Assessing policy decisions related to water distribution systems in Alaska Native villages

Providing access to potable water has been a cornerstone of public health efforts in Alaska Native villages since 1957. Water infrastructure policy in Alaska has focused on two distribution systems as alternatives to the collection and “self hauling” of water from nearby rivers or streams: small vehicle haul systems, which involve the regular delivery of potable water, and piped distribution. Piped systems have relatively high capital costs (paid by government) and low operational costs (paid by local villages) while small vehicle haul systems have relatively low capital costs and relatively high operational costs. There has been no formal evaluation of the public health implications of these water distribution systems.

We used the 2008 Alaska House Count Inventory to determine water distribution systems by household and village. We further collected data on knowledge, attitudes and practices relating to treated water use among those living in homes served by different distribution systems. Finally, we compared rates of water-related infections relevant to this population.

Small vehicle haul systems are being developed at the fastest rate in Native Alaskan villages. Water-related knowledge, attitudes and practices vary between households served by the different water distribution methods. Treated water use was highest among households served by piped water distribution systems. Households that use the most water tend to have the lowest rates of water-related infections.

Policy makers should consider how water distribution methods influence knowledge, attitudes and practices, as well as rates of water-related infections when determining support for future programs in Alaska Native villages.