Abstract
Background: New Zealand (NZ) is currently expanding community water fluoridation (CWF) through the implementation of the Health (Fluoridation of Drinking Water) Amendment Act 2021. The aim of this study was to assess access to and performance of CWF in NZ and the health equity potential of the Health (Fluoridation of Drinking Water) Amendment Act 2021.
Methods: We conducted a longitudinal audit of CWF schemes using 66,700 weekly fluoride testing results from 111 water distribution zones (WDZ). Results: We estimated that 50.7% of the NZ population had access to CWF, including 44.2% of the Māori population and 52.0% of the non-Māori population. People living in areas of highest deprivation had greater access (53.6%) than those living in areas with the least deprivation (49.4%). Water suppliers met the optimal fluoride level only 60.7% of the time during the observation period. We estimated that the first tranche of directives to councils to fluoridate would reduce inequity in access to CWF for Māori by 75%, while there would be an even greater proportion of people living in areas of high deprivation with access.
Conclusion: The Health (Fluoridation of Drinking Water) Amendment Act is pro-equity and will facilitate greater access and potential performance of CWF in NZ.