Community-based Policies and Support for Free Drinking Water in U.S. Municipalities

Abstract

We examined community-level characteristics associated with free drinking water access policies in U.S. municipalities. This cross-sectional study used data from a nationally representative survey of city managers/officials from 2,029 local governments conducted in 2014. Outcome measures were four policies regarding free drinking water access. Explanatory measures were population size, rural/urban status, census region, poverty prevalence, education, and racial/ethnic composition. We used multivariable logistic regression to test differences. For community planning, 56.3% of local governments had at least one plan with a written objective to provide free drinking water in outdoor areas; municipalities in Northeast and South region and municipalities with 50% of non-Hispanic (NH) white were less likely to have a plan. For existing policies and funding, 59.2% had polices or budget provisions for free drinking water in parks and outdoor recreation areas. Municipalities in Northeast and South region were less likely to have such a policy or budget provision. For future community development, 9.3% provided incentives for placing drinking fountains in outdoor publicly accessible areas. For local building standards, 7.7% had a municipal plumbing code drinking fountain standard that differed from the statewide plumbing code; municipalities with lower proportion of NH whites were more likely to have it. Free drinking water in parks and outdoor recreation areas are supported by written plans, a policy or budget provision in over half of municipalities. Drinking water promotion through development incentives or a more robust municipal plumbing code was rare. Encouraging the consumption of water instead of sugary drinks is a strategy to improve healthier diets and reduce disease risk.