Access to safe water in sufficient quantities is essential for drinking, cooking, sanitation and hygiene. This essential service is recognized as a basic health need by the World Health Organization and improving access is one of the key Sustainable Development Goals tracked by the United Nations. Despite substantial progress, Alaska ranks last among US States in the percentage of homes with water and sewer service. Many published studies in Alaska have shown that persons of all ages who live without adequate access to water and sewer services have higher rates of infectious diseases, including respiratory infections such as pneumonia, skin infections such as boils, invasive bacterial infections such as meningitis and infectious diarrhea. Improving access to in-home water/sewer services has been shown to reduce rates of these infections in rural Alaska.
Sources:World Health Organization’s materials on water and sanitation serviceshttps://www.who.int/water_sanitation_health/en/Sustainable Development Goal #6: “access to adequate and equitable sanitation and hygiene for all”https://www.un.org/development/desa/disabilities/envision2030-goal6.htmlScientific publications on water and sanitation and health in Alaskahttps://dec.alaska.gov/water/water-sewer-challenge/resources/health-running-water/
In rural Alaska, community-wide piped systems and vehicle haul systems are increasingly expensive to construct, maintain and replace. Many communities cannot afford the high operation and maintenance costs associated with piped or haul systems. Current funding is not adequate to serve remaining homes or to make the improvements required for healthy living. New technologies and engineering approaches are needed to achieve the goal of water and sanitation service for all homes. A 2018 GAO report on drinking water and wastewater infrastructure found that “Indian Health Service’s process for selecting projects can discourage funding some projects that address the most severe sanitation deficiencies, especially those with a relatively high cost per home. As a result, some projects to serve homes without water infrastructure can remain unfunded for many years.”
Much of the water and sanitation infrastructure in rural Alaska needs major repair or replacement. This need, and the lack of access to in-home services, has created conditions of water insecurity and scarcity in some communities. Some systems are at the end of their expected engineered lifespan, whereas others are threatened by a combination of factors such as permafrost thaw, erosion and flooding. These are expected to worsen with climate warming and will increase costs. Maintaining and supporting community capacity to operate and maintain systems is an ongoing challenge.
Sources:Living in utility scarcity: energy and water insecurity in Northwest Alaska. Eichelberger LP, Am J Public Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866609/Climate change damages to Alaska public infrastructure and the economics of proactive adaptation. Proceedings of the National Academy of Sciences https://www.pnas.org/content/early/2016/12/20/16110561134th National Climate Assessment, Alaska Chapter. https://nca2018.globalchange.gov/chapter/26/
Fluoride is one of the top 10 public health achievements of the 20th century according to the CDC. It is supported by the American Dental Association, the World Health Organization and other national and international health associations. The US Community Preventative Services Task Force lists water fluoridation as and evidence based practice to reduce dental decay.
Collecting and sharing information about the efficacy and costs savings associated with fluoridation is detailed by the Association of State and Territorial Dentists as an evidence-based best practice.
Sources:Association of State & Territorial Dentists – Best Practices Project Section IV, # 4 https://www.astdd.org/bestpractices/BPAFluoridation.pdf
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