Examining Recent Trends in the Racial Disparity Gap in Tap Water Consumption: NHANES 2011–2018

Abstract

Objective. As tap water distrust has grown in the US with greater distrust among Black and Hispanic households, we aimed to examine the most recent trends in not drinking tap water including the period covering the US Flint Water Crisis and racial/ethnic disparities in these trends. Design, Setting, and Participants. We analyzed data from the cross-sectional National Health and Nutrition Examination Survey data (2011-2018) for 9,439 children aged 2-19 and 17,268 adults. Log-binomial regressions and marginal predicted probabilities examined US nationally-representative trends in tap water consumption overall and by race/ethnicity. Results. Among US children and adults, respectively, in 2017-2018 there was a 63% (adjusted prevalence ratio [PR]:1.63, 95% CI: 1.25-2.12, p<0.001) and 40% (PR:1.40, 95% CI: 1.16-1.69, p=0.001) higher prevalence of not drinking tap water compared to 2013-2014 (pre-Flint Water Crisis). For Black children and adults, the probability of not drinking tap water increased significantly from 18.1% (95% CI: 13.4-22.8) and 24.6% (95% CI: 20.7-28.4) in 2013-14 to 29.3% (95% CI: 23.5-35.1) and 34.5% (95% CI: 29.4-39.6) in 2017-2018. Among Hispanic children and adults, not drinking tap water increased significantly from 24.5% (95% CI: 19.4-29.6) and 27.1% (95% CI: 23.0-31.2) in 2013-14 to 39.7% (95% CI: 32.7-46.8) and 38.1% (95% CI: 33.0-43.1) in 2017-2018. No increases were observed among white children and adults. Conclusions. Approximately 20% of US children and adults did not drink tap water post-Flint Water Crisis in 2017-2018. Black and Hispanics' probability of not drinking tap water continued to increase compared to whites.