Flanagan Sara V, Spayd Steven E, Procopio Nicholas A, Chillrud Steven N, Ross James, Braman Stuart, Zheng Yan
Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA; Graduate School of Public Health and Health Policy, City University of New York, 55 W 125th Street, New York, NY 10027, USA; New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA.
New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA.
Sci Total Environ. 2016 Aug 15;562:1010-1018. doi: 10.1016/j.scitotenv.2016.03.199. Epub 2016 Apr 30.
Arsenic, a toxic element naturally found in groundwater, is a public health concern for households drinking from wells. Private well water is not regulated to meet the federal drinking water arsenic Maximum Contaminant Level (MCL) of 10μg/L, or the more protective 5μg/L New Jersey (NJ) state MCL. In the absence of consistent private well regulation, public health efforts have relied on promoting testing in affected communities to various degrees of success. Few interventions publish results, and more often focus on the outcome of tested wells rather than who completed a test, and more importantly, who did not. Through our survey of randomly selected addresses (n=670) in 17 NJ towns we find higher rates of arsenic testing in areas with a history of testing promotion. However, we also see a stronger correlation of testing behavior with income and education in high promotion areas, suggesting that community engagement activities may be exacerbating socioeconomic status (SES) testing disparities. Well owners with a bachelor's degree had ten times greater odds of participating in our direct mail testing intervention than those with less education when tests cost $40. After all households (n=255) were offered free tests to overcome many of the usual testing barriers - awareness, convenience, and cost - only 47% participated and those who chose to return water samples were of higher income and education than those who did not. Our findings highlight that while efforts to promote and provide arsenic testing succeed in testing more wells, community testing interventions risk increasing SES disparities if those with more education and resources are more likely to take advantage of testing programs. Therefore, testing interventions can benefit by better targeting socially vulnerable populations in an effort to overcome SES-patterned self-selection when individuals are left alone with the responsibility of managing their drinking water quality.
砷是一种天然存在于地下水中的有毒元素，对于饮用井水的家庭来说，它是一个公共卫生问题。私人井水不受监管，无法达到联邦饮用水中砷的最大污染物水平（MCL）10μg/L，或更具保护性的新泽西州（NJ）州MCL 5μg/L。在缺乏统一的私人井水监管的情况下，公共卫生工作在不同程度上依赖于在受影响社区推广检测，但取得的成效各异。很少有干预措施公布结果，而且更多地关注检测过的水井的结果，而不是谁完成了检测，更重要的是，谁没有检测。通过对新泽西州17个城镇随机选择的地址（n = 670）进行调查，我们发现，在有检测推广历史的地区，砷检测率更高。然而，我们也看到，在高推广地区，检测行为与收入和教育的相关性更强，这表明社区参与活动可能会加剧社会经济地位（SES）检测差距。当检测费用为40美元时，拥有学士学位的水井所有者参与我们直接邮寄检测干预的几率是受教育程度较低者的十倍。在为所有家庭（n = 255）提供免费检测以克服许多常见的检测障碍——意识、便利性和成本——之后，只有47%的家庭参与了检测，选择返还水样的家庭比未参与的家庭收入和教育水平更高。我们的研究结果表明，虽然推广和提供砷检测的努力成功地检测了更多的水井，但如果教育程度和资源更多的人更有可能利用检测项目，社区检测干预就有可能加剧SES差距。因此，检测干预可以通过更好地针对社会弱势群体来受益，以克服当个人独自负责管理其饮用水质量时出现的SES模式的自我选择问题。
