IADR Abstract Archives
Disparities in Consumption of Community Systems Drinking Water: 2005–2014 NHANES
Objectives: Community water fluoridation ranks among the 10 great public health achievements of the 20th century. In order to effectively protect against dental caries, people need to consume the water. We sought to determine socio-demographic variation in consumption of community systems water in the U.S. population.
Methods: Cross-sectional data were analyzed for a nationally representative sample of 42,140 participants aged ≥2 years in the 2005–2014 National Health and Nutrition Examination Survey. Interviewers administered a 24-hour dietary recall interview that asked about the participant’s source of the tap water and a response of “community supply” was used to create the binary classification of drinking community systems water. Binary logistic regression for survey samples was used to estimate odds ratios as measures of association between drinking community systems water and sociodemographic characteristics.
Results: Overall, 68.1% of the US population aged ≥2 years reported drinking community systems water. Sociodemographic variation was greatest for race/ethnicity (ranging from 57.9% for Mexican-Hispanics to 69.7% for non-Hispanic Whites, P<0.001) and for head-of-household education (ranging from 54.3% for less than 9th grade to 77.9% for college degree or higher, P<0.001). In a multivariable model that adjusted for age, gender, race/ethnicity, nativity status, education and income, there was a monotonic reduction in odds of drinking community systems water across successively lower levels of education (for those with less than 9th grade, odds ratio=0.4, 95% confidence limits=0.3,0.5, relative to college degree or higher) while variation among race/ethnic groups was not statistically significant.
Conclusions: There was a strong, positive gradient between educational attainment and drinking community systems water. Adjustment for the confounding effect of education nullified disparities among racial/ethnic groups that were seen in univariate analysis. These findings suggest that increased education could ameliorate racial/ethnic disparities in consumption of tap water from community water systems in the United States.
Methods: Cross-sectional data were analyzed for a nationally representative sample of 42,140 participants aged ≥2 years in the 2005–2014 National Health and Nutrition Examination Survey. Interviewers administered a 24-hour dietary recall interview that asked about the participant’s source of the tap water and a response of “community supply” was used to create the binary classification of drinking community systems water. Binary logistic regression for survey samples was used to estimate odds ratios as measures of association between drinking community systems water and sociodemographic characteristics.
Results: Overall, 68.1% of the US population aged ≥2 years reported drinking community systems water. Sociodemographic variation was greatest for race/ethnicity (ranging from 57.9% for Mexican-Hispanics to 69.7% for non-Hispanic Whites, P<0.001) and for head-of-household education (ranging from 54.3% for less than 9th grade to 77.9% for college degree or higher, P<0.001). In a multivariable model that adjusted for age, gender, race/ethnicity, nativity status, education and income, there was a monotonic reduction in odds of drinking community systems water across successively lower levels of education (for those with less than 9th grade, odds ratio=0.4, 95% confidence limits=0.3,0.5, relative to college degree or higher) while variation among race/ethnic groups was not statistically significant.
Conclusions: There was a strong, positive gradient between educational attainment and drinking community systems water. Adjustment for the confounding effect of education nullified disparities among racial/ethnic groups that were seen in univariate analysis. These findings suggest that increased education could ameliorate racial/ethnic disparities in consumption of tap water from community water systems in the United States.