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Detecting community response to water quality violations using bottled water sales
Edited by Arun Agrawal, University of Michigan, Ann Arbor, MI, and approved August 28, 2019 (received for review March 28, 2019)

Significance
This study addresses a problem of national interest given that elevated levels of drinking-water contaminants affect communities across the United States. While violations of quality standards are tracked by the US EPA, it is unknown how communities respond and whether appropriate measures are taken to avoid exposure. Regulations that guide public notification of violations have not been updated in 2 decades, and there is no systematic approach for prioritizing assistance. Understanding the extent of community averting actions could improve public notification protocols and targeting of technical assistance from state regulators and public health agencies. We assess how averting behavior differs across violation types and community demographics. Such knowledge can improve public communication in order to reduce adverse health consequences.
Abstract
Drinking-water contaminants pose a risk to public health. When confronted with elevated levels of contaminants, individuals can take actions to reduce exposure. Yet, few studies address averting behavior due to impaired water, particularly in high-income countries. This is a problem of national interest, given that 9 million to 45 million people have been affected by water quality violations in each of the past 34 years. No national analysis has focused on the extent to which communities reduce exposure to contaminated drinking water. Here, we present an assessment that sheds light on how communities across the United States respond to violations of the Safe Drinking Water Act, using consumer purchases of bottled water. This study provides insight into how averting behavior differs across violation types and community demographics. We estimate the change in sales due to water quality violations, using a panel dataset of weekly sales and violation records in 2,151 counties from 2006 to 2015. Critical findings show that violations which pose an immediate health risk are associated with a 14% increase in bottled water sales. Generally, greater averting action is taken against contaminants that might pose a greater perceived health risk and that require more immediate public notification. Rural, low-income communities do not take significant averting action for elevated levels of nitrate, yet experience a higher prevalence of nitrate violations. Findings can inform improvements in public notification and targeting of technical assistance from state regulators and public health agencies in order to reduce community exposure to contaminants.
Footnotes
- ↵1To whom correspondence may be addressed. Email: maura.allaire{at}uci.edu.
Author contributions: M.A. and U.L. designed research; M.A. performed research; M.A., T.M., and S.Z. analyzed data; and M.A. wrote the paper.
The authors declare no conflict of interest.
This article is a PNAS Direct Submission.
Data deposition: Regression data associated with this research are available at Dataverse (https://dataverse.harvard.edu/dataverse/allaire).
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1905385116/-/DCSupplemental.
Published under the PNAS license.
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