Lack of in-home piped water and reported consumption of sugar-sweetened beverages among adults in rural Alaska

Public Health Nutr. 2020 Apr;23(5):861-868. doi: 10.1017/S1368980019002477. Epub 2019 Sep 24.


Objective: To assess whether a community water service is associated with the frequency of sugar-sweetened beverages (SSB) consumption, obesity, or perceived health status in rural Alaska.

Design: We examined the cross-sectional associations between community water access and frequency of SSB consumption, body mass index categories, and perceived health status using data from the 2013 and 2015 Alaska Behavioral Risk Factor Surveillance System (BRFSS). Participants were categorized by zip code to 'in-home piped water service' or 'no in-home piped water service' based on water utility data. We evaluated the univariable and multivariable (adjusting for age, household income and education) associations between water service and outcomes using log-linear survey-weighted generalized linear models.

Setting: Rural Alaska, USA.

Subjects: Eight hundred and eighty-seven adults, aged 25 years and older.

Results: In unadjusted models, participants without in-home water reported consuming SSB more often than participants with in-home water (1·46, 95 % CI: 1·06, 2·00). After adjustment for potential confounders, the effect decreased but remained borderline significant (1·29, 95 % CI: 1·00, 1·67). Obesity was not significantly associated with water service but self-reported poor health was higher in those communities without in-home water (1·63, 95 % CI: 1·05, 2·54).

Conclusions: Not having access to in-home piped water could affect behaviours surrounding SSB consumption and general perception of health in rural Alaska.

Keywords: Arctic; Rural health; Sugar-sweetened beverage; Water.

MeSH terms

  • Adult
  • Aged
  • Alaska / epidemiology
  • Body Mass Index
  • Cross-Sectional Studies
  • Dietary Sugars / administration & dosage
  • Dietary Sugars / adverse effects
  • Feeding Behavior*
  • Female
  • Health Status
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Obesity / epidemiology*
  • Risk Factors
  • Rural Population / statistics & numerical data*
  • Sugar-Sweetened Beverages / adverse effects
  • Sugar-Sweetened Beverages / statistics & numerical data*
  • Water
  • Water Supply / statistics & numerical data*


  • Dietary Sugars
  • Water