Abstract
Abstract Over half of U.S. adults visit parks regularly. Thus, it is important to understand how park drinking water sources affect visitors’ water consumption. In this cross-sectional study of 30 San Francisco Bay Area parks, 4 day-long direct observations of visitors’ drinking water and other beverages were conducted, along with audits of sugar-sweetened beverage access and drinking water source conditions, including flow, appeal, and obstructions. Outcomes were log-transformed to account for skewness, and results were analyzed using mixed-effects regression models to account for matching and clustering by park and observation day. A greater proportion of water sources in low-income parks were unappealing (57.14 vs. 25.00%, P = 0.01) or in a poor condition (69.70 vs. 43.24%, P = 0.03). A lower proportion of visitors drank water from park fountains that were unappealing (−31%), had poor flow (−22%), or had obstructions (−58%) than those without these conditions. Although only obstructions to the source and water intake were significantly related after adjustment, we observed important effects on water intake by water source appeal and flow. As park water source conditions contribute to water intake, cities should consider installing appealing, functional, and easy to access water sources in parks, particularly those in lower-income neighborhoods.
Highlights
Sugar-sweetened beverages (SSBs) are the largest contributor of added sugar and a major dietary calorie source (Reedy & Krebs-Smith 2010; Bailey et al 2018)
The SF Health Improvement Partnership (SFHIP) found that low-income Latino, African American, and Asian Pacific Islander (API) San Franciscans had limited access to clean tap water in public spaces and that this was a barrier in substituting SSBs with tap water
While the demographics of residents in San Francisco (SF) study park neighborhoods were representative of the city as a whole, demographics of Oakland study park neighborhoods had a higher proportion of API and a lower proportion of African American and Latino residents as compared with Oakland overall
Summary
Sugar-sweetened beverages (SSBs) are the largest contributor of added sugar and a major dietary calorie source (Reedy & Krebs-Smith 2010; Bailey et al 2018). A lack of access to safe, affordable tap water and mistrust of its safety contribute to lower tap water intake among African Americans and Latinos compared with other groups (Gorelick et al 2011; Drewnowski et al 2013). These disparities in tap water intake lead to increased spending on bottled drinks that may displace other essential purchases (Gorelick et al 2011; VanDerslice 2011; Brooks et al 2017). Individuals who consume bottled water may be deprived of fluoride in tap water, which can prevent dental caries (Centers for Disease Control and Prevention 2001)
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