Using Environmental Surveillance to Increase Access to Water in Schools

Introduction:  Availability of free, unsweetened drinking water during the school day, particularly at lunch, has been recommended by the Institute of Medicine, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics. In Cleveland, Ohio, access to drinking water has been advocated as a nutrition strategy in the Healthy Cleveland Resolution signed into action by Mayor Frank Jackson in 2011.

Methods: As part of a larger food environment surveillance study, trained research assistants conducted a lunch period observations in 2012 in K-8 schools of the Cleveland Metropolitan School District, which serves over 38,000 students. They recorded any form unsweetened water available free-of-charge in the dining or serving areas, including water fountains, pitchers, bottles, dispenser, or some other way.

Results:  Of the 67 K-8 schools observed, 37 (55%) had water available at no cost during lunch. Of those, 35 had water fountains in the dining area, and 2 had water dispensers. These data were presented to the Healthy Cleveland Nutrition Committee, a multi-sector partnership organized by the Cleveland Department of Public Health. In response, the Committee adopted ‘water access in schools’ as a priority for nutrition-related policy-level interventions in both schools and other venues where children spend time (e.g., recreation centers). Additionally, the Committee prioritized indicators of water access for future surveillance to examine the impact of water access policies on school buildings and recreation centers.

Discussion: Environmental surveillance can be used to both foster and evaluate policy that can promote good nutrition and reduce obesity trends.