Availability of water services and lower respiratory tract infection

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It should shock readers that in the United States the absence of “modern water service” (piped in home water, well water, or water delivered by a closed haul truck; plus septic removal by a municipal system, septic tank with drain field, or evacuation by a covered haul truck) could be analyzed for association with community rates of lower respiratory tract infection (LRI). Twenty-one of 108 selected communities evaluated in Alaska had less than 20% of homes connected to modern water services; more than 90% of residents in such communities were Alaska Natives. After controlling for crowding, unemployment, education, tobacco use, wood stove use and poverty, lack of modern water services was still associated with increased community rates of outpatient and inpatient care for children with LRI (mean inpatient LRI 20 per 100 child-years vs 8.5 per 100 child-years). Although the author cautions that safe and convenient clean water and sewage is unlikely to abolish disparities, they are a start and, seemingly, a basic right of our citizens.