title: Spatial relationships among dairy farms, drinking water quality, and maternal-child health outcomes in the San Joaquin Valley.
abstract: OBJECTIVE
  Access to clean and affordable water is a significant public health issue globally, in the United States, and in California where land is heavily used for agriculture and dairy operations. The purpose of this study was to explore the geographic relationships among dairy farms, nitrate levels in drinking water, low birth weight, and socioeconomic data at the ZIP code level in the San Joaquin Valley.
  
  
  METHODS
  This ecological study used a Geographic Information System (GIS) to explore and analyze secondary data.
  
  
  METHODS
  A total of 211 ZIP codes were analyzed using spatial autocorrelation and regression analysis methods in ArcGIS version 10.1.
  
  
  RESULTS
  ZIP codes with dairies had a higher percentage of Hispanic births (p = .001). Spatial statistics revealed that ZIP codes with more dairy farms and a higher dairy cow density had higher levels of nitrate contamination. No correlation was detected between LBW and unsafe nitrate levels at the ZIP code level.
  
  
  CONCLUSIONS
  Further research examining communities that use private and small community wells in the San Joaquin Valley should be conducted. Birth data from smaller geographic areas should be used to continue exploring the relationship between birth outcomes and nitrate contamination in drinking water.
authors.affiliation: Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, California.
authors.forename: Sarah Brown
authors.initials: SB
authors.lastname: Blake
mesh_terms: D000383:Agriculture / Q000706:statistics & numerical data*; D000818:Animals; D002140:California; D002417:Cattle; D060766:Drinking Water / Q000737:chemistry*; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D009566:Nitrates / Q000032:analysis*; D011247:Pregnancy; D012959:Socioeconomic Factors; D062206:Spatial Analysis; D060753:Water Quality
chemical_list: D060766:Drinking Water; D009566:Nitrates
keywords: dairy farms; drinking water; low birth weight; nitrate contamination