The relationship between in-home water service and the risk of respiratory tract, skin, and gastrointestinal tract infections among rural Alaska natives

Am J Public Health. 2008 Nov;98(11):2072-8. doi: 10.2105/AJPH.2007.115618. Epub 2008 Apr 1.

Abstract

Objectives: We investigated the relationship between the presence of in-home piped water and wastewater services and hospitalization rates for respiratory tract, skin, and gastrointestinal tract infections in rural Alaska.

Methods: We determined in-home water service and hospitalizations for selected infectious diseases among Alaska Natives by region during 2000 to 2004. Within 1 region, infant respiratory hospitalizations and skin infections for all ages were compared by village-level water services.

Results: Regions with a lower proportion of home water service had significantly higher hospitalization rates for pneumonia and influenza (rate ratio [RR] = 2.5), skin or soft tissue infection (RR = 1.9), and respiratory syncytial virus (RR = 3.4 among those younger than 5 years) than did higher-service regions. Within 1 region, infants from villages with less than 10% of homes served had higher hospitalization rates for pneumonia (RR = 1.3) and respiratory syncytial virus (RR = 1.2) than did infants from villages with more than 80% served. Outpatient Staphylococcus aureus infections (RR = 5.1, all ages) and skin infection hospitalizations (RR = 2.7, all ages) were higher in low-service than in high-service villages.

Conclusions: Higher respiratory and skin infection rates were associated with a lack of in-home water service. This disparity should be addressed through sanitation infrastructure improvements.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alaska / epidemiology
  • Child
  • Child, Preschool
  • Gastrointestinal Diseases / epidemiology*
  • Gastrointestinal Diseases / ethnology
  • Gastrointestinal Diseases / microbiology
  • Health Status Disparities*
  • Hospitalization / statistics & numerical data
  • Housing / classification*
  • Humans
  • Indians, North American / statistics & numerical data*
  • Infant
  • Influenza, Human / epidemiology
  • Influenza, Human / ethnology
  • Inuits / statistics & numerical data*
  • Middle Aged
  • Pneumonia / epidemiology
  • Pneumonia / ethnology
  • Respiratory Syncytial Virus Infections / epidemiology
  • Respiratory Syncytial Virus Infections / ethnology
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / ethnology*
  • Risk Assessment
  • Rural Health / statistics & numerical data*
  • Skin Diseases, Infectious / epidemiology*
  • Skin Diseases, Infectious / ethnology
  • Water Supply*