# Potential Lead Risk and Water Consumption Behavior in the Chicago Area: A Coordinated Oral Health Promotion (CO-OP) Study Analysis

## TL;DR

This study explores why many Chicago families avoid tap water, finding that younger parents are more likely to avoid it despite low lead risk in their area.

## Contribution

The study identifies demographic and perception-based factors influencing tap water avoidance in Chicago, independent of actual lead risk.

## Key findings

- 65% of caregivers report their child never drinks tap water.
- Younger parents (<30 years) are more likely to avoid tap water (OR = 1.89).
- Tap water avoidance is not aligned with actual lead risk estimates.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Water consumption patterns in the United States have changed in the last several decades, with many people now choosing to purchase bottled water instead of drinking municipal water.

Water consumption patterns in the United States have changed in the last several decades, with many people now choosing to purchase bottled water instead of drinking municipal water.

Public health significance—Why is this work of significance to public health?
Because of the cost and other risks associated with bottled water, it is important to determine how much of water consumption patterns are driven by actual risk versus perceived risk and personal preferences.

Because of the cost and other risks associated with bottled water, it is important to determine how much of water consumption patterns are driven by actual risk versus perceived risk and personal preferences.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
A greater understanding of decision-making regarding drinking water sources is needed to better support individuals and families in their choice of drinking water.

A greater understanding of decision-making regarding drinking water sources is needed to better support individuals and families in their choice of drinking water.

Municipally provided water is low-cost, considered safe in most communities, and usually fluoridated to improve oral health. Yet, many Chicago region families report relying on other water sources. We investigated if safety and quality concerns were associated with these decisions; we also investigated whether there were spatial trends related to lead risk associated with water choice preferences. We used self-reported water consumption behavior data from the Coordinated Oral Health Promotion (CO-OP) Study, a longitudinal cohort of young children and their families. Respondents’ residences (N = 331) were geolocated at the census tract level. We evaluated associations between parent demographics, estimated lead risk and water preferences. Among those who “Never” gave their children tap water, we investigated demographic characteristics associated with viewing tap water as “Not safe”. Sixty-five percent (n = 216) of caregivers report that their child “Never” drinks tap water. Ordinal logistic regression indicates that parents aged <30 years are more likely to respond “Never” relative to “Sometimes” or “Always” (OR = 1.89; CI = 1.04, 3.40). Among those in the “Never” category, we grouped reasons into safety concerns (n = 114), observed quality concerns (n = 48), and preference (n = 40). We found that the decision not to give children municipal water is not aligned with the estimated lead risk. Understanding water consumption choice mechanisms is important for communities seeking safe and quality drinking water.