Disparities in well water outreach and assistance offered by local health departments: A North Carolina case study

Abstract

Drinking water supplied by private wells is a national concern that would benefit from improved outreach and support to ensure safe drinking water quality. In North Carolina (NC), local health departments (LHDs) have private well programs that enforce statewide well construction standards, offer water testing services, and provide well water outreach and assistance. Programs were evaluated to determine their capacity and capability for well water outreach and assistance and identify differences among programs. All LHDs reported overseeing the construction of new wells as required by law. However, services provided to existing well users were offered infrequently and/or inconsistently offered. Lack of uniformity was observed in the number of LHD staff and their assigned responsibilities; the costs and availability of well water testing; and the comfort of LHD staff communicating with well owners. While the total number of staff was lower in LHDs in rural counties, the number of outreach activities and services offered was typically not related to the number of well users served. Variations in structure and capacity of well programs at LHDs have created unequal access to services and information for well users in NC. This research underscores the need to examine infrastructure that supports the well water community on a national scale.