Reasons why low-income people in urban areas do not drink tap water.
BACKGROUND
Despite its higher cost and potential environmental effect compared with those of tap water, bottled water consumption has been increasing over the past decade, especially in low-income communities in which children are at a higher risk of developing caries.


METHODS
The authors used a systematic sequential sampling design for the Water Consumption Survey to collect information about water consumption beliefs and practices from clients attending 4 public health centers in Los Angeles County (LAC). The authors used health belief model constructs to examine why some low-income residents in LAC do not drink tap water.


RESULTS
From October through December 2013, 1,230 participants completed the Water Consumption Survey (86% response rate); the authors included 1,171 participants in the final analysis. Hispanic and African-American participants accounted for the largest proportions (38% and 37%, respectively). Overall, 48% of participants reported drinking tap water daily compared with 58% who reported drinking bottled water daily. The health belief model construct of perceived health risks (that is, perceived threats) significantly predicted why survey participants did not drink tap water. Other results revealed several misconceptions about tap water fluoridation and differences in beliefs about tap water safety according to income level.


CONCLUSIONS
Fluoridated tap water is a low-cost, ecologically friendly resource that provides health benefits seldom found in bottled water. However, mistrust about the quality and safety of tap water may make those in low-income communities more vulnerable to the effects of not receiving adequate fluoride and thus at higher risk of developing caries.


PRACTICAL IMPLICATIONS
Future interventions should encourage tap water use by dispelling misconceptions and educating low-income people in urban areas of LAC about the health benefits of fluoridated tap water and the safety of its sources. In addition, patient encounters could be an opportunity for pediatric dentists, general dentists, and other health care providers to reinforce the health benefits of tap water fluoridation and its use.
['Family|Leila|L|', 'Zheng|Guili|G|', 'Cabezas|Maritza|M|', 'Cloud|Jennifer|J|', 'Hsu|Shelly|S|', 'Rubin|Elizabeth|E|', 'Smith|Lisa V|LV|', 'Kuo|Tony|T|']
D002140:California D002648:Child D060766:Drinking Water D005457:Fluoridation D005459:Fluorides D006801:Humans D014881:Water Supply
bottled water Fluoridation drinking water patient education