.

11:41

That is something that's usually determined by

11:43

municipalities. It's sometimes determined by voters. But

11:46

in as much as he could

11:49

lead a lot of people to distrust fluoride for

11:51

the first time and to question the science that

11:53

shows fluoride has done far, far

11:56

more good than harm, he

11:58

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17:00

greenlight.com/explained. Now,

17:06

after years of fluoride research, Procter

17:08

& Gamble proudly announces triumph over

17:11

tooth decay for everyone everywhere. It's

17:13

Today Explained. We're back this time

17:15

with Michael Schulson of Undark Magazine.

17:17

He's a reporter and editor there.

17:19

And then generally write a lot

17:21

about scientific controversies and kind of

17:24

debates over what science says and

17:26

does not say. Michael's recent writing

17:28

is about fluoride. The science on

17:30

fluoride is not settled. Many

17:32

public health experts in the dental community love

17:35

it. But a small

17:37

number of experts in the

17:39

toxicology community have been asking

17:41

questions about negative effects on

17:43

developing brains. This

17:50

starts in the U.S. in the

17:53

early 20th century, largely from kind

17:55

of incidental observations, which is that

17:57

people drinking water with. naturally

18:00

occurring levels of fluoride seem to

18:02

have some lower rates of tooth

18:05

decay. And by the

18:07

1940s, there were some public health

18:09

researchers or some dental researchers who

18:12

came to think that it seemed like the

18:14

evidence was actually fairly strong, that there was

18:16

something about the exposure of teeth to a

18:19

little bit of added fluoride that could help

18:21

to slow or prevent the

18:23

effects of tooth decay. Grand

18:25

Rapids' fight against tooth decay started

18:28

in January 1945 when fluoride

18:31

was added to the water supply. So you

18:33

start to see municipalities in the 1940s doing

18:36

this. Wisconsin is a leader, Michigan

18:38

is a leader, and some of the initial

18:40

evidence that comes back from some of these

18:43

interventions suggests that it's been really helpful. It's

18:45

really helping to reduce rates

18:47

of tooth decay, especially in children,

18:49

and to improve oral health in these

18:52

communities. After six years

18:54

of fluoridation, the study shows

18:56

that the six-year-old children who drank the

18:58

water from birth had 65% less

19:00

tooth decay. All

19:08

right, so it's wonderful news. The kids'

19:10

teeth are getting better. Where and when

19:12

do the conspiracies about fluoride in the

19:14

water start? You know, there's

19:17

a specific story that I have been fascinated

19:19

by for a long time, which is the

19:21

story of Stevens Point, Wisconsin, in the 1940s,

19:23

where there was debate in the community

19:27

about whether or not to add fluoride to

19:29

the water. This was this exciting new possible

19:32

intervention. Some local citizens felt some

19:34

concerns about it. They were worried

19:37

that fluoride could be poisonous,

19:39

that it could have some toxic effects, and

19:41

they pushed back, and

19:43

essentially were pushing for

19:45

a referendum, seemed to have

19:47

gotten the city council to stop. And

19:50

then in secret, the city council decided

19:52

to add fluoride to the water anyway,

19:54

and did so before that process had

19:56

finished. And so some of

19:58

the specific concerns that those people... people were raising

20:00

about toxicity may not have borne out. But

20:02

at the same time, if they were feeling

20:05

like there was something about fluoride that was

20:07

conspiratorial, in that case, they were correct. Elected

20:09

officials in their community were going behind their

20:11

back to do something that they had concerns

20:13

about. How does the mistrust

20:16

about fluoride develop in the ensuing years?

20:20

It becomes this kind of issue

20:22

that a lot of different groups

20:24

that have some deep distrust in

20:26

public health or some deep distrust

20:28

in government more broadly can

20:30

kind of express some of those

20:32

anxieties through or come to see,

20:35

through that lens, come to see

20:37

this as being a threatening or

20:39

dangerous intervention. You're not going

20:41

to shove fluoridation down our throats. What

20:44

right has a politician got to

20:46

tamper with our drinking water? The

20:48

John Birch Society, the kind of

20:51

right-wing organization famously takes up fluoride as

20:53

one cause. There are concerns about fluoride

20:55

being, in some ways, a communist plot

20:58

related to brain control. If

21:00

you were to try to design something

21:02

that would become a locus of

21:04

these fears, you almost could do it

21:07

better. It's invisible. It's in

21:09

the water. It comes out of your tap. It's

21:11

very difficult to avoid. If

21:13

you don't trust the people who are making

21:15

that decision on your behalf, this is a

21:17

way that their decision-making is coming directly into

21:20

your home, directly into the stuff that you're

21:22

putting in your body. And

21:24

fluoride has, over the years, inspired a

21:26

tremendous amount of fear and concern. What

21:30

is the attitude of science toward fluoride

21:32

in the water? And how does that

21:35

evolve? So I think

21:37

one piece of context that's important to

21:39

understand here is that, like

21:42

many things, at higher doses, fluoride is

21:44

toxic. And I don't think that that's

21:46

been a controversial point during this period.

21:48

The question is whether the much, much

21:50

lower doses of fluoride that are appearing

21:53

in water actually have some effect. Going

22:00

into the 1980s and 1990s, you

22:03

have small numbers of

22:05

scientists who express some concerns about

22:07

potentially toxic effects from fluoride, but

22:09

this is really by no means

22:11

kind of anywhere near even a

22:13

consensus or non-fringe position during this

22:16

period. In the 1980s, there's

22:18

some people at EPA who raised some

22:20

questions about fluoridation. And then in the

22:22

1990s, you start

22:24

to see more research coming in

22:27

particular from China and India, looking

22:30

at communities that have high

22:32

naturally occurring levels

22:34

of fluoride in their water and

22:36

starting to detect some potential link

22:39

between higher levels of fluoride and

22:41

lowered IQ in children. These studies

22:43

are by all accounts very

22:45

poorly done. There are a lot of other

22:47

things that could be causing this effect besides

22:49

the fluoride, but getting into the early 2000s,

22:53

especially you start to see some researchers at

22:55

least noting this and asking some questions about,

22:57

okay, is there a pattern here that we

22:59

need to investigate more? Huh, and then do

23:01

they? They do, although

23:03

it happens slowly. In 2006, there's

23:05

a kind of a panel of

23:08

advisors commissioned on behalf of the

23:10

federal government, say some

23:13

of this evidence about neurotoxicity

23:15

is suggestive enough that we

23:17

need to see more research. And

23:20

that begins in particular to trigger

23:23

some studies, some initial

23:25

research within the National Toxicology Program,

23:27

which is housed within

23:30

the National Institutes of Health by

23:32

especially the mid 2010s, the

23:35

National Toxicology Program, is

23:37

beginning to invest some considerable

23:39

resources both in funding research,

23:42

funding epidemiological research on fluoride,

23:44

and also commissioning a systematic

23:46

review by some of their

23:48

own scientists, meaning an intensive,

23:50

intensive, exhaustive look through the

23:52

scientific literature to try to

23:55

understand whether there's a pattern here

23:57

that merits further attention or even...

23:59

warrants more serious concern. Where

24:04

is the science on this today?

24:07

What do we know we know, and what do

24:09

we know we don't know yet? Yeah,

24:12

you know, it's a tough question, and it's a

24:14

question where, depending on who you ask, you can

24:16

get dramatically different answers. What I would say is

24:18

that there is a small

24:20

body of evidence that suggests that

24:22

there may be some link between

24:24

fluoride and neurodevelopmental effects, so

24:27

especially sort of negative effects for

24:29

fetuses or for young children, at

24:32

doses of fluoride that are not that

24:34

much higher, or maybe actually are the

24:36

same as what people are routinely encountering

24:38

when drinking water that

24:40

has been treated as part of a community

24:43

water fluoridation program. So the sort of typical

24:45

fluoridated water that most Americans get out of

24:47

their taps. I wouldn't say that

24:49

there is, by any means, a scientific consensus around

24:51

that at this point, but at the same time,

24:53

I don't think it's a fringe position

24:55

within the worlds of environmental epidemiology

24:58

or toxicology to say, we

25:00

see a concerning signal here, and this is something that we

25:02

need to be paying more attention to. At

25:04

the same time, you have some folks who are

25:07

really skeptical of this research. You have, especially in

25:09

the world of dental public health, some

25:11

researchers who say, we just don't think these studies are

25:13

very good, and we don't think the evidence is

25:16

nearly strong enough to be making these

25:18

kinds of changes to a public health

25:20

program. And you have other people outside the

25:22

dental health world as well, who are also

25:24

raising some concerns about this research. We

25:27

learned in the first half of the show that

25:30

RFK can't just go and take the fluoride out

25:32

of the water. Cities, municipalities have to make that

25:34

decision. We also talked in the first

25:36

half of the show about the problem of

25:39

RFK being he does have some

25:41

good points. And

25:43

I'm not a conspiracy theorist, but

25:46

I read a piece like yours, and I

25:48

found myself thinking, huh, if

25:50

I were a parent where my brain might go

25:53

is, it is gonna be

25:55

easier to fix my kid's teeth than it

25:57

is to fix my kid's brain. If fluoride

25:59

does something, to their development.

26:02

Yeah. You know, I think

26:04

this is one of those areas where

26:07

dismissing even having the conversation as

26:09

being not OK, or

26:12

saying even considering this is engaging

26:14

in conspiracy theory, has the potential

26:17

to backfire for people

26:19

who have public health in mind. I think,

26:21

as I said before, it is not a

26:23

fringe position right now within

26:25

the world of environmental epidemiology and toxicology that

26:27

there may at least be some signal here

26:31

researchers should be paying attention to. But

26:33

I think this brings us back to this really deep

26:36

question in public

26:38

health, which is, how do you communicate uncertainty?

26:41

And what does it look like to talk

26:43

about uncertainty in public? And

26:45

answering that is well above my pay grade, but

26:47

I think it's something that we all do well

26:49

to wrestle with. Michael

26:51

Schulson of Undark

26:53

Magazine. Amanda Llewellyn produced today's

26:55

show, Joly Meyers edited. Patrick

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Boyd and Rob Byers engineered. Laura Bullard aggressively checked the

27:00

facts. Special thanks to Michael

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Schenck, out walking the streets and asking

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the questions. I'm Noelle King. It's Today

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Explained. Do

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hubspot.com/marketers. Support

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for this podcast comes from Stripe. Stripe

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