Lack of in-home piped water and reported consumption of sugar-sweetened beverages among adults in rural Alaska

Abstract

Objective:To assess whether a community water service is associated with the frequency of sugar-sweetened beverages (SSB) consumption, obesity, or perceived health status in rural Alaska.Design:We examined the cross-sectional associations between community water access and frequency of SSB consumption, body mass index categories, and perceived health status using data from the 2013 and 2015 Alaska Behavioral Risk Factor Surveillance System (BRFSS). Participants were categorized by zip code to ‘in-home piped water service’ or ‘no in-home piped water service’ based on water utility data. We evaluated the univariable and multivariable (adjusting for age, household income and education) associations between water service and outcomes using log-linear survey-weighted generalized linear models.Setting:Rural Alaska, USA.Subjects:Eight hundred and eighty-seven adults, aged 25 years and older.Results:In unadjusted models, participants without in-home water reported consuming SSB more often than participants with in-home water (1·46, 95 % CI: 1·06, 2·00). After adjustment for potential confounders, the effect decreased but remained borderline significant (1·29, 95 % CI: 1·00, 1·67). Obesity was not significantly associated with water service but self-reported poor health was higher in those communities without in-home water (1·63, 95 % CI: 1·05, 2·54).Conclusions:Not having access to in-home piped water could affect behaviours surrounding SSB consumption and general perception of health in rural Alaska.

Coping strategies for individual and household‐level water insecurity: A systematic review

“…Water and food insecurity are overlapping epidemics (Krumdieck et al, 2016;Workman & Ureksoy, 2017;Wutich & Brewis, 2014), with many studies highlighting the trade-offs that households routinely make between purchasing water at the expense of other domestic expenditures such as food (Collins et al, 2019;Mason, 2014;Pelto & Armar-Klemesu, 2015). Consuming less nutritious food to cope with water insecurity can lead to undernutrition, particularly in children (Schuster et al, 2020;Workman & Ureksoy, 2017;Zolnikov, 2014), whereas consuming sugar-sweetened beverages to meet hydration needs (Javidi & Pierce, 2018;Mosites et al, 2020;Rosinger, Bethancourt, & Francis, 2019) can lead to over-nutrition, dental carries, and increased risk of chronic diseases, such as diabetes (Imamura et al, 2015). On the other hand, reliance on food sources for adequate water intake may also reflect a buffering strategy against gastrointestinal illnesses that could arise from consuming contaminated water (Rosinger & Tanner, 2015).…”

“…While there is growing research on the syndemic nature of food and water insecurity (Brewis et al, 2019;Collins et al, 2019;Maxfield, 2020;Pelto & Armar-Klemesu, 2015;Workman & Ureksoy, 2017;Wutich & Brewis, 2014), more work is needed to understand the causal nature of this relationship. Specifically, the impacts of water insecurity-related coping strategies on nutrition (e.g., consuming sugar-sweetened beverages to replace water, choosing foods based on water needed to prepare them) should be explored further (Javidi & Pierce, 2018;Mosites et al, 2020;Rosinger et al, 2019). The consequences of these coping strategies for individual and household health and wellbeing also need to be better quantified.…”

“…For one, water insecurity manifests in ways beyond scarcity and unreliable supply, such as poor water quality and excess (e.g., chronic or catastrophic flooding). Second, water insecurity does not only affect households and individuals in low‐income countries; indeed, there is a rapidly expanding literature on water insecurity in middle‐ and high‐income contexts (e.g., Eichelberger, 2016; Eichelberger, 2019; Javidi & Pierce, 2018; Jepson, 2014; Mosites et al, 2020; Ranganathan & Balazs, 2015; Sohns, Ford, Robinson, & Adamowski, 2019; Stillo & MacDonald Gibson, 2016; Thomas, Hickel, & Heavener, 2016; White, Murphy, & Spence, 2012). Finally, a more multidisciplinary understanding of water insecurity experiences is necessary to identify a wide range of context‐specific coping strategies.…”

Participatory Modeling of Water Vulnerability in Remote Alaskan Households Using Causal Loop Diagrams

“…Stakeholders described how increased water access therefore decreases the incidence of dental and medical complications, such as insulin resistance, diabetes, and obesity from sugary drinks. A recent study found that not having access to in-home piped water has a borderline significant effect on behaviors surrounding sugarsweetened beverage consumption and general perception of health in rural Alaska (Mosites et al, 2020).…”

Building adaptive capacity in a changing Arctic by use of technology

“…Access to high-quality education is also an issue because retaining qualified teachers in rural Alaska and Nunavut is a challenge (Goldsmith 2010, Kaden et al 2016, Rodon and Lévesque 2018. Furthermore, health in some regions is negatively affected by the lack of piped water and sewer services in rural Alaska, resulting in poor oral hygiene and higher rates of infectious diseases (Thomas et al 2016, Mosites et al 2020. Arctic communities commonly have poor water treatment systems that make them vulnerable to heavy rainfall and rapid snowmelt, which can contaminate surface water and increase the likelihood of waterborne diseases (Harper et al 2020).…”