RE-ACT Podcast for April 2014

Disparities in Access to Public Water and Sewer Service in North Carolina

RE-Act Podcast-April 2014 by REACT_Podcast


Paul Halverson


Paul K. Halverson, Dr.P.H., M.H.S.A., FACHE
Professor and Founding Dean
Indiana University Richard M. Fairbanks School of Public Health



Dr. Jacqueline MacDonald Gibson

Jacqeline MacDonald Gibson, Ph.D., M.S.C.E.
Assistant Professor
Department of Environmental Sciences and Engineering
Gillings School of Global Public Health



Halverson: Hello and welcome to RE-ACT, the podcast supporting evidence-based practice for public health agencies. I am your host, Dr. Paul Halverson.

Today we are visiting with Dr. Jacqueline Macdonald Gibson who is the Associate Professor of Environmental Sciences and Engineering at the Gillings School of Public Health at the University of North Carolina Chapel Hill.  You are doing some incredible work that I think is important to all of us in practice and practice research.  Could you give us a thumbnail sketch of what you’re working on and what the preliminary findings are?

Gibson:  Sure, I am looking at disparities in access to municipal water and sewer services in North Carolina.  As you probably know, one of the greatest advances to public health really over the last 100 plus years has been extending municipal water and sanitation services to most communities. But, here in North Carolina we have communities that are located right on the fringes of towns and cities or sometimes there are donut holes within towns and cities that historically, due to discriminatory practices, were zoned out of municipal services. So, this project is trying to map out for the first time: where these communities are located, how many people are lacking municipal water and sewer services who really should have been provided with that service if it was not for the historic discriminatory practices, and what the public health risks might be.

Halverson:  What have you found so far?

Gibson:   We have looked very carefully one county in North Carolina, Wake County, which is the second largest county by population and home of the state capital Raleigh.  And we have found that race is actually a significant predictor of whether people near towns and cities actually have water and sewer services.  The higher the minority population in a census block, the higher the risk that people will be relying on private wells and septic systems which may be failing and not have access to treated municipal water and waste water disposal services. 

Halverson:  The implications of that for practice are fairly significant.  Do you intend to extend this research to other municipalities or jurisdictions in North Carolina?

Gibson:   Yes, we initially had hoped to do a statewide mapping, but we found where we’re able to do mapping is for counties where the tax records indicate who does and does not have water and sewer services.  So, we will be looking at more counties and we are very interested in getting this message out to public health practitioners because we believe they have a strong and important role to play in advocating for the extension of water and sewer services for these communities.

Halverson:  This could have a substantial impact on human health but also a substantial impact on budget for infrastructure and this is an important issue for all of us in practice it seems.  Will this methodology be widely available and do you imagine being able to conduct this kind of analysis on a state by state basis.

Gibson:   Yes we will. We are actually compiling the first systematic data set that looks at this issue in any state and we will make the data set available to other researchers as well as publish our methods for developing the data set and conducting the analysis so that other people can do these kinds of analyses and certainly this is a problem that exists in a lot of states in the southeastern United States.

Halverson:  Well, every study has limitations, do you have limitations in this study that are particularly unique or that would cause you concern about the generalizability of this research?

Gibson:   That’s a good question, One of the major limitations is our ability to get data on who does and doesn’t have water service.  Up until 1990, the US Census collected that kind of information and after the 1990 census they stopped asking that question.  So, as I mentioned we have been relying on tax data and for Wake County every tax parcel indicates whether there is municipal water and sewer service is provided but many counties do not have that kind of information. So, we may be limited in our ability to extend this analysis to other counties.  As far as the public health impact that is something we will be exploring in the future, we actually have plans to go out and sample well water in some of these communities and do septic system inspections, so we can’t definitively conclude yet whether there are public health risks due to these disparities.

Halverson:  It does provide an opportunity at least to know where to look perhaps because of this association that you’ve described.  Thank you so much for giving us a glimpse into your research.  I do believe that it is very important and frankly critical for us as we move forward.  Another excellent example of the importance of practice-based research.  I think you’ve done a great job of explaining some incredibly important and exciting research. Thank you Jackie for being with us and we appreciate the opportunity to learn of your research early as this unfolds.  Thank you so much.

Gibson:   Thank you.

Halverson:  Until next time, I’m Dr. Paul Halverson and this has been RE-ACT.