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There are significant regulatory gaps that affect 43.5 million people in the U.S. who rely on groundwater from private water wells for their drinking water. Although some local environmental health agencies provide support to private water well owners, individual private water well owners must protect themselves. This study assessed the local practices of environmental health professionals in Kansas regarding private water wells. An 18-item survey was distributed to all 61 members of the Kansas Environmental Health Association in 2016. A 90% survey response rate was achieved. In local Kansas communities, sampling of private well water occurs most frequently as a result of a homeowner's request (57%) or at the time of a real estate transaction (54%). Nearly one third of respondents reported that their jurisdictions neither inspect wells nor sample well water. Most respondents indicated their organizations did not have the capability to analyze samples for common contaminants such as pesticides (76%) or volatile organic compounds (71%). In Kansas, there appears to be a lack of uniformity in inspection, sampling, and analysis practices and policies for private water wells. Additional research is needed to determine if these results are consistent across the U.S., Introduction Approximately 15% of U.S. households, which encompass 43.5 million people, rely on private water supplies (defined for this article as water wells that are not part of a public [...]

In 2009, groundwater contamination was discovered in a west Wichita neighborhood; the contamination was later attributed to the disposal of tetrachloroethylene (also called PERC or PCE) from dry cleaning facilities. Although the dry cleaning businesses were in operation for approximately 50 years, the extent of resident exposure to the contamination is unknown. Many residents in the affected area relied on nonpublic water wells for drinking, cooking, bathing, and irrigation. The residents were not aware that their wells had become contaminated by PERC at levels exceeding the Safe Drinking Water Act standard of 5 ppb. In 2014, the Kansas Department of Health and Environment connected these homes to the City of Wichita's public water system. In 2015, our team conducted focus groups with area residents to address any lingering needs and concerns. Participants reported general satisfaction with their homes' connectivity to city water. Participants reported poor communication, however, regarding the initial notification about the groundwater contamination in their neighborhood; most were notified through the media. This communication failure continued after their homes were connected to Wichita's public water supply. Participants shared many potential health concerns and requested that a health study be conducted of their neighborhood. Needs and concerns are ongoing among focus group participants, most of which could be addressed through regular communication with affected residents., Introduction Contaminants, such as volatile organic compounds (VOCs), are mobile in the environment and often are a source of groundwater contamination (U.S. Geological Survey, 2016). These compounds can migrate from [...]

A community-based participatory research process was used to develop an environmental initiative in Wichita, Kansas, called the Wichita Initiative to Renew the Environment (WIRE). The two-year project, led by University of Kansas School of Medicine-Wichita faculty and a community-based organization, was funded by the U.S. Environmental Protection Agency. The project aimed to identify, prioritize, and address Wichitans' environmental concerns by engaging the community to assist in developing the project design, establish a community-based environmental leadership council to guide the project, and identify and prioritize the community's environmental concerns based on impact and perceived urgency for action. The collaboration identified community priorities as: trash disposal, pollution in the Arkansas River and groundwater, and mobile source air pollution. Through WIRE, community members actively engaged and participated in identifying and prioritizing 19 environmental concerns most pertinent to the community, establishing an organization of 25 community members, and setting the stage for future projects to address those problems., Introduction Community-based participatory research (CBPR) can serve as a process to identify, prioritize, and address health or environmental concerns (O'Fallon & Dearry, 2002), and bridge gaps between communities and academics [...]

Background: Many nonpublic water well users unknowingly consume contaminated groundwater containing unsafe levels of pollutants. This has important implications for more than 13 million households in the United States that rely upon nonpublic water wells for drinking, cooking, and other household uses. Although public water quality is regulated through the Safe Drinking Water Act, there are no drinking water standards for nonpublic water well quality in Kansas, nor is there an adequate public health infrastructure in place to prevent or address potential exposures to contamination. OBJECTIVES: This project was conducted to identify promising action steps that would protect Kansans relying on nonpublic water wells for drinking, cooking, and other household purposes. METHODS: The project team consisted of public health, environmental health, and legal professionals with experience working on groundwater quality issues impacting nonpublic water wells in Kansas. From 2015 through 2018, the team established and convened an advisory group; reviewed relevant state statutes and regulations, all Kansas county environmental codes, and a representative sample of 23 city water well codes; conducted an extensive review of academic literature to identify best practices; conducted dozens of key informant interviews; proposed recommendations; engaged dozens of stakeholders through a survey of these proposed recommendations; and conducted interactive webinars to identify which organizations need to lead each of the recommendations. Discussion: The project team developed 18 recommendations. The recommendations are organized by survey respondents' perceptions of potential public health impact. There are very few standard practices in Kansas that ensure safe water for nonpublic household water wells. Although not all of the 18 recommendations may be applicable to other communities and states, many likely would be useful for governmental agencies, academic institutions, nonprofit organizations, and others to consider. These recommendations offer more protections for nonpublic household water well users than any resource we have found., Introduction Many nonpublic well water users are unknowingly consuming water contaminated with industrial solvents, pesticides, or other contaminants at levels that are unsafe. In a study conducted by the U.S. [...]

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a public nutritional assistance program for low-income women and their children up to age five. This study provides insight into maternal characteristics associated with breastfeeding among urban versus rural women. A secondary analysis was conducted using the Pregnancy Nutrition Surveillance System dataset of women enrolled in the Kansas WIC program in 2011. Geographic residency status was obtained through application of the Census tract-based rural-urban commuting area codes. Descriptive variables included maternal demographics, health, and lifestyle behaviors. A multivariable binary logistic regression was used to obtain adjusted odds ratios with 95 % confidence intervals. The outcome variable was initiation of breastfeeding. A P value of [less than or equal to]0.05 was considered statistically significant. The total sample size was 17,067 women. Statistically significant differences regarding socio-demographics, program participation, and health behaviors for urban and rural WIC participants were observed. About 74 % of all WIC mothers initiated breastfeeding. Urban women who were Hispanic, aged 18-19, high school graduates, household income >$10,000/year, and started early prenatal care were more likely to breastfeed. Urban and rural women who were non-Hispanic black with some high school education were less likely to breastfeed. Increased breastfeeding initiation rates are the result of a collaborative effort between WIC and community organizations. Availability of prenatal services to rural women is critical in the success of breastfeeding promotion. Findings help inform WIC program administrators and assist in enhancing breastfeeding services to the Kansas WIC population., Author(s): Lisette T. Jacobson[sup.1] , Philip Twumasi-Ankrah[sup.1] , Michelle L. Redmond[sup.1] , Elizabeth Ablah[sup.1] , Robert B. Hines[sup.1] , Judy Johnston[sup.1] , Tracie C. Collins[sup.1] Author Affiliations: (1) Department of [...]

The 2006 Centers for Disease Control recommendations for routine HIV screening in all health care settings could include dental clinics an important testing venue. However, little is known about patients' attitudes regarding the routine use of rapid oral HIV screening at an urban free dental clinic. This pilot study seeks to evaluate the patient perspective on rapid HIV screening in this setting. In June 2007, patients at a free dental clinic in Kansas City, Missouri, were provided an attitude assessment survey prior to their dental visit. This dental clinic serves a diverse patient population consisting of approximately 37% white, 47% black, 6% Hispanic, 4% Asian, and 1% Native American uninsured patients. Results were analyzed for acceptance of testing and potential barriers. Of the 150 respondents, 73% reported they would be willing to take a free rapid HIV screening test during their dental visit. Overall, 91% of Hispanics, 79% of Caucasians, and 73% of African American patients reported they would be willing to be screened. Patients with a history of multiple prior screening tests for HIV were more likely to agree to oral rapid HIV screening in the dental clinic. The majority (62%) reported that it did not matter who provided them with the screening result, although some (37%) preferred their dentist above any other provider. Low self-perception of risk (37%) and having already received screening elsewhere (24%) were the main reasons for not accepting a free, rapid HIV screening. Overall, dental clinic patients widely accepted the offer of rapid oral HIV screening. Rapid HIV screening in the dental clinic setting is a viable option to increase the number of individuals who know their HIV status.

Primary care is defined as a regular source of care characterised by continuity, comprehensiveness, co-ordination, availability and convenience (Donaldson et al 1996, Stewart et al 1997). Lack of such a [...]