In‐Home Tap Water Consumption Trends Changed Among U.S. Children, but Not Adults, Between 2007 and 2016

Abstract

Despite evidence that tap water is often safer and cheaper than alternative sources, tap water is avoided when perceived to be unsafe. Therefore, we conducted the first nationally representative U.S. trends analysis of in‐home tap water avoidance between 2007 and 2016. We tested whether changes occurred during/after the Flint water crisis, and whether not drinking tap from one's main water source differed by age, race/ethnicity, and socioeconomic status across time. Finally, we tested whether tap water avoidance was associated with higher prevalence of bottled water consumption among children. We used data on 12,915 children and 23,139 adults from the National Health and Nutrition Examination Survey. Significant covariate‐adjusted quadratic time trends were found in the prevalence of avoiding tap water with an inflection at 2013–2014 for children, but not adults. Piecewise log‐binomial regressions estimated that between 2007 and 2014 each survey cycle was associated with 14% lower prevalence of not drinking tap water (prevalence ratio [PR] 0.86, 95% CI: 0.80–0.93), but in 2014–2016 a 53% (95% CI: 1.12–2.09) higher prevalence was found for children corresponding to the water crisis. Younger children, Hispanic, non‐Hispanic black, and those from low socioeconomic status backgrounds had consistently higher probability of avoiding tap water over time. Children who avoided tap water had 92% higher prevalence of drinking bottled water. In 2015–2016, 78% of non‐Hispanic black children who avoided tap water drank bottled water on a given day. Avoiding tap water may indicate underlying water insecurity in the United States. Efforts to address tap water distrust have critical health and economic implications.

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

“…It is critical to monitor trends in the lack of any tap water consumption beyond average mean intakes because this can provide a window into potential underlying water insecurity. Second, we also found that prevalence of any bottled water consumption on a given day was 25% higher in 2017-18 than 2013-14, supporting the recent trends of increasing bottled water intake in the US 12,27 .…”

“…We adjusted for the range 21 of the following covariates: age (2-5, 6-11, 12-19, 20-39, 40-59, 60+), sex, federal income to poverty ratio (FIPR; ratio of family income to the federal poverty guideline 22 : £130%, 131-350%, >350%), household reference educational attainment (for children/adolescents; high school graduate/GED equivalent and some college were released combined) and educational attainment (for adults), and whether respondents were born in the US or not 12,19 .…”

“…While previous work documented an increase in US children not drinking tap water in 2015-2016 12 during the Flint Water Crisis compared to prior years, it is critical to surveil this important health behavior as a way to monitor trust and usage of tap water. Therefore, we examined whether not drinking tap water in the US continued to increase in 2017-2018 by analyzing nationally-representative trends among children/adolescents and adults, and whether disparities in this behavior persisted by race/ethnicity.…”

Exposing the myths of household water insecurity in the global north: A critical review

“…Non‐whites consumed bottled water at higher rates, particularly within Latino communities (Hobson et al, 2007). In the United States, nationally representative data from 2007 to 2016 showed that after the Flint water crisis, tap water avoidance increased, especially among Hispanic and non‐Hispanic black populations, and households in lower socio‐economic classes (Rosinger & Young, 2020). It is also evident that the bottled water industry has relied on—and in many cases has actively fostered—diminished trust in municipal delivery systems (Doria, 2006), using slick marketing campaigns to promote bottled water as “pure” and more healthful that tap water (Pacheco‐Vega, 2019; Zenner, 2018).…”

Healthy beverage initiatives in higher education: an untapped strategy for health promotion

“…According to data from the National Health and Nutrition Examination Survey, rates of tap water avoidance are increasing, particularly following the Flint drinking water crisis which exposed Detroit residents to unsafe levels of lead, a potent neurotoxin (21,22) . While the majority of tap water in developed countries is regularly tested for safety by water suppliers, lead can still enter drinking water at the tap through lead-laced plumbing, solder or fixtures in older buildings.…”