title: Arsenic in private well water part 2 of 3: Who benefits the most from traditional testing promotion?
abstract: Arsenic, a toxic element naturally found in groundwater, is a public health concern for households drinking from wells. Private well water is not regulated to meet the federal drinking water arsenic Maximum Contaminant Level (MCL) of 10μg/L, or the more protective 5μg/L New Jersey (NJ) state MCL. In the absence of consistent private well regulation, public health efforts have relied on promoting testing in affected communities to various degrees of success. Few interventions publish results, and more often focus on the outcome of tested wells rather than who completed a test, and more importantly, who did not. Through our survey of randomly selected addresses (n=670) in 17 NJ towns we find higher rates of arsenic testing in areas with a history of testing promotion. However, we also see a stronger correlation of testing behavior with income and education in high promotion areas, suggesting that community engagement activities may be exacerbating socioeconomic status (SES) testing disparities. Well owners with a bachelor's degree had ten times greater odds of participating in our direct mail testing intervention than those with less education when tests cost $40. After all households (n=255) were offered free tests to overcome many of the usual testing barriers - awareness, convenience, and cost - only 47% participated and those who chose to return water samples were of higher income and education than those who did not. Our findings highlight that while efforts to promote and provide arsenic testing succeed in testing more wells, community testing interventions risk increasing SES disparities if those with more education and resources are more likely to take advantage of testing programs. Therefore, testing interventions can benefit by better targeting socially vulnerable populations in an effort to overcome SES-patterned self-selection when individuals are left alone with the responsibility of managing their drinking water quality.
authors.affiliation: Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA; Graduate School of Public Health and Health Policy, City University of New York, 55 W 125th Street, New York, NY 10027, USA; New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA. Electronic address: Flanagan@ldeo.columbia.edu.
authors.forename: Sara V
authors.initials: SV
authors.lastname: Flanagan
authors.affiliation: New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA. Electronic address: Steve.Spayd@dep.nj.gov.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Spayd
authors.affiliation: New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA. Electronic address: Nick.Procopio@dep.nj.gov.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Procopio
authors.affiliation: Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA. Electronic address: Chilli@ldeo.columbia.edu.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Chillrud
authors.affiliation: Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA. Electronic address: JRoss@ldeo.columbia.edu.
authors.forename: James
authors.initials: J
authors.lastname: Ross
authors.affiliation: Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA. Electronic address: SBraman@ldeo.columbia.edu.
authors.forename: Stuart
authors.initials: S
authors.lastname: Braman
authors.affiliation: Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA; Graduate School of Public Health and Health Policy, City University of New York, 55 W 125th Street, New York, NY 10027, USA; Queens College, City University of New York, 65-30 Kissena Blvd, Flushing, NY 11367, USA. Electronic address: YZheng@ldeo.columbia.edu.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zheng
mesh_terms: D001151:Arsenic / Q000032:analysis*; D004784:Environmental Monitoring / Q000379:methods* / Q000592:standards; D060587:Groundwater / Q000737:chemistry; D006801:Humans; D009515:New Jersey; D018570:Risk Assessment; D014874:Water Pollutants, Chemical / Q000032:analysis*; D014876:Water Pollution; D014881:Water Supply / Q000706:statistics & numerical data; D060986:Water Wells
chemical_list: D014874:Water Pollutants, Chemical; D001151:Arsenic
keywords: Arsenic; Drinking water; New Jersey; Private well; Socioeconomic status; Testing promotion