Exposure to contaminated drinking water and health disparities in North Carolina

Objectives. To examine drinking water quality in majority Black periurban neighborhoods in Wake County, North Carolina, that are excluded from nearby municipal water service and to estimate the health benefits of extending water service. Methods. We tested 3 samples collected July through December 2014 in 57 private wells for microbial contaminants. We compared contaminant prevalences to those in adjacent community water systems (35 280 samples from routine monitoring). Using a population intervention model, we assessed the number of annual emergency department visits for acute gastrointestinal illness that is preventable by extending water services to the 3799 residents of these periurban communities. Results. Overall, 29.2% of 171 private well samples tested positive for total coliform bacteria and 6.43% for Escherichia coli, compared with 0.556% and 0.00850% of municipal system samples. An estimated 22% of 114 annual emergency department visits for acute gastrointestinal illness could be prevented by extending community water service. Conclusions. Predominantly Black periurban neighborhoods excluded from municipal water service have poorer quality drinking water than do adjacent neighborhoods with municipal services. These disparities increase the risk of emergency department visits for acute gastrointestinal illness.