Follow Our Blog: The Confluence
Tap water stands at the intersection of multiple issue areas including water resources, the environmental impacts of beverage choices, and infrastructure needs. Tap water is also a public health issue. COVID-19, for example, has elevated the need for tap water access for basic hygiene such as handwashing.
The University of California, Agriculture and Natural Resources Nutrition Policy Institute (NPI), coordinator of the National Drinking Water Alliance, puts a focus on plain water as a healthy replacement for sugar-sweetened beverages. These beverages are the largest single source of added sugars in the American diet, a top source of calories, and a risk factor for numerous chronic diseases. However, concerns about tap water safety and barriers to access present challenges to making water the beverage of choice.
Lorrene Ritchie and Christina Hecht of NPI are among the co-authors of “Drinking Water in the United States: Implications of Water Safety, Access, and Consumption,” a new paper published online in Annual Review of Nutrition. The authors use a socioecological lens – considering the complex web of individual, relationship, community, and societal factors – to review the dynamics of drinking water consumption. This socioecological framework elucidates myriad factors that bear on the ability to drink tap water, including disparities in safety, access, and consumption.
A brief review of the evidence comparing current trends in drinking water intake in the U.S. to requirements across age and racial/ethnic groups reveals that most people do not drink enough plain water. While fluids can come from a variety of sources, there are many benefits of choosing water over sugar-sweetened beverages. Primary among these are the health benefits. Consumption of sugar-sweetened beverages increases the risk of cardiovascular diseases, type 2 diabetes, fatty liver disease and other metabolic diseases, dental decay, certain cancers, and risk of mortality. In addition, water, especially tap water, is not only a healthy form of hydration but is affordable, has a smaller environmental footprint, and, often, is fluoridated to strengthen and protect tooth enamel.
However, to enable tap water consumption, U.S. tap water safety must be ensured. While most U.S. tap water meets federal and state standards, there are times and places where it does not. The paper makes policy recommendations to improve tap water safety in the U.S. For example, lead in drinking water remains a concern. As the authors note, “drinking water can represent 20% or more of an individual's total lead exposure” and the potential lead exposure for infants fed with formula made of powder reconstituted with tap water is a particular concern.
Regulatory mechanisms to reduce lead in drinking water include federal, such as the Lead and Copper Rule, and state, such as mandates for testing for lead in school or childcare tap water. Challenges to detecting and reducing lead in tap water range from the building-specific nature of lead in plumbing to the lack of consensus on an acceptable level of lead in drinking water. Strategies to reduce drinking water exposure to lead include, as examples, the San Francisco Public Utilities Commission program to provide no-charge home tap water lead testing for families in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC, a federal child nutrition program) and efforts in cities to remove and replace both the utility-owned and privately-owned portions of all lead service lines.
Crucially, the authors' advance the concept of “effective access” to drinking water, which includes not only physical elements but also strategies for drinking water education and promotion. They write: “Effective drinking water access is necessary to maximally promote consumption. Key components include safety and aesthetics of drinking water; characteristics, features, location, and placement of drinking water sources; upkeep and maintenance; availability of drinking vessels; and water-related education and promotion.”
Each of these components is reviewed with a discussion of strategies to achieve effective access across the lifecourse from pregnancy and infancy to older adulthood, focusing primarily on U.S. settings but including approaches from other countries. Recommendations for research, policies, and practices needed to ensure optimal water intake by all include protecting watersheds and sourcewater from contamination by industry, agriculture, and other human activities; enhancing oversight of public water systems; and supporting increased capacity among small and rural water systems.
It is also important to improve infrastructure from public water systems to taps; establish a health-based standard for lead from taps in homes, schools, and childcare facilities; issue U.S. Department of Agriculture (USDA) guidance for monitoring tap water safety and remediation in schools and childcare facilities that participate in federal nutrition programs; and disseminate best practices for school districts and childcare providers to resolve water quality issues. Furthermore, there is a need to counter misperceptions of tap water safety and place accurate information about water quality within a broader context of costs and relative risks so that consumers can make more informed beverage choices.
Access to appealing drinking water can be improved by strategies including requiring USDA monitoring of effective access to water in schools and childcare facilities that participate in federal nutrition programs (rather than simply the presence of a water dispenser); ensuring effective water access in all public settings (e.g., public buildings, parks) in addition to workplaces and restaurants; and reducing access to unhealthy beverages (e.g., sugar-sweetened beverages).
Finally, there is a need to emphasize drinking water in the Dietary Guidelines for Americans, including prominently featuring water on public-facing nutrition materials such as the MyPlate graphic, the ubiquitous nutrition-education tool in U.S. The new 2020-2025 Dietary Guidelines for Americans are currently in development. Enabling consumption of water – that is, making tap water safe, accessible, and appealing -- is an essential complement to work to discouraging consumption of sugar-sweetened beverages.
The review was published online in September 2020 by the journal Annual Review of Nutrition. Authors are Anisha Patel of Stanford Medicine Division of General Pediatrics, Christina Hecht and Lorrene Ritchie of University of California Nutrition Policy Institute, Angie Cradock of Harvard T.H. Chan School of Public Health, and Marc Edwards of Virginia Polytechnic Institute and State University. For more drinking water information and resources, visit the National Drinking Water Alliance, coordinated by the Nutrition Policy Institute.
Kristine Diekman is an artist, educator, and Professor of media at the California State University San Marcos School of Arts. Her digital media project, Run Dry, tells the story of the water crisis in California's San Joaquin Valley.
Could you provide an overview of the Run Dry project?
Run Dry is a story of small, rural California communities and their struggle to remain connected to the most precious resource—water. This digital media project combines short documentary films, personal stories, photographs, and data visualizations about water scarcity and contamination in the San Joaquin Valley. It asks, what does clean water bring us and why should we tell the story of its loss?
Without water, we cannot drink, bathe, cook, or clean. It is indispensable for empowerment, health, dignity, and economic security. Water is a human right, yet ten percent of the world's population, mostly in rural areas, lives without safe water. The personal stories in Run Dry investigate the significance of water and reveal the systems of power that govern its distribution. The project addresses how water is accessed, what systems govern water resources, how they have developed over decades, and how they impact human well-being today. Audiences learn specifically about how race, class, migration, water policy, climate, hydrology, and agricultural history combined to create the water crisis in the San Joaquin Valley.
What was your inspiration for the Run Dry project, and how did the project come to be?
I was inspired to connect people to a human understanding of the value of water and how scarce a resource it is. Run Dry was originally funded by the California Humanities Community Stories Grant, which supports projects that tell unheard stories of marginalized communities. In 2014 when the drought hit hard, I was compelled to collect the personal stories of people living without water, or with contaminated water, in the San Joaquin Valley. Media outlets had been focusing on these stories of hardship, and only a few sustained their reporting or connected water scarcity to larger issues. I wanted to make something comprehensive that also had community impact and empowered people living there.
I collaborated with the Community Water Center and Self-Help Enterprises in Visalia to identify individuals who wanted to share their stories. I also focused on success stories of communities connecting to neighboring water systems. I highlighted efforts to install water tanks to temporarily bring water into homes and the work of local water board members to improve community conditions. An animation I produced explaining groundwater contamination and scarcity is still being used by the Community Water Center.
This project spanned 2014-17. Since then, do you think the water shortage and contamination issues in the San Joaquin Valley have changed?
Since 2017, California has had some years with above-average rain and snowpack, but it is never completely free of drought. Climate change affects the snowpack, which previously provided reliable surface water that could be utilized over time. During 2011-15, little to no surface water was allocated to San Joaquin Valley farms from the State Water Project or the Central Valley Project.
Without surface water for irrigation, farmers pumped water from underground aquifers at greater and greater depths, some as deep at 2000 feet, which depleted shared groundwater. Private family wells that reach on average 100 to 200 feet began to run dry as the aquifer lowered below that of private domestic wells. Well drilling is very expensive and most rural residents could not afford to drill deeper wells. The State Groundwater Management Act (SGMA) was enacted to alleviate this through regional water regulation. But equitable solutions are still in the future as plans for water sustainability won't be fully implemented until 2040.
The project highlights how important it is to inform people about the personal impacts of water access. What do you hope people will take away from the stories in Run Dry?
When I show these videos to people, they are shocked. Viewers generally don't know a lot about the human impacts of water scarcity, even in their backyards. I found it sadly ironic that some scientists who viewed it – people that have the most in-depth information about water science, hydrology, climatology, and climate research – did not necessarily connect the importance of their work to the human condition. This is not their fault. The compartmentalization of knowledge and research, especially the divide between the arts, humanities, and the sciences leads to this disconnect. My hope is that the films help people feel personally connected to the issues through storytelling.
The public was also not aware of the threat of water scarcity due to drought. One of the messages is about water conservation, which everyone can do. Find out where your water comes from. Once you understand the complexities of water conveyance in California, you will be more likely to conserve what does reach your faucet. In the video This Happens to Real People, Mary Schaffer says, “Go to one of these areas that don't have no water and see how the people are having to live and what they are having to do to get by. You'll be more conscious with your water. Conserve that water, because we could run out. We are very close to being out again, and this time it will be everybody.” We need to work together as residents, policy makers, and scientists to make sure our water use is sustainable, not just now but into the future.
Watching these stories can lead to feeling a bit hopeless. How did gathering them impact you?
I have made several documentary and educational films that focus on telling the personal stories of struggle. These include films about gang prevention, pregnancy prevention, the legal system, and others. Each time I engage with an interview subject, I am deeply affected. My role as filmmaker is to facilitate the stories and be a witness. I provide time and space for someone to tell me about their life or community. As a filmmaker I often do not go into these projects with a deep knowledge of the subject. I let the experts and community members educate me.
With this project, I started to educate myself about water conveyance, water science, and water policy. It is truly a complex and unending story. I do think there is hope in mitigating water contamination. There are grassroots organizations, like the Community Water Center, that work tirelessly to facilitate community members speaking at hearings for policy change. They connect municipal systems, help to install water treatment facilities, and gather data to support their mission. Water sampling and monitoring is crucial, and the state is working towards compliance. As for drought and climate change, I believe that California will always have a tenuous relationship to water – either too much or too little. Do we spend on storage or environmental health? Agriculture or wildlife? Small rural communities or urban centers? I do hope that the State Groundwater Management Act will reflect true community need.
What are you working on now, and what are your plans for future projects?
I haven't truly finished Run Dry yet. There are two outstanding features. First is real-time GIS maps, which I will add to the Run Dry website. I want people to understand the relationship between climate change, water, socio-economics, agriculture, migration, and other factors. I hope that when people see this data visualized, they will understand how interlocked these factors are. Second, I promised to bring the project back to the San Joaquin Valley, where it originated. The public library system in Tulare County has agreed to house the project, show the films, and create a place for residents to provide feedback. Because of COVID-19, this project is temporarily suspended.
Educating young people about climate change is important, too. I am working across academic disciplines to create college curricula that helps students connect science to the human condition. A team of faculty from across CSU campuses in the sciences, social sciences, and humanities developed a proposal for an integrated, interdisciplinary, and experiential hydrosocial curriculum for students. Hydrosocial studies focus on how people, societies, institutions, technology, science, and geo-political interests interact synergistically to allocate, protect, and understand water's importance as a community resource. The curriculum is designed to address both social and environmental relationships we have with water in California from humanistic and scientific viewpoints, something I think is desperately needed.
As the climate heats up and droughts intensify, especially in the American Southwest, it's crucial that households reduce their water usage. Water districts urge their customers to save, but their messaging generally lacks rigorous evaluation of efficacy.
In a new paper, researchers from UC Santa Barbara reveal how a large-scale field experiment in messaging based on psychological science significantly reduced water consumption on the Central Coast of California.
The paper, “How managers can reduce household water use through communication: A field experiment,” in the Journal of Policy Analysis and Management, details how the researchers designed messaging based on the information-motivation-behavioral skills model (IMB) for single-family households.
Co-author Sarah Anderson, an associate professor of environmental politics in the Bren School of Environmental Science & Management, said the IMB model has been used successfully to modify behaviors in health care, especially in preventing the spread of HIV.
In short, the model posits that “individuals must have the requisite information, motivation, and behavioral skills to engage in and maintain behavior change,” according to a 2019 paper, also co-authored by Anderson, that analyzed 24 conservation studies that used aspects of the IMB model. “People need to know what the problem is, how they can solve it, and be motivated to take action.” That paper summarizing 24 other studies provided the impetus for the Central Coast experiment.
“Nearly every message water districts and researchers send to save water can be put into those three categories of information, motivation, or behavior,” said Anderson, who noted that while those efforts were being used, they weren't being evaluated in any kind of consistent way. “And so that led us to think, ‘Oh, it's worth trying to develop a rigorous test to evaluate messaging campaigns within this framework and see whether it appears that you need all three components or whether partial messages work.”
In the new study, the researchers randomly assigned 7,500 households to receive mailings featuring different aspects of the IMB model and measured their water use. A customer group of 2,500 households that did not receive messaging served as a control. All households that received messaging reduced water consumption — 509 gallons on average each — in the first month. As the paper notes, if all 10,000 households had been sent mailings, more than 5 million gallons would have been saved in the first month.
Researchers also found evidence that messaging using all parts of the IMB model could contribute to the savings lasting longer.
“If you include all the components of this information, motivation, and behavior,” Anderson said, “there's some indicative evidence that the effects might be a bit longer lasting. They're not necessarily bigger, but they might last a little longer, persist a little longer.”
She noted that the water district they worked with had been actively working to reduce water use with messaging and advice. So it was a pleasant surprise to find that sending another mailing further reduced water use, which she calls “promising.”
“That's a pretty cost-effective intervention if it actually works and lasts for a couple of months,” she said. “It's pretty cheap to send an effective mailer.”
Additionally, the study found that the messaging resulted in bigger reductions in high-water households. Anderson calls that “a good lesson for water districts, that those are the folks that you ought to message to if you've got a limited budget — really focus on those high water use households.”
Demonstrating the effectiveness of messaging has implications beyond reduced water usage. Not only does the study offer a kind of low-tech template for water districts, it could help protect the environment as water gets scarce in the face of climate change, Anderson said.
“Going forward,” she said, “water districts are going to be facing a choice between investing in expensive and environmentally disruptive infrastructure and just getting people to reduce their water usage. And so effective messaging has an additional dividend in not having to invest money to cause environmental destruction.”
This is a guest post from Jim Logan at UC Santa Barbara that was originally published at The Current.
Claudia Diaz Carrasco is a 4-H youth development advisor with UC Cooperative Extension in Riverside and San Bernardino counties who has expertise in developing water programs for diverse youth communities.
Can you tell us a little about yourself and your work as a 4-H advisor?
I was hired five years ago and, at the time, it was one of the few positions I saw focused on underserved communities. I'm originally from Mexico and becoming a 4-H youth development advisor gave me the opportunity to give back to my community by working with other 4-H professionals and the community itself to diversify the program locally. We are, for example, looking at how we can engage communities that might not know about 4-H but could benefit from the framework we use for developing leadership skills and life skills. In the counties that I serve – Riverside and San Bernardino – we're exploring how we can use this model for communities newly integrating into the U.S. These counties are a bit misunderstood because while we are close to Los Angeles, much of the area has traditionally been and continues to be rural. 4-H has had a strong presence here for a long time, but we've been working recently to extend the program to underserved youth. I have the privilege of being at the forefront in diversity, equity, and inclusion efforts with an organization that understands and provides space to explore and lead in those areas.
Can you tell us a little bit more about what 4-H is and how the program looks in Riverside and San Bernardino counties?
4-H is a national organization – in fact, it is international – and it looks different in every state and abroad. But the main goal is to use project-based learning to foster life skills and leadership development. In California, that traditionally looks like a community club, which could be as small as five kids from three different families that get together once a month to do projects they are interested in, whether it's raising farm animals or starting a community garden. Some kids like LEGO building, others are drawn to kitchen science or canning. They might be trained by their parents who are volunteering, or by advisors like me from the university that train community volunteers or staff from other institutions, and those adults meet with the kids on a regular basis. A lot of my work in 4-H has been about engaging diverse, underrepresented youth. When I started, I saw a challenge for parents who have two jobs or work evenings and therefore don't always have the capacity to do after school activities, which limits who can participate in 4-H. Unfortunately, we don't have the budget to hire personnel to deliver the program in the community. But, we do have the recognition of the university and that opens doors so we can meet people where they are. We're now making progress on having projects defined by communities rather than a set curriculum.
You developed a water-based youth program. Can you tell us how that program came to be and what it involves?
I stumbled into water. I had a small grant with the National Parks that was blending culture and environmental education. As part of the project, we visited historical and cultural markers along the Santa Ana River – the biggest watershed in southern California – where we also saw a lot of water pollution and invasive species. Immediately the kids were like, what can we do about this? We started coming up with service projects, and that caught the attention of the Disney Conservation Fund, which supported a project specifically about water. We began by working with high school students who were already passionate about the river, then they engaged younger kids in conservation as part of a team teaching model. We try to take the kids on a field trip when we have the funds, because that's a big part of what motivates the teenagers and it's life changing for the younger kids – we made a video to show how excited the kids are outside. That's the beauty of working with youth – this was not a project that I dreamt up from my office, it was really driven by their interests.
You have spoken about the importance of having culturally appropriate youth programming. What advice might you have for others?
I start by saying one size doesn't fit all. We tend to use cookie cutter approaches because they can easily be repeated. I instead ask people if they are sure they want to do culturally appropriate programming because not all organizations are ready for that work and can make things harder for themselves and communities. That's not a reflection of whether an organization or given researcher is good or bad, it's about the effort it takes. If they are ready, I begin by teaching what culture is – there are many ways to think about it, but the shortest definition is that culture is who we are. There are things that we see like food, skin color, parties, and music. And there are things that we don't see like values and beliefs. You have to get to know the culture – shop in the same places as the community, attend events there, just to get a feel of what community members experience day to day! We have to be responsive to what is happening locally and recognize when we are not part of the culture. I'm a Latina, I grew up in Mexico, so I've experienced both Mexican and Mexican American culture, but it's not the same as people who were born here. I often need a cultural broker, someone who has the trust of a community and can be a bridge. For example, people often think if we just translate information, that makes it culturally appropriate, but you have to go beyond translation to actual engagement. Develop with the community versus for them, that's the change in mentality it takes.
What is your favorite part of the work you do with youth on water issues?
I think it's the direct connection with the culture of science. For me, it's both a personal and a professional journey. I'm a scientist, an engineer, and I was trained to be a linear thinker, teaching was just point A to point B. But then I started working with social scientists and interviewing people in the community and I had to change how I thought. Youth programming tends to emphasize the model of short, middle, and long term outcomes related to knowledge gains and changes in beliefs and behaviors. But from my own upbringing, for example, I already had a good attitude about taking care of the environment, the belief that things like not letting the water run too long mattered. All it took for me to change my behavior even more was to spend six or eight hours cleaning the river with the kids and now I see every single drop of water as precious. I wish every Californian could afford this type of experience. I think organizations need to recognize that “affordable” includes not only no fees for access, but also transportation services, and even just having free time. Sometimes our communities don't have that luxury, and recognizing that is a great place to start!
Greg Pierce is the Associate Director of the Luskin Center for Innovation at UCLA and serves as a Senior Researcher, leading the Water, Environmental Equity, and Transportation programs.
Your research is centered on basic service provision, with a focus on water and transportation. Can you tell us a little more about your work?
I started out over a decade ago focusing broadly on basic service access in urban areas in low and middle-income countries. I'm a social scientist through and through, and I got into water and transportation somewhat by coincidence. Because I was concentrating on what individuals, households, and communities need in terms of basic services, water was a natural fit. As I've gone on in my career, I've seen that you can't look at things like water, other utilities, or transportation as single issues – a household that is dealing with water access is also likely to have a transportation access challenge.
My current research supports policies to advance California's legislative Human Right to Water, which defines high quality, affordable, and accessible water as a right. Those three tenets are pretty universal and my work, particularly with the State Water Resources Control Board (the Board), is focused on understanding deficits in those areas. I'm looking at efforts by local, regional, and state actors to address those deficits, as well as what households and communities do when those efforts are inevitably insufficient. In that vein, I've been working with the Board to develop a statewide drinking water affordability plan. We delivered a report to the state legislature in February, but implementation has been on pause because of COVID. I've also been working with the Board to support their work identifying where water systems and private wells fail to meet water quality standards, and coming up with solutions to inform the spending of the Safe and Affordable Drinking Water Fund authorized by Senate Bill 200.
Overall, water affordability is a big topic, and it's new enough that it doesn't have an entrenched definition. There are no state or federal support programs, and drinking water systems are super fragmented. That's true nationally and in California, where we have 3,000 community water systems. They all have different ways of setting rates, which allows for local control but leads to people paying vastly different amounts for the same quantity of water. Our research found a statewide approach that pools resources to offer more equal levels of affordability assistance makes a lot of sense.
You do policy-relevant research with a variety of organizations. What kinds of advice might you offer to researchers interested in doing the same?
There are many ways to inform policy and I certainly respect all of them. You can do “pure science” and if done well, it can by itself impact policy, but I think that's rare unless you work on communicating your results in a clear way. I've mostly been approaching it by working with agencies, sometimes under contract and sometimes independently. I also work with communities and organizations to provide information they can act on to influence policy. That's where I find an inherent tension between standard academic research and the stylized sense of going through a policy process. It's one thing to do a piece of research, and another thing to see a policy implemented, and yet another to see it be meaningful to the people that it impacts.
I say that, however, as someone privileged to be working in California where it's relatively easy to do policy-informed research related to environmental justice. Ultimately, I think what's clear is you can't just write a paper and send it to people and expect them to pay attention, you have to show up to their meetings and get to know them.
What do you see as some of the California water issues on the horizon?
In addition to the access issues I've talked about, small water system consolidation comes to mind. While most everyone is on board at this point, there are still many institutional and governance obstacles that end up in the weeds of local politics and history. Another more unique topic I've been working on is related to trust in urban water systems. There are communities in LA and the Bay Area where disadvantaged, minority-majority communities don't trust their water, yet the water quality isn't technically violating any regulatory standards. The mistrust is exacerbated by issues related to affordability, as well as broader disenfranchisement of people in low-income neighborhoods. We've identified the problems, now we're trying to work on solutions, but it's really not on the radar for most people.
The other issue I would raise is how to handle the fact that the cost of water must increase as we wean ourselves off imported, climate-insensitive water supplies. We have infrastructure to maintain and have to recognize there is no new low-cost water source coming. Therefore, we have to move toward more resilient local and regional supplies, which cost more than current supplies. I'm concerned that if we aren't proactive, we are going to wind up with a series of regressive, fixed charges on people's water bills to offset the absolutely necessary increased costs we're facing to make our local and regional supplies resilient.
What do you find most interesting when it comes to water-related research?
California as a state is relatively young. Our water infrastructure history is intricate and to do water policy well and address the underlying problems, you've got to know that history. I find arcane administrative and governance history fascinating. The way that some conversations, particularly around local water reliance, are looping back to discussions that predate settler colonial practices is necessary. At this point, we have to look back, recognize our mistakes, and think about how to adapt. Since the drought, I have seen an increase in public awareness around moving away from water imports, as well as on the Human Right to Water, so I see some room for optimism. The other thing is thing is I'm just a water nerd, so it's all pretty interesting.