AUTHOR=Alzahrani Fahad , Alhussain Khalid 

TITLE=Health implications of safe drinking water act violations: a county-level analysis

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1588338

DOI=10.3389/fpubh.2025.1588338

ISSN=2296-2565

ABSTRACT=Health-based drinking water violations impact millions of Americans each year. This study examines the relationship between 13 measures of drinking water quality, related to health-based violations of the Safe Drinking Water Act, and three self-reported health outcomes (general, physical, and mental health). Analyzing cross-sectional data from 3,100 counties in the United States using regression analysis, we found statistically significant relationships between health-based violations and all self-reported health outcomes. Specifically, counties with more health-based violations reported a higher percentage of people with fair or poor health, and more physically and mentally unhealthy days. Our findings indicate that a single health-based violation in an average county incurs yearly medical costs of approximately $3.48 million for physical health and $4.85 million for mental health. These results highlight the need for policymakers and health professionals to prioritize interventions that address these violations, particularly in vulnerable communities, to mitigate their long-term health impacts.