Yesterday Canadian economics blogger Mike Moffatt posted his thoughts about the costs of reducing the murder rate by 30 percent through water treatment. The post was based on a Big Think article that studied correlations between higher lithium amounts in public drinking water and drops in suicides and violent crime rates.

Lithium, a mood-booster, is used as psychotropic treatment against bipolar disorder. The theory, in a nutshell, is that giving the public a little bit of lithium makes us all a little more mentally stable.

The idea’s met some outcry. Aside from the ethical issues surrounding mental health, the Big Think author notes that lithium is known to be more powerful than fluoride, with greater chances of side effects.

But lithium isn’t the only substance that can be added to public drinking water. Thiamine has been proposed as a means of eradicating Wernicke-Korsakoff syndrome among alcoholics. And the use of fluoride has repeatedly caused a stir.

After six decades of fluoride use in public water supplies, there is still little scientific consensus on the issue.

The U.S. Centers for Disease Control and Prevention listed fluoridation of drinking water among 10 great public health achievements of the last century. At a a price near one dollar per citizen each year, the U.S. surgeon general has lauded fluoridation for its cost-effectiveness. More than 65 percent of the population uses fluoridated water.

But WHO data shows little-to-no difference in oral hygiene between countries who chose whether to fluoridate public water. WHO only advocates fluoridation for countries with poor health infrastructure, and removal of fluoride from water sources with too much of the substance.

Most European countries, western and eastern, started fluoridating until the ’70s and ’90s, respectively. Some countries now fluoridate salt or even milk instead, and toothpaste with fluoride has been prevalent since the 1970’s.

This month, the U.S. government proposed lowering the amount of fluoride added to public water for the first time in almost 50 years over increasing rates of fluorosis among children.

Fluoridation gained prevalence in the Western world in the 1950s, decades after researches studied a lower rate of cavities in areas where water sources are naturally rich in fluoride. Under the red threat, paranoid Americans rallied against fluoridation, calling it a communist plot to undermine public health and brainwash the population. Some today even argue that fluoridation violates Nuremberg laws forbidding human experimentation.

Fluoridation has often been controversial in Canada. Anti-fluoridation activists often point to research claiming a correlation with everything from lower IQ scores to diminishing thyroid hormone levels. Communities across Canada debate fluoridation every few years, a trend that’s existed since fluoridaiton began in Canada.

In recent years, research on humans and rats has proposed a link between fluoride and childhood osteosarcoma in boys, a rare bone cancer that killed Terry Fox and often leads to amputations. The Canadian Cancer Society notes that these claims are heavily contested and require further study. Conflicting research suggests long-time exposure to fluoride may not increase the risk of osteosarcoma. When fluoride is ingested, half the substance is absorbed by the bones and accumulates over time.

In a November referendum in Waterloo, Ontario, 50.3 percent voted against continuing fluoridation. Last week, the Calgary Herald published an editorial calling for an end to fluoridation. The city is considering doing away with its aging fluoridation equipment, which would cost $6 million to replace.

A 2009 Health Canada report found that 43 percent of Canadians use fluoridated tap water. Water quality falls under provincial jursidiction and fluoride usage in Canada varies by region, with Ontario clocking in at almost 76 percent fluoridation, a number that drops to 6.4 percent in Quebec and 3.7 for British Columbians.

Health Canada recommends 0.7 parts per million fluoride to water, the same level now being proposed in the U.S. Toronto’s fluoride level was reduced from 1.2 p.p.m. to 0.8 p.p.m. In 1999, then to 0.6 p.p.m. in 2005.

[Creative Commons Water photograph by Flickr user visualpanic]

Despite numerous guilty verdicts, rogue milk farmer Michael Schmidt will not back down. He will not pay the $55,000 in fines, and he won’t cease selling his illegal product. “It will go to the next level,” he explains in his thick German accent. “Appeal Court, Supreme Court; I might as well go.”

If Schmidt seems unrepentant, it’s because he’s guilty: for years, he’s been distributing raw unpasteurized milk to 200 local families from his small Durham, Ont., farm in a quasi-legal cow-share operation, where customers literally buy the cow and get the milk for free. This violates the 1938 Milk Act, which made the selling of raw milk illegal in Canada (the only G8 country to do so). But with the new popularity of the green and organic movements, publicity and sales “going up a lot,” Schmidt is no longer flying under the radar.

The Ministry of Health immediately released a stern statement following a 2006 raid on Schmidt’s farm: “Make no mistake about it—drinking unpasteurized milk is not good for you.” Raw milk can carry salmonella, E. coli, and listeria, they say, citing 117 cases of enteric illness associated with unpasteurized dairy in Ontario since 2005. Disease-causing bacteria can cause many transmissible diseases, including “mild illnesses, long-lasting serious diseases, and even death.”

But for Schmidt’s customers, raw milk is a superior product being crushed by a monopolizing dairy lobby. They believe pasteurization—the process of blasting milk at 72°C for 15 seconds to kill bacteria—also eliminates healthy antibodies, natural enzymes, and vitamins. Advocates say it’s good for people with lactose intolerance, and can even calm symptoms of attention deficit disorder. Plus, it’s delicious: “It’s richer, sweeter, not so watery,” says Schmidt. “It’s what milk’s supposed to taste like.”

“He’s a great marketer,” says Bill Mitchell, spokesperson for the Dairy Farmers of Ontario. Mitchell has a 20-year history with the farmer, including Schmidt’s claim he was ignored when he offered to work with the dairy industry to produce safe raw milk. Despite what Schmidt wants you to think, says Mitchell, this is not a dairy industry issue, it’s a health issue: “A guy from an unlicensed farm selling unpasteurized milk in mason jars he washes by hand is an outbreak waiting to happen.”

For others still, whether raw milk is safe or not, it’s a basic human right for informed consumers to choose what they eat. “People should not think this is a milk issue,” says Schmidt. “It happened to be milk in my case, but the real problem is the government infringing on people’s rights.” Schmidt filed a challenge under the Canadian Charter of Rights and Freedoms in June.

Somewhere between every Canadian’s right to consumption and absolute prohibition is the only workable solution: an effective system of regulating raw milk (and its defiant producers like Schmidt, who will surely sell it anyway). For informed consumers who know its real risks—not just its lore of benefits—legal raw milk should be nothing to cry over.

With swine flu in the air, the Calgary Flames went to the front of the line. Are they the mythical "Second Tier"?

[Editor’s note: today we introduce “Body Politic,” a new blog column about medicine and public health, written by Lyndsie Bourgon. Visit her website or follow her on Twitter. Body Politic will appear every other Thursday.]

As the Calgary Flames hit the ice this weekend they appeared to show no great superpower, which is what I was hoping would happen when they got their H1N1 shots before the rest of us.

Both the Flames and Maple Leafs made the news for stepping ahead of the pregnant, young, old and needy for flu jabs recently, and in doing so they became unwilling examples of what could happen if a two-tiered health care system were adopted in Canada — that is, if it hasn’t been already.

As flu clinics were overwhelmed and shutting down in Calgary’s Brentwood community, the Flames and 100 of their closest associates and family members lined up for the shot separately. And it’s no surprise that it’s an Alberta team that was one of the first to get caught asking for a preferential care during a global pandemic.

Alberta’s health care policy plays an important role in the debate surrounding two-tiered health care in Canada. For years Albertan politicians have argued that the “third way” of health care could be the saving grace of a backed-up, overwhelmed medical system. What better way for the privileged to get the care they need than by paying for it? And those poor people can still receive their public option, too.

Officials fired the two top health care workers related to the case, and Ontario is “investigating” how players received the shot. But it was Alberta Liberal opposition leader David Swann who hit the real issue:

“It’s a failure of leadership that we are providing vaccines willy-nilly to whoever has money, to whoever has access, when cancer patients, when chronic lung patients, when pregnant women and their children can’t get it… It’s a violation of the basic principles of public health care.”

While it’s true that two-tier health care could theoretically relieve some strain on the health care system by lessening wait times and work loads at public facilities, the H1N1 vaccine debacle shows what’s likely to happen when the idea is exploited in Canada — during true medical emergencies, those with enough money will trump those who are in true need of treatment that cannot (or will not), for whatever reason, jump the line.

But who can blame them? What’s wrong with this scenario is not just that the Flames or the Leafs decided to hunt out the H1N1 shots for themselves. It’s the idea that players are somehow socially exempt from waiting in line with us common folk because they can pay for something more. It’s the same treatment that skips them to the front of months-long wait lists for MRIs and reconstructive surgeries.

Hockey might be our national pastime, but our players shouldn’t be treated like superheroes when it comes to the health system.