The economic value of Quebec's water fluoridation program

dc.contributor.authorTchouaket, Eric
dc.contributor.authorBrousselle, Astrid
dc.contributor.authorFansi, Alvine
dc.contributor.authorDionne, Pierre Alexandre
dc.contributor.authorBertrand, Elise
dc.contributor.authorFortin, Christian
dc.date.accessioned2021-02-18T22:38:44Z
dc.date.available2021-02-18T22:38:44Z
dc.date.copyright2013en_US
dc.date.issued2013
dc.description.abstractAim Dental caries is a major public health problem worldwide, with very significant deleterious consequences for many people. The available data are alarming in Canada and the province of Quebec. The water fluoridation program has been shown to be the most effective means of preventing caries and reducing oral health inequalities. This article analyzes the cost-effectiveness of Quebec’s water fluoridation program to provide decision-makers with economic information for assessing its usefulness. Methods An approach adapted from economic evaluation was used to: (1) build a logic model for Quebec’s water fluoridation program; (2) determine its implementation cost; and (3) analyze its cost-effectiveness. Documentary analysis was used to build the logic model. Program cost was calculated using data from 13 municipalities that adopted fluoridation between 2002 and 2010 and two that received only infrastructure grants. Other sources were used to collect demographic data and calculate costs for caries treatment including costs associated with travel and lost productivity. Results The analyses showed the water fluoridation program was cost-effective even with a conservatively estimated 1 % reduction in dental caries. The benefit-cost ratio indicated that, at an expected average effectiveness of 30 % caries reduction, one dollar invested in the program saved $71.05–$82.83 per Quebec’s inhabitant in dental costs (in 2010) or more than $560 million for the State and taxpayers. Conclusion The results showed that the drinking-water fluoridation program produced substantial savings. Public health decision-makers could develop economic arguments to support wide deployment of this population-based intervention whose efficacy and safety have been demonstrated and acknowledged.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipWe would like to thank the Ministry of Health and Social Services (MSSS) of Quebec, which funded this project, as well as the Canadian Institutes of Health Research (CIHR) and the Fonds de recherche du Québec – Santé (FRQS) which fund the Canada Research Chair in Evaluation and Health System Improvement held by Astrid Brousselle and also funded the postdoctoral fellowships of Éric Tchouaket (4P Training Program: Prevention, Promotion and Public Policy, and PHIRNET: Population Health Intervention Research Network) and Alvine Fansi.en_US
dc.identifier.citationTchouaket, E., Brousselle, A., Fansi, A., Dionne, P. A., Bertrand, E., & Fortin, C. (2013). The economic value of Quebec’s water fluoridation program. Journal of Public Health, 21, 523-533. https://doi.org/10.1007/s10389-013-0578-3.en_US
dc.identifier.urihttps://doi.org/10.1007/s10389-013-0578-3
dc.identifier.urihttp://hdl.handle.net/1828/12689
dc.language.isoenen_US
dc.publisherJournal of Public Healthen_US
dc.subjectWater fluoridation
dc.subjectDental caries
dc.subjectLogic model
dc.subjectCosts
dc.subjectBenefits
dc.subjectCost-effectiveness
dc.subject.departmentSchool of Public Administration
dc.titleThe economic value of Quebec's water fluoridation programen_US
dc.typeArticleen_US

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