Factors driving drinking water preferences among atlanta-area pediatric patients

Abstract Background . Global environmental pressures threaten water safety and security. Climate-driven extreme weather stresses water infrastructure and supply, including in US cities. Even when water sources are classified as safe, individuals, including those from historically marginalized communities, may distrust their in-home tap water. Consumption of bottled water further contributes to plastic waste and environmental harm. This pilot study aims to understand the drinking water preferences of patients at a safety net pediatric clinic in Atlanta, Georgia towards informing individual and systems-level water-related climate and health adaptation measures. Methods. Guardians of patients >28 days to <12 years were invited to participate during their child’s well visit. Participants were administered a survey on their family’s drinking water consumption preferences, the reasoning behind these choices, and their access to information on water safety. Descriptive statistics were used to analyze the results. Findings . Of 201 participants, 77% (155) drank only bottled water, 21% (42) drank tap and bottled water, and only 2% (4) drank exclusively tap water. The most selected reasons for exclusive bottled water consumption were: concern that tap is not clean or safe (74%, 114), taste (56%, 86), convenience (26%, 40), and water clarity (13%, 20). Sixty-seven percent of participants did not know how to access emergency alerts like boil water advisories. Conclusion . The overwhelming majority of families who obtain their healthcare at our clinic choose bottled water over tap water, and water safety concerns are the key factor driving this decision. Most patients lack access to real-time basic public health messaging on water advisories. These findings suggest an opportunity for clinicians to provide guidance on drinking-water in clinical encounters and for interdisciplinary partnerships to support clinicians in this climate adaptation measure.