Racial disparities in access to U.S. community water systems: effects on children’s health

Abstract

BACKGROUND AND AIMS: Racial minority communities at the fringes of some U.S. cities and towns lack access to the regulated community water systems afforded to their non-minority neighbors. These communities rely on unregulated water sources that typically are not monitored or treated, leaving residents at risk of exposure to contaminants. This research assessed the effects of exclusion from municipal water service on children’s lead (Pb) exposure and of early-life Pb exposure from drinking water on teenage juvenile delinquency. METHODS: We linked blood Pb measurements for 59,483 children under age six to information about their drinking water sources, demographic characteristics, and household and neighborhood environmental variables. For 13,580 children who reached age 14 by the end of our study period, we also retrieved juvenile delinquency data. We examined associations between blood Pb and water source using a mixed-effects tobit regression model and the effects of Pb in drinking water on teenage juvenile delinquency risks using a two-stage, least-squares regression model. RESULTS: In the full data set, children relying on unregulated water sources had blood Pb levels that were 20% higher (p<0.001) than children with community water service. Further, this early-life increased Pb exposure was significantly associated with an increased risk of juvenile delinquency. Compared to children with community water service, those relying on private wells had a 21% (p<0.001) higher risk of being reported for any delinquency and a 38% ((p<0.001) increased risk of being reported for serious delinquency after age 14. CONCLUSIONS: Access to a regulated community water supply is associated with decreased exposure to Pb, compared to reliance on unregulated private sources, presumably due to the requirement that community supplies monitor for and control Pb. In turn, decreased Pb exposure is significantly associated with decreased juvenile delinquency. These results underscore the public health benefits of community water supplies. KEYWORDS: drinking water, lead, juvenile delinquency, children’s health