Trends and determinants of drinking water practices among North Carolina children.

Objectives: To identify trends and determinants of drinking water practices [bottled (BW) versus community water (CW) consumption] among families of pediatric patients presenting to an academic dental institution over 15 years.

Methods: Electronic health record data were obtained for all first-time routine-care patients ages 0-16 presenting to UNC-Chapel Hill's Pediatric Dentistry Clinics from 2002 to 2016, including families' primary drinking water source and patient demographics (e.g., age, gender, residence, insurance status). Data analyses included descriptive and bivariate methods and multivariable modeling using a P < 0.05 statistical significance criterion.

Results: BW consumption has increased over time, from 17 percent in 2004 to 42 percent in 2016 (n = 2,920; P < 0.05). Medicaid-enrolled children [prevalence ratio (PR) = 2.1; 95% confidence interval (CI) = 1.8-2.4] and residents of rural counties (PR = 1.3, 95% CI = 1.1-1.5) were significantly more likely to consume BW versus CW.

Conclusions: BW consumption among NC children has been increasing and is most prevalent among low-income families and in rural areas.