Good morning. We’re unpacking how exactly Robert F. Kennedy Jr. plans to Make America Healthy Again – more on that below, along with snowplows in the Florida Panhandle and key endorsements in the Liberal leadership race. But first:

• Trudeau says that Trump’s promised ‘golden age’ is at odds with imposing tariffs on Canada
• A former health research head says that mysterious brain symptoms in New Brunswick demand a probe
• Gazans’ joy over the ceasefire dims as they visit their ruined homes and dig for the dead

Toward the end of Donald Trump’s inauguration speech, sandwiched between his promises to take back the Panama Canal from China and extend manifest destiny to Mars, the newly minted U.S. President had this to say about America’s well-being: “We will end the chronic disease epidemic and keep our children safe, healthy and disease-free.”

That’s a tall order for anyone, much less an avowed anti-vaxxer with no medical background who’s boasted about a worm eating part of his brain. But Robert F. Kennedy Jr. continues to enjoy Trump’s support to lead the Department of Health and Human Services – despite the objections of 77 Nobel laureates, 17,000 physicians, the American Public Health Association and people who’ve survived polio. Kennedy’s confirmation hearing is meant to get under way later this month; he’s already been making the rounds on Capitol Hill to convince U.S. senators he’s up for the job.

He’s also given them ample fodder to derail his nomination. Kennedy has repeatedly insisted that childhood vaccines cause autism. (That theory has been debunked. ) He declared that 60 per cent of American kids have neurological diseases, autoimmune diseases, and food allergies. (There’s no basis for that claim.) He’s said that antidepressants cause school shootings and poppers cause AIDS. (Incorrect.) He suggested COVID-19 may have been “ethnically targeted” to spare Chinese people and Ashkenazi Jews. (No.)

Still, when Trump said in November that Kennedy could “go wild on health,” one project shot to the top of his priority list. “On January 20, the Trump White House will advise all U.S. water systems to remove fluoride from public water,” Kennedy posted on social media. That obviously didn’t happen in Trump’s Day 1 executive-order blitz. But the President hasn’t backed away from Kennedy’s proposal: He told an interviewer that getting rid of fluoride “sounds okay to me.”

The war on fluoride

Let’s take a closer look at this particular plank of Kennedy’s Make America Healthy Again movement. He argues that fluoride – a naturally occurring mineral in nearly all water sources – is an “industrial waste” linked to cancer, neurodevelopmental disorders and arthritis. The CDC disagrees, but much of Kennedy’s opposition to fluoride stems from a 2019 Canadian study, which linked lowered IQ scores in 512 children with very high maternal fluoride exposure during pregnancy.

Here’s the trouble with that study. “The way they measured fluoride was in maternal urine, which is an indirect measure, and the way they measured IQ has been questioned as well,” Paul Allison, a professor in the faculty of dental medicine and oral health sciences at McGill University, told me. (Also, the amount of fluoride in drinking water – 0.7 milligrams per litre – is significantly lower than the 1.5-mg threshold that could cause adverse effects.) Beyond that, the researchers refused to make their data publicly available, so epidemiologists haven’t been able to reproduce their analyses. “This is one study,” Allison said. “There are thousands and thousands that record the benefit of fluoride vis a vis dental decay.”

And that’s the purpose of fluoride in our drinking water: It’s a hugely cost-efficient and equitable means to strengthen tooth enamel and prevent dental decay, which is the world’s most common non-communicable disease. Oral disease contributes to an annual $1-billion in productivity losses in Canada alone; tooth decay accounts for one-third of all day surgeries performed on children aged 1 to 5.

“There’s no doubt that the cost of putting fluoride in the water is much, much less than the cost to the general community of treating dental decay,” Allison told me. A study in the Journal of Public Health found that every dollar invested in Quebec’s water-fluoridation program saved between $71 and $82 per resident in dental costs in 2010 – or upwards of $560-million for the province and its taxpayers.

Riding a wave

In November, however, Montreal officials moved to end water fluoridation in six West Island towns, after a Kennedy booster filed a petition with the city. And in the weeks after the U.S. election, about 20 communities across America voted against fluoride in their own water supply. “All it takes is a few people to jump up and down on social media and cite poor information,” Allison said. “If I were a mayor and had no training in health – or the resources to look into this properly – I might be concerned. But the science is still strong.”

That’s why more than 72 per cent of Americans drink fluoridated water. Canada’s access, on the other hand, isn’t nearly that high – we teeter just below 39 per cent. Ontario is roughly on par with the U.S.; in Northwest Territories, fluoridated water reaches 68 per cent of residents. There’s virtually zero coverage in New Brunswick, Yukon, Newfoundland and Labrador, or B.C. Alberta is around 43 per cent, but in 2011, Calgary stopped water fluoridation. Within three years, kids in Calgary were significantly more likely to have cavities than their peers in Edmonton, still sipping on water with fluoride.

Even if Kennedy is confirmed by the Senate, it’s unlikely he – or Trump – could dispense with fluoride in one fell swoop. Decisions over water systems take place on a local level, and any long-term reform to limit fluoride in tap water is left up to the Environmental Protection Agency. But the U.S. market is still betting on a boom in dental visits. As soon as Trump picked Kennedy to be his health czar, stocks for dental-hygiene companies soared.

A rare winter storm barged through Texas yesterday, blanketing New Orleans in 13 centimetres of snow, prompting the first-ever blizzard warning along the Gulf Coast, and forcing Florida Panhandlers to bust out the snowmobiles. Read more here and see more photos of the winter wonderland here.