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Disparities in plain, tap and bottled water consumption among US adults: National Health and Nutrition Examination Survey (NHANES) 2007–2014

  • Asher Y Rosinger (a1) (a2) (a3) (a4), Kirsten A Herrick (a4), Amber Y Wutich (a5), Jonathan S Yoder (a6) and Cynthia L Ogden (a4)...

Differences in bottled v. tap water intake may provide insights into health disparities, like risk of dental caries and inadequate hydration. We examined differences in plain, tap and bottled water consumption among US adults by sociodemographic characteristics.


Cross-sectional analysis. We used 24 h dietary recall data to test differences in percentage consuming the water sources and mean intake between groups using Wald tests and multiple logistic and linear regression models.


National Health and Nutrition Examination Survey (NHANES), 2007–2014.


A nationally representative sample of 20 676 adults aged ≥20 years.


In 2011–2014, 81·4 (se 0·6) % of adults drank plain water (sum of tap and bottled), 55·2 (se 1·4) % drank tap water and 33·4 (se 1·4) % drank bottled water on a given day. Adjusting for covariates, non-Hispanic (NH) Black and Hispanic adults had 0·44 (95 % CI 0·37, 0·53) and 0·55 (95 % CI 0·45, 0·66) times the odds of consuming tap water, and consumed B=−330 (se 45) ml and B=−180 (se 45) ml less tap water than NH White adults, respectively. NH Black, Hispanic and adults born outside the fifty US states or Washington, DC had 2·20 (95 % CI 1·79, 2·69), 2·37 (95 % CI 1·91, 2·94) and 1·46 (95 % CI 1·19, 1·79) times the odds of consuming bottled water than their NH White and US-born counterparts. In 2007–2010, water filtration was associated with higher odds of drinking plain and tap water.


While most US adults consumed plain water, the source (i.e. tap or bottled) and amount differed by race/Hispanic origin, nativity status and education. Water filters may increase tap water consumption.

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1. Cutler, D & Miller, G (2005) The role of public health improvements in health advances: the twentieth-century United States. Demography 42, 122.
2. Hanna-Attisha, M, LaChance, J, Sadler, RC et al. (2015) Elevated blood lead levels in children associated with the Flint drinking water crisis: a spatial analysis of risk and public health response. Am J Public Health 106, 283290.
3. US Environmental Protection Agency (2017) Drinking Water Requirements for States and Public Water Systems. Washington, DC: US EPA.
4. Gleick, PH (2010) Bottled and Sold: The Story Behind Our Obsession with Bottled Water. Washington, DC: Island Press.
5. Maloney, J (2017) Soda loses its US crown: Americans now drink more bottled water. The Wall Street Journal, 9 March. (accessed January 2018).
6. Natural Resources Defense Council, Inc. (1999) Bottled Water. Pure Drink or Pure Hype? New York: NRDC.
7. VanDerslice, J (2011) Drinking water infrastructure and environmental disparities: evidence and methodological considerations. Am J Public Health 101, Suppl. 1, S109S114.
8. Drewnowski, A, Rehm, C & Constant, F (2013) Water and beverage consumption among adults in the United States: cross-sectional study using data from NHANES 2005–2010. BMC Public Health 13, 1068.
9. Eggers, M, Moore-Nall, A, Doyle, J et al. (2015) Potential health risks from uranium in home well water: an investigation by the Apsaalooke (Crow) Tribal Research Group. Geoscience 5, 6794.
10. Lalumandier, JA & Ayers, LW (2000) Fluoride and bacterial content of bottled water vs tap water. Arch Fam Med 9, 246250.
11. Victory, KR, Cabrera, NL, Larson, D et al. (2017) Comparison of fluoride levels in tap and bottled water and reported use of fluoride supplementation in a United States–Mexico border community. Front Public Health 5, 87.
12. Doria, MF (2006) Bottled water versus tap water: understanding consumers’ preferences. J Water Health 4, 271276.
13. Pierce, GS & Gonzalez, S (2017) Mistrust at the tap? Factors contributing to public drinking water (mis)perception across US households. Water Policy 19, 112.
14. Gibson, JM, DeFelice, N, Sebastian, D et al. (2014) Racial disparities in access to community water supply service in Wake County, North Carolina. Am J Public Health 104, e45.
15. Jepson, W (2014) Measuring ‘no-win’ waterscapes: experience-based scales and classification approaches to assess household water security in colonias on the US–Mexico border. Geoforum 51, 107120.
16. Viscusi, WK, Huber, J & Bell, J (2015) The private rationality of bottled water drinking. Contemp Econ Policy 33, 450467.
17. Patel, AI, Shapiro, DJ, Wang, YC et al. (2013) Sociodemographic characteristics and beverage intake of children who drink tap water. Am J Prev Med 45, 7582.
18. Kant, A, Graubard, B & Atchison, E (2009) Intakes of plain water, moisture in foods and beverages, and total water in the adult US population – nutritional, meal pattern, and body weight correlates: National Health and Nutrition Examination Surveys 1999–2006. Am J Clin Nutr 90, 655663.
19. Rosinger, A & Herrick, K (2016) Daily water intake among US men and women, 2009–2012. NCHS Data Brief issue 242, 18.
20. Pierce, G & Jimenez, S (2015) Unreliable water access in US mobile homes: evidence from the American Housing Survey. Housing Policy Debate 25, 739753.
21. Brooks, CJ, Gortmaker, SL, Long, MW et al. (2017) Racial/ethnic and socioeconomic disparities in hydration status among US adults and the role of tap water and other beverage intake. Am J Public Health 107, 13871394.
22. Dye, BA, Thornton-Evans, G, Li, X et al. (2015) Dental caries and tooth loss in adults in the United States, 2011–2012. NCHS Data Brief issue 197, 18.
23. National Center for Health Statistics (2015) National Health and Nutrition Examination Survey (NHANES): Questionnaires, Datasets, and Related Documentation. Hyattsville, MD: NCHS.
24. National Center for Health Statistics (2015) National Health and Nutrition Examination Survey (NHANES): MEC In-Person Dietary Interviewers Procedures Manual. Hyattsville, MD: NCHS.
25. National Center for Health Statistics (2015) National Health and Nutrition Examination Survey: NHANES Response Rates and CPS Totals. Hyattsville, MD: NCHS.
26. Moshfegh, AJ, Rhodes, DG, Baer, DJ et al. (2008) The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr 88, 324332.
27. US Department of Health and Human Services (2016) US Federal Poverty Guidelines. Washington, DC: DHHS.
28. Williams, BL & Florez, Y (2002) Do Mexican Americans perceive environmental issues differently than Caucasians: a study of cross-ethnic variation in perceptions related to water in Tucson. Environ Health Perspect 110, Suppl. 2, 303310.
29. Jain, M, Lim, Y, Arce-Nazario, JA et al. (2014) Perceptional and socio-demographic factors associated with household drinking water management strategies in rural Puerto Rico. PLoS One 9, e88059.
30. Merkel, L, Bicking, C & Sekhar, D (2012) Parents’ perceptions of water safety and quality. J Community Health 37, 195201.
31. de França Doria, M (2010) Factors influencing public perception of drinking water quality. Water Policy 12, 119.
32. Pape, AD & Seo, M (2015) Reports of water quality violations induce consumers to buy bottled water. Agric Resourc Econ Rev 44, 7893.
33. Balazs, CL & Ray, I (2014) The drinking water disparities framework: on the origins and persistence of inequities in exposure. Am J Public Health 104, 603611.
34. Balazs, C, Morello-Frosch, R, Hubbard, A et al. (2011) Social disparities in nitrate-contaminated drinking water in California’s San Joaquin Valley. Environ Health Perspect 119, 12721278.
35. Teodoro, MP, Haider, M & Switzer, D (2016) US environmental policy implementation on tribal lands: trust, neglect, and justice. Policy Stud J. Published online: 24 October 2016. doi: 10.1111/psj.12187.
36. Berck, P, Moe-Lange, J, Stevens, A et al. (2016) Measuring consumer responses to a bottled water tax policy. Am J Agric Econ 98, 981996.
37. McLaren, L, Patterson, S, Thawer, S et al. (2017) Exploring the short-term impact of community water fluoridation cessation on children’s dental caries: a natural experiment in Alberta, Canada. Public Health 146, 5664.
38. Johansson, L, Solvoll, K, Bjørneboe, GE et al. (1998) Under- and overreporting of energy intake related to weight status and lifestyle in a nationwide sample. Am J Clin Nutr 68, 266274.
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Public Health Nutrition
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