“If Providers Had Recommended It, We Would Have Had It Tested”: Rural Mothers’ Perspectives on Barriers and Facilitators to Testing for Arsenic in Their Well Water


Arsenic in well water is associated with risk of cancer, cardiovascular disease, diabetes, and adverse pregnancy and childhood outcomes. More than 1 in 10 private water wells in New Hampshire contain arsenic concentrations exceeding the U.S. Environmental Protection Agency’s maximum contaminant level of 10 µg/L arsenic. In July 2019, New Hampshire became the second state in the country to reduce the maximum contaminant level for arsenic in public water to 5 ppb through the signing into law of HB 261. Testing is the only way to identify whether well water contains arsenic, as arsenic is odorless, colorless, and tasteless; however, private well water testing often does not occur as recommended. Therefore, we sought to determine perspectives of pregnant women about testing their well water. We conducted three focus groups with a total of 12 mothers of young children. Most knew of the need to test for radon and some talked about fluoride but they had not been aware of the need to regularly test for arsenic in well water. Most reported that their healthcare providers had not asked them whether they had tested their water for arsenic; however, the mothers reported that they thought the recommendation would have motivated them to pursue testing. Other barriers included cost and perception of testing as a complicated and time-consuming task. In conclusion, rural mothers of young children are willing to test for arsenic in their well water if their healthcare providers recommend it.


Speaker / Author: 
Anna M. Adachi-Mejia, PhD, Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice
Carolyn J. Murray, MPH, MD, Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice
Margaret R. Karagas, PhD, Geisel School of Medicine at Dartmouth
Month Year: 
October 2019
Page #: 
Publication Month: 
October 2019
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