Risk perceptions of drinking bottled vs. tap water in a low-income community on the US-Mexico Border

Abstract

Background Previous studies have shown that low-income Latinos generally drink bottled water over tap water and might be at increased risks for cavities from unfluoridated bottled water. In order to better design interventions, it is important to understand the risk perceptions of this unique high-risk yet historically marginalized group. Methods We interviewed low-income Latino households (n = 90) from Nogales, Arizona who primarily drink bottled water and asked them to evaluate potential health risks of drinking tap water compared to 16 other voluntary activities. Unpaired t-tests were used to determine if statistically significant (α = 0.05) differences occurred in perceived risk by drinking-water source and differences among demographic groups in their level of (dis)agreement with statements regarding tap or bottled water safety. To assess significant differences (α = 0.05) in perceived risks and voluntariness to engage in a number of activities, including drinking local tap water and drinking water in different geographic regions, a one-way analysis of variance (ANOVA) followed by Scheffe’s post-hoc test (a conservative post-hoc test) with adjustment for the number of pairwise comparisons was used. Results Participants viewed bottled water to be significantly safer to consume than tap water (p < 0.001). On a Likert scale from 1 (low risk) to 5 (high risk), “drinking tap water in Nogales, Arizona” received an average score of 4.7, which was significantly higher than the average perceived risk of drinking San Francisco, California tap water (µ = 3.4, p < 0.001), and as risky as drinking and driving (µ = 4.8, p = 1.00) and drinking Nogales, Sonora, Mexico tap water (µ = 4.8, p = 1.00). Ninety-eight percent of participants feared that drinking local tap water could result in illness, 79% did not drink their water because of fear of microbial and chemical contamination and 73% would drink their water if they knew it was safe regardless of taste. Conclusions These results suggest that fear of illness from tap-water consumption is an important contributing factor to increased bottled water use. Future efforts should focus on the development of educational and outreach efforts to assess the safety and risks associated with tap-water consumption.

Measured and Modeled Comparisons of Chemical and Microbial Contaminants in Tap and Bottled Water in a US–Mexico Border Community

“…One of the key factors that will affect public health interventions in this community is understanding the reasons for the lack of trust in the quality of local tap water and working toward the restoration of trust. Risk perceptions of drinking local tap water have been characterized by the population of interest in this study . Similar studies that investigate tap and bottled water quality and risk perceptions that drive drinking water choice should be conducted in other rural and/or marginalized communities as contaminants and historical trust issues may be different in hopes of achieving water justice for these populations.…”

“…MCHC is a federally qualified health center and the major provider of medical, dental, and preventive care in Santa Cruz County. Together with MCHC, we designed a follow-up study to understand the differences between municipal tap water and the drinking/cooking water that these low-income families purchased, along with gathering more information regarding their risk perceptions and fluoride supplementation. , …”

“…Together with MCHC, we designed a follow-up study to understand the differences between municipal tap water and the drinking/cooking water that these low-income families purchased, along with gathering more information regarding their risk perceptions and fluoride supplementation. 3,38 Promotoras (community health workers) from MCHC helped us recruit families and conduct the surveys in the homes, while research staff collected the samples. All participants were provided results via mail in English and Spanish from both the bottled water and tap water samples obtained in their homes.…”

“…Understanding tap versus bottled water quality can be especially important in communities with historic tap water quality challenges. In the US–Mexico Border region, there is high bottled water consumption among some communities and concerns regarding both chemical and microbial risks that likely drive drinking water behaviors . The preference for bottled over tap water comes at a high economic cost, where bottled water can be 100–1000 times more expensive than tap water, , and this can be especially impactful on low-income marginalized communities, such as those in the US–Mexico Border.…”

“…The preference for bottled over tap water comes at a high economic cost, where bottled water can be 100–1000 times more expensive than tap water, , and this can be especially impactful on low-income marginalized communities, such as those in the US–Mexico Border. The preference for bottled over tap water may be driven by a lack of trust due to previous tap water quality issues and concern that this may be associated with the high prevalence of lupus and multiple myeloma. − One municipality, in particular, Nogales, Arizona, is a region with high bottled water consumption and potential tap water contamination. − A chemical contaminant specific to this area is trichloroethylene (TCE) where industrial solvents contaminate the groundwater. There is evidence of the community’s exposure, including the detection of TCE in the breast milk of nursing mothers …”