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DiSalvo RW, Hill EL. Drinking Water Contaminant Concentrations and Birth Outcomes. JOURNAL OF POLICY ANALYSIS AND MANAGEMENT : [THE JOURNAL OF THE ASSOCIATION FOR PUBLIC POLICY ANALYSIS AND MANAGEMENT] 2023; 43:368-399. [PMID: 38983462 PMCID: PMC11230651 DOI: 10.1002/pam.22558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Previous research in the US has found negative health effects of contamination when it triggers regulatory violations. An important question is whether levels of contamination that do not trigger a health-based violation impact health. We study the impact of drinking water contamination in community water systems on birth outcomes using drinking water sampling results data in Pennsylvania. We focus on the effects of water contamination for births not exposed to regulatory violations. Our most rigorous specification employs mother fixed effects and finds changing from the 10th to the 90th percentile of water contamination (among births not exposed to regulatory violations) increases low birth weight by 12% and preterm birth by 17%.
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Affiliation(s)
- Richard W DiSalvo
- Princeton School of Public and International Affairs, Princeton University
| | - Elaine L Hill
- Department of Public Health Sciences and Department of Economics, University of Rochester & NBER, 265 Crittenden Blvd., Box 420644, Rochester, NY
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Rosinger AY, Broyles LMT. Water Insecurity Is a Structural, Often Invisible Barrier to Healthy Beverage Patterns and Nutritious Diets. J Nutr 2023; 153:3153-3155. [PMID: 37777115 DOI: 10.1016/j.tjnut.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023] Open
Affiliation(s)
- Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States; Department of Anthropology, Pennsylvania State University, University Park, PA, United States.
| | - Lauren M T Broyles
- Population Research Institute, Pennsylvania State University, University Park, PA, United States
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Marion JW. Self-Reported Consumption of Bottled Water v. Tap Water in Appalachian and Non-Appalachian Kentucky. JOURNAL OF APPALACHIAN HEALTH 2023; 5:32-49. [PMID: 38022490 PMCID: PMC10629886 DOI: 10.13023/jah.0502.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Introduction Quantitative studies on drinking water perceptions in Appalachia are limited. High-profile water infrastructure failures in the U.S. and Eastern Kentucky, coupled with human-made and natural disasters in the Appalachian Region, have likely impacted opinions regarding tap water. Purpose To use existing unexplored data to describe baseline tap water v. bottled water consumption in Kentucky. Methods Telephone-based cross-sectional data were obtained from the 2013 Kentucky Health Issues Poll (KHIP) directed by the Foundation for a Healthy Kentucky. Among many items in KHIP, self-reported consumption of bottled water over tap water, reasons for bottled water use, and demographic data were obtained. Results Among Appalachian (n=356) and non-Appalachian (n=1,125) Kentucky respondents, a significantly higher frequency of Appalachian Kentuckians reported drinking bottled water more often than tap water relative to non-Appalachian Kentuckians (57% v. 34%; X2 p < 0.001). Appalachian residency significantly predicted bottled water consumption in simple and multivariable logistic regression adjusted for significant covariates (i.e., age, sex, and race). Among persons consuming bottled water more than tap water, Appalachian Kentuckians reported significantly more concerns regarding tap water taste or smell (p = 0.005) and safety (p = 0.008) than non-Appalachians. Implications These results from 2013 data pre-date headline news items related to public water and likely underestimate current bottled water preferences. New data are needed, and these results warrant further investigation into tap water aesthetics in Appalachia, bottled water consumption impacts on personal finances, and approaches to build public trust for public drinking water among multiple populations including Appalachian Kentuckians.
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Rosinger AY, Bethancourt HJ, Young SL. Tap Water Avoidance Is Associated with Lower Food Security in the United States: Evidence from NHANES 2005-2018. J Acad Nutr Diet 2023; 123:29-40.e3. [PMID: 35872245 PMCID: PMC10119945 DOI: 10.1016/j.jand.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/03/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Food insecurity has profound nutritional and public health consequences. Water insecurity may exacerbate food insecurity, yet little is known about the association between water and food insecurity in the United States or other high-income countries. OBJECTIVE This study aimed to estimate how tap water avoidance, a proxy of water insecurity, covaries with food insecurity; examine how the probability of food insecurity changed by tap water avoidance between 2005 and 2018; and test how the association between tap water avoidance and food insecurity differed across income and housing statuses. DESIGN This was a secondary analysis of the cross-sectional 2005-2018 National Health and Nutrition Examination Survey. PARTICIPANTS/SETTING Participants were 31,390 US adults 20 years and older. MAIN OUTCOME MEASURES The main outcome was food insecurity, using the US Food Security Survey Module. STATISTICAL ANALYSES Adjusted logistic regression models estimated how tap water avoidance was associated with the odds of food insecurity. Predicted probabilities of food insecurity over time and by income and housing status were plotted using marginal standardization. RESULTS Adults who avoided tap water had 21% higher odds (95% CI 1.09 to 1.34) of food insecurity compared with those who drank tap water. The probability of any food insecurity doubled between 2005-2006 and 2017-2018 and was consistently higher for tap water avoiders. Food insecurity decreased across both tap water drinkers and avoiders as income increased, but was higher among tap water avoiders at all income levels. Likewise, food insecurity was higher among renters than among homeowners but was higher among tap water avoiders in both housing groups. CONCLUSIONS Tap water avoidance is positively associated with food insecurity in the United States, and both insecurities have increased over time. Efforts to mitigate food insecurity should simultaneously address water insecurity issues, including tap water availability and quality, as these may be a modifiable contributors to food insecurity.
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Affiliation(s)
- Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA; Department of Anthropology, Pennsylvania State University, University Park, PA.
| | - Hilary J Bethancourt
- Department of Anthropology, Northwestern University, Evanston, IL; Institute for Policy Research, Northwestern University, Evanston IL
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, IL; Institute for Policy Research, Northwestern University, Evanston IL
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Rosinger AY. Using Water Intake Dietary Recall Data to Provide a Window into US Water Insecurity. J Nutr 2022; 152:1263-1273. [PMID: 35102375 PMCID: PMC9071280 DOI: 10.1093/jn/nxac017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/06/2021] [Accepted: 01/24/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In the United States, problems with the provision of safe, affordable water have resulted in an increasing number of adults who avoid their tap water, which could indicate underlying water insecurity. Dietary recalls provide critical nutritional surveillance data, yet have been underexplored as a water insecurity monitoring tool. OBJECTIVES This article aims to demonstrate how water intake variables from dietary recall data relate to and predict a key water insecurity proxy, that is, tap water avoidance. METHODS Using 2005-2018 NHANES data from 32,329 adults, I examine distributions and trends of mean intakes of total, plain (sum of tap and bottled water), tap, and bottled water, and percentage consuming no tap and exclusive bottled water. Second, I use multiple linear and logistic regressions to test how tap water avoidance relates to plain water intake and sugar-sweetened beverage (SSB) consumption. Next, I use receiver operating characteristics (ROC) curves to test the predictive accuracy of no plain water, no tap, and exclusive bottled water intake, and varying percentages of plain water consumed from tap water compared with tap water avoidance. RESULTS Trends indicate increasing plain water intake between 2005 and 2018, driven by increasing bottled water intake. In 2017-18, 51.4% of adults did not drink tap water on a given day, whereas 35.8% exclusively consumed bottled water. Adults who avoided their tap water consumed less tap and plain water, and significantly more bottled water and SSBs on a given day. No tap intake and categories of tap water intake produced 77% and 78% areas under the ROC curve in predicting tap water avoidance. CONCLUSIONS This study demonstrates that water intake variables from dietary recalls can be used to accurately predict tap water avoidance and provide a window into water insecurity. Growing reliance on bottled water could indicate increasing concerns about tap water.
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Young SL, Frongillo EA, Jamaluddine Z, Melgar-Quiñonez H, Pérez-Escamilla R, Ringler C, Rosinger AY. Perspective: The Importance of Water Security for Ensuring Food Security, Good Nutrition, and Well-being. Adv Nutr 2021; 12:1058-1073. [PMID: 33601407 PMCID: PMC8321834 DOI: 10.1093/advances/nmab003] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 12/21/2022] Open
Abstract
Water security is a powerful concept that is still in its early days in the field of nutrition. Given the prevalence and severity of water issues and the many interconnections between water and nutrition, we argue that water security deserves attention commensurate with its importance to human nutrition and health. To this end, we first give a brief introduction to water insecurity and discuss its conceptualization in terms of availability, access, use, and stability. We then lay out the empirical grounding for its assessment. Parallels to the food-security literature are drawn throughout, both because the concepts are analogous and food security is familiar to the nutrition community. Specifically, we review the evolution of scales to measure water and food security and compare select characteristics. We then review the burgeoning evidence for the causes and consequences of water insecurity and conclude with 4 recommendations: 1) collect more water-insecurity data (i.e., on prevalence, causes, consequences, and intervention impacts); 2) collect better data on water insecurity (i.e., measure it concurrently with food security and other nutritional indicators, measure intrahousehold variation, and establish baseline indicators of both water and nutrition before interventions are implemented); 3) consider food and water issues jointly in policy and practice (e.g., establish linkages and possibilities for joint interventions, recognize the environmental footprint of nutritional guidelines, strengthen the nutrition sensitivity of water-management practices, and use experience-based scales for improving governance and regulation across food and water systems); and 4) make findings easily available so that they can be used by the media, community organizations, and other scientists for advocacy and in governance (e.g., tracking progress towards development goals and holding implementers accountable). As recognition of the importance of water security grows, we hope that so too will the prioritization of water in nutrition research, funding, and policy.
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Affiliation(s)
- Sera L Young
- Department of Anthropology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Zeina Jamaluddine
- London School of Tropical Medicine and Hygiene, London, England
- American University of Beirut, Lebanon, Beirut
| | | | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Claudia Ringler
- Environment and Production Technology Division, International Food Policy Research Institute, Washington, DC, USA
| | - Asher Y Rosinger
- Department of Biobehavioral Health and Department of Anthropology, Pennsylvania State University, State College, PA, USA
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Becerril-Arreola R, Bucklin RE. Beverage bottle capacity, packaging efficiency, and the potential for plastic waste reduction. Sci Rep 2021; 11:3542. [PMID: 33633137 PMCID: PMC7907389 DOI: 10.1038/s41598-021-82983-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/25/2021] [Indexed: 11/09/2022] Open
Abstract
Plastic pollution is a pressing issue because authorities struggle to contain and process the enormous amount of waste produced. We study the potential for reducing plastic waste by examining the efficiency with which different polyethylene terephthalate (PET) bottles deliver beverages. We find that 80% of the variation in bottle weight is explained by bottle capacity, 16% by product category, and 1% by brand. Bottle weight is quadratic and convex function of capacity, which implies that medium capacity bottles are most efficient at delivering consumable product. Local data on PET bottle sales and municipal waste recovery validate the findings. A 20% shift in consumption from smaller to larger bottles could reduce the production of PET waste by over 10,000 t annually in the U.S. alone.
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Fortunato MS, González AJ, Tellechea MF, Reynoso MH, Vallejos F, Donaire AN, Korol SE, Gallego A. Evaluation of bottled water quality by determining nitrate concentration. JOURNAL OF WATER AND HEALTH 2020; 18:681-691. [PMID: 33095192 DOI: 10.2166/wh.2020.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The presence of nitrate in sources of drinking water is a matter of concern because of its potential risk for human health. In many countries like Argentina, an increasing proportion of the population chooses to consume bottled water, among other reasons, for lack of water access. The present study was conducted (a) to evaluate the quality of bottled waters by determining nitrate concentration, (b) to relate bottled water quality with water access, (c) to analyze public awareness about bottled water quality and consumption habits of the population in the urban area of Buenos Aires. Two locations were selected, Ciudad Autónoma de Buenos Aires (C.A.B.A.) and Malvinas Argentinas in Buenos Aires Province (PBA), with percentages of water access of 99.6% and 8.8%, respectively. Random samples from both locations (n = 100) were analyzed. A survey was conducted in order to inquire about perception of population on bottled water quality and their consumption habits. In C.A.B.A., no sample exceeded the 45 mg/L limit value in force in Argentina, while in Malvinas Argentinas, 34% of the brands analyzed showed values above it. The survey revealed that 71.7% of people consume bottled water. While people in C.A.B.A. do so mainly out of habit, safety is the priority in PBA.
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Affiliation(s)
- María Susana Fortunato
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Salud Pública e Higiene Ambiental, Junín 956 (1113), Ciudad Autónoma de Buenos Aires, Argentina E-mail:
| | - Ana Julieta González
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Salud Pública e Higiene Ambiental, Junín 956 (1113), Ciudad Autónoma de Buenos Aires, Argentina E-mail:
| | - María Florencia Tellechea
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Salud Pública e Higiene Ambiental, Junín 956 (1113), Ciudad Autónoma de Buenos Aires, Argentina E-mail:
| | - Mariano Humberto Reynoso
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Salud Pública e Higiene Ambiental, Junín 956 (1113), Ciudad Autónoma de Buenos Aires, Argentina E-mail:
| | - Favia Vallejos
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Salud Pública e Higiene Ambiental, Junín 956 (1113), Ciudad Autónoma de Buenos Aires, Argentina E-mail:
| | - Andrea Natalia Donaire
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Salud Pública e Higiene Ambiental, Junín 956 (1113), Ciudad Autónoma de Buenos Aires, Argentina E-mail:
| | - Sonia Edith Korol
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Salud Pública e Higiene Ambiental, Junín 956 (1113), Ciudad Autónoma de Buenos Aires, Argentina E-mail:
| | - Alfredo Gallego
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Salud Pública e Higiene Ambiental, Junín 956 (1113), Ciudad Autónoma de Buenos Aires, Argentina E-mail:
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