Saturday, May 8, 2010

Making The Safe Drinking Water Act More Effective – Brad Frithsen

In the 1970s public attention and support was behind a string of legislative initiatives aimed at cleaning up the environment. In 1974, one of these initiatives led to the passage of the Safe Drinking Water Act (SDWA). The SDWA was created to ensure the health of citizens was maintained by enforcing public water systems to comply with strict guidelines around the cleanliness of public water (24). Proponents of the bill realized the danger that was posed to the public health by the contaminants that could enter the public drinking water system through various sources including the improper disposal of chemicals, use of pesticides, and animal wastes among others (24).
On its surface, the mechanics of the SDWA appear to be fairly robust. Penalties for non-adherence to the SDWA are high; up to $25,000 per day for non-compliance (29) and the measures for meeting the SDWA are quite extensive (26). To ensure that the letter of the law is met, the Environmental Protection Agency (EPA) grants State governments the power to enforce the mandates of the SDWA and to make them even stronger (29). The SDWA also requires that municipalities inform the public of the safety of its drinking water by sending out water quality report cards on an annual basis (27).
Yet despite this law and the mechanisms in place to ensure enforcement, millions of illnesses occur each year that can be linked to water contaminants (4). Research conducted by the New York Times found that 40% of the nation’s water systems violated the SDWA at least one time in 2008. The effects of these infractions range from that of gastrointestinal illness to exposure to potentially deadly levels of toxins such as lead, arsenic, manganese, and barium that could contribute to cancer (5). Many of these violations occur with government knowledge and have no level of punishment enforced (4). There is also reason to believe that the SDWA doesn’t even come close to monitoring all of the potentially toxic substances in our drinking water. Currently only 91 contaminants are regulated by the SDWA even though according to the EPA, more than 60,000 chemicals are used within the United States (6). Hundreds of these chemicals have been linked with cancer and found in the public water supply (6) but because they do not fall within the law are considered legal.
Simply having legislation in place does not guarantee that it will be effective as a public health intervention. Public health legislation cannot remain static but rather has to change as new information becomes available that leaves the original bill lacking in its intentions. The SDWA was signed in 1974 and has only been amended twice (1986 and 1996) even though a large body of research has become available since then suggesting that the bill must be strengthened in order to secure clean water to the public. Public health advocates, in this case EPA officials, have to create public support so that the SDWA is strengthened in order to ensure that the law’s intentions are met. This paper will review why EPA officials have been unable to strengthen the SDWA and develop an intervention strategy to counter these critiques.

Critique 1: Reframe The Argument

The EPA has allowed opponents of efforts to strengthen the SDWA to frame the argument in their favor. Major opponents of amendments aimed at strengthening the SDWA have been from industry advocates. These groups have been able to frame the issue so that increased enforcement or amendment of the SDWA would equate to having an adverse impact on the core values of the public. There are several arguments from industry leaders against restructuring the law but this critique will focus on the argument of strengthening the SDWA by including the practice of hydraulic fracturing in its regulatory framework.
In 2005 the Energy Policy Act exempted hydraulic fracturing from the SDWA (12). Hydraulic fracturing, or fracking, is a method of reaching a reservoir of oil or gas by injecting liquid into a rock formation causing a crack to form. Oil or gas can then be extracted from the well created by the crack (20). Many of the fracturing fluids contain chemicals that can be toxic to humans (7) and advocates for clean drinking water oppose the use of fracking in gas and oil exploration because of the potential contamination of Underground Source of Drinking Water (USDW and regulated under the SDWA as of 1996). In June 2009 the Fracturing Responsibility and Awareness of Chemicals Act (FRAC) bill was introduced with the intention to eliminate the hydraulic fracturing exemption created by the 2005 law (11). This proposal was met with immediate consternation from the oil and natural gas industries. Their argument was that strengthening the SDWA would weaken American businesses, increase costs to consumers, and lower the disposable incomes of Americans (8,14, 19). Reframing the argument in this way sways public support towards the industry’s side and weakens the EPA’s ability to argue for strengthening the measure.
Reframing the argument has been deployed in the attempt to block various bills that had the intention of improving public health. The tobacco industry attempted to frame itself as an agent that was looking out for the public while painting anti-tobacco advocates as “zealots, health fascists, paternalists, and government interventionists” (22).
Legislation to lower the legal blood-alcohol limits has run into opposition groups that have framed the argument so that passing such legislation will have an adverse effect on the core values of ordinary citizens. When New Jersey tried to lower the legal blood-alcohol limit to 0.08% from 0.10% it was met with opposition from the New Jersey Restaurant Association. The association’s argued that such legislation will take away their consumer’s freedom to enjoy a couple of drinks with dinner (10). A 1997 Restaurants & Institutions publication argued that legislation to adopt a 0.08% Blood Alcohol Content level would effect the bottom line of businesses and essentially made someone who had a couple of social drinks into a common criminal (2).
This tactic was also successfully used to block the Clinton Administration’s Health Care Reform efforts in 1994. Opponents of the reform used formative research to identify the core values of the public and then using this knowledge framed their argument against the reform so that the public feared that proposal would “bankrupt the country, reduce the quality of care, and lead to jail terms for people who wanted to stick with their family doctor.” (22).
EPA officials must be able to reframe the enforcement and strengthening of SDWA in such a way that the public will recognize that continued failure endangers their core values. Core values that have been identified in previous public health policies initiatives include those of freedom, independence, economic opportunity, control, and fairness/equality (22).

Critique 2: Places Too Much Responsibility on Individuals to Ensure Compliance

According to the EPA’s 2009 Ground Water and Drinking Water Statistics report approximately 294 million people receive their water from a public water system that must comply with the SDWA. Ninety-six percent of a population is a large constituency to have to answer to. I find it surprising that the EPA hasn’t developed an easier method to notify the public of their water quality and more importantly developed a method that allows for the public to easily voice their concerns about unsatisfactory findings and lax enforcement.
The SDWA requires that the public be notified of the quality of its drinking water. The EPA provides consumers with a list of reports; consumer confidence reports, state compliance reports, and a public database called the Safe Drinking Water Information System (28). The EPA site that contains the links to these reports also lists ways in which consumers can become involved in discussions about the quality of their drinking water. The major flaw in this method of public notification is that it is an individual approach to involving the consumer in the discussion. The title of the EPA’s campaign implies the very individual nature of the intervention: “It’s Your Drinking Water: Get to Know it and Protect it!” (28). EPA officials make the assumption that the public will decide that the risks of being exposed to contaminants in their drinking water will outweigh the inconvenience of speaking up and demanding clean water. This approach however, is not a successful one. It assumes too much.
The EPA asks the public to “Be Informed, Be Observant, and Be Involved” in order to protect public drinking water (23) on their Protect Your Drinking Water For Life page of their website but it places too much responsibility on the individual to create a demand for clean drinking water. The EPA has to continue to provide the information but make it easier for the public to get involved in process of strengthening the public’s water system.

Critique 3: Lack of Imagery

Turn on the tap in most households and more often than naught, the water that pours from the tap is clear, odorless, and free of any bad taste. Toxic water does not have to look, smell, or taste toxic. Occasionally you might hear on the news that a city or town is on notice to boil its tap water because of a discovery that its drinking water is contaminated (it happened in my home in Gloucester last summer) but it appears that there isn’t ever any lingering affect of this information on the non-affected public. The fact that the issue is not clearly identifiable makes it difficult for clean drinking water advocates to gather public support.
Commercial brands often incorporate some form of visual or verbal cue that triggers a memory of their product when mentioned or viewed. Blitstein, Evans, and Driscoll wrote that because public health initiatives may require this type of cue even more than commercial products because unlike commercial brands, public health brands are selling an intangible product (1).
Currently the EPA uses the imagery that its water is free of contaminants and is completely safe to drink. Throughout the website there are pictures of crystal clear water being poured into glasses by children and elderly people as well as pictures of employees dutifully treating the public water at water systems. The fact that people’s drinking water is not safe however invalidates the promise that these images make. The EPA does not use imagery that invokes a memory in consumers of why there is a danger of toxic tap (i.e. industry leaders battling enforcement and strengthening of SDWA). The public needs more than a list of contaminants that are present in their water. Advocates for safe drinking water need to supply the public with some form of imagery that can assist them with remembering the dangers that may be present in their drinking water.


Currently the EPA essentially relies on the belief that providing consumers of public drinking water with data on the quality of the water provided to them from public treatment systems is sufficient in gaining their support to improve enforcement. My intervention to assist strengthening the SDWA would focus its efforts on getting the public to believe that the law’s increased strength and enforcement was necessary in maintaining their core values. This is necessary because currently industry leaders are framing the argument in a way that any amendments strengthening the SDWA would adversely affect the public’s core values. The reframed argument could position the need to strengthen the SDWA by highlighting these values:
*Freedom: What is more basic than the thought that you should be able to turn on your tap water, fill a glass, and give it to your child? The intervention would reframe the argument so that a weakened SDWA threatens this freedom.
*Independence: A strong and effective SDWA will allow you to drink or use tap water when and however you want. A weakened SDWA limits that independence by forcing you to have to boil your water before using it or going to the store to buy bottled water. A strong and effective SDWA gives you the independence in that you do not have to depend on clean water to be brought to your home or community from other sources.
*Control: Strengthening the SDWA gives you and not the gas and oil industry control over your health and the health of your children.
*Fairness/Equality: Clean drinking water should be something that all Americans have access to but yet some have this access and other do not. The intervention can frame the issue so that a weakened SDWA threatens the equality that everyone should have access to clean drinking water.
(framework templates based on those used in Siegel-22)
Reframing the argument for strengthening the SDWA should increase public support for the issue. If successful, the next step of the intervention would be to increase public involvement in demanding that the bill is enforced at the very minimum but ultimately strengthened to actually achieve its goal of making drinking water clean. The EPA and/or the State do a very good job of providing the consumer with data about their drinking water but as my critique pointed out, more is needed than simply providing the data and assuming that the consumer will act on it. This portion of the intervention would include:
*A template letter that can be sent from the EPA website to the consumer’s Federal and State legislators. The template would be available when contaminant levels were in excess or when polluters were found to be unpunished. The template would include all of the necessary information (i.e. contaminants X, Y, Z were found at levels above the recommended levels or Company A was found to have violated the SDWA by contaminating the public drinking water and has yet to pay a fine).
*The EPA can provide the public with test kits that test for contaminants that are not currently regulated under the SDWA. The test kits can test for a handful of contaminants so that it is not overwhelming. Each kit can come with contact information of legislators. The thinking here is that if a consumer can see first hand what is in their water, then they might take more ownership over the process of strengthening the SDWA.
Finally, the intervention must create some form of imagery in order to make the issue resonate with consumers. The EPA needs to create the image that it is there to serve the people by protecting them from industries that seek profit over public safety. This intervention would use imagery similar to that used in the Mass Department of Public Health and American Cancer Society advertisements against smoking. By highlighting some of the illnesses and hardships brought about by contaminated drinking water, the intervention would attempt to trigger a visceral response in the public. The advertisements could use stories used in the New York Times articles on toxic waters that describe a child who develops painful rashes from the contaminants in his bathwater (5). These contaminants are from the local coal company. The intervention could also use similar techniques as those used in the Truth campaign such as placing oil and gas industry leaders in advertisements that highlights their disregard for public health.

Defense of Intervention Section 1: Frame-setting

Altering the frame of the argument is key to garnering the support of the public behind public health initiatives, which in turn can be an effective tool towards coaxing lawmakers to examine potential changes in the current legislation. The findings of Martino, et al revealed that humans tend to make decisions based on the frame in which those decisions are made. In their study, they found that people were more likely to gamble when they were in a “loss” frame and more likely not to gamble when placed in a “gain frame” (3). Successfully reframing an issue not only frames the argument but also suggests the solution (22).
The group Mothers Against Drunk Driving (MADD) is an excellent example of how public pressure can force reticent legislators to participate in a public health intervention (16). MADD was established in 1980 and has been involved in the creation of multiple pieces of legislation aimed at protecting public health by reducing fatalities related to drunk driving. Some of these include raising the minimum drinking age to 21, increasing health risk warnings on alcohol packaging, and reducing the legal blood-alcohol limit in several states (16).
Establishing anti-smoking legislation is another excellent example of how public pressure can influence legislation that affects public health. Public health advocates have been able to use the growing support of anti-smoking citizens to establish legislation that limit the negative effects of smoking. These initiatives include limiting smoking in restaurants and workplaces, reducing tobacco advertisements in magazines, and strengthening rules that make it difficult for underage kids to purchase tobacco products.
Both of these initiatives were able to reframe the way in which the public health question was being presented in legislation. The arguments were framed in such a way that the legislation was essential in maintaining the core values of the individuals. For example, every employee should have the freedom to work in an environment that will not adversely affect their health or everyone should have the freedom to not have their lives shortened by a drunk driver.

Defense of Intervention Section 2: Dependence on individual participation

Public health initiatives that are based on the belief that consumers will act rationally to protect their health and well being are seldom successful. Successful interventions strategies cannot assume that consumers will digest information and incorporate it into behavior changes in their life. The Health Lifestyle Habits study conducted on US adults between 1988-2006 is a perfect example of this. The study revealed that even though an abundance of evidence linking a healthy lifestyle with a decrease in cardiovascular disease was available, only a small number of Americans adhered to these measures (15). A study on the effects of the National Youth Anti-Drug Media Campaign found that an increased exposure to information about the consequences of drug use were for the most part ineffective, and in one sample actually increased pro marijuana use intentions (13). A similar effect can be witnessed in HIV prevention programs in the MSM community that have at the core of their intervention strategy the need to use condoms each and every time that intercourse takes place (21). The rising rate of HIV infection among the MSM community is evidence that such interventions are ineffective.

Defense of Intervention Section 3: Use of imagery

Opponents of smoking used vivid imagery to persuade the public to pay closer attention to the dangers of smoking. The American Cancer Society posted a posthumous video from Yul Brynner pleading with the public to avoid smoking because it killed him. The Massachusetts Department of Public Health took the story of one dying smoker to create moving anti-smoking commercials. The commercials depicted a young woman named Pam Laffin who despite being only 31 when she died looked much older. The commercials depicted the ultimate truth about smoking risk: smoking kills people in their 30s, addiction occurs rapidly and is severe, and smoking kills mothers (17, 18, 30). The Truth campaign used imagery in their anti-tobacco campaign. Truth used the image of a youth rebelling against the tobacco corporations to successfully meet aspired self-image of the public’s youth. In doing so the campaign was able to shift tobacco use behavior among young people (9).
Mothers Against Drunk Driving has posted numerous public service announcements focusing on the lives of children who have been ended because of a drunk driving incident. These PSAs do not consist of statistics that are easily forgotten about. They contain video montages of the laughing children or teenagers who became victims to drunk driving. MADD PSAs use a repetitive message to emphasize what is at stake if drunk driving is not considered a serious threat to public health.
Corporate products that have created successful marketing campaigns have usually used some method of imagery to enhance the ideal that their product is selling. The Marlboro Man sold the ideal of individuality and ruggedness. The silhouette of Michael Jordan that Nike uses sells the belief that wearing Nike products will give the consumer the feeling that they can fly through the air with grace and agility. According to Evans and Hastings, imagery can be a central component in creating associations with a product (9).


Access to clean drinking water should be something that nobody should worry about in the United States. Unfortunately this is not a reality. The Safe Drinking Water Act is a robust piece of legislation that is responsible for ensuring clean drinking water but it is not comprehensive enough nor is it enforced consistently. The EPA, as the public health officials for this issue need to reframe the argument so that consumers realize that their core values of freedom, control, and independence are threatened if the SDWA is not strengthened. The EPA also must develop a method involving more than just providing data about water to the public. This assumption that the public will act in a rational manner is flawed.


1. Blitstein JL, Evans WD, Driscoll DL. “What is a Public Health Brand?” Public Health Branding: Applying Marketing for Social Change (Chapter 2). Oxford: Oxford University Press, 2008, pp 25-41.

2. Deadline on the BAC Debate: Lobbyists Argue Effectiveness of the 0.08% BAC in Curtailing Drunk Driving. There’s No Question About Its Effect on Restaurant’s Bottom Lines. Restaurants and Institutions. 15 Aug 1997.

3. De Martino B, Kumaran D, Seymour B, and Dolan RJ. “Frames, Biases, and Rational Decision-Making in the Human Brain.” Science Vol. 313 (Aug 2006): 684-687.

4. Duhigg, C. “Millions in U.S. Drink Dirty Water, Records Show.” The New York Times. Web. 7 December 2009.

5. Duhigg, C. “Clean Water Laws Are Neglected, at a Cost in Suffering.” The New York Times. Web. 12 September 2009.

6. Duhigg, C. “That Tap Water is Legal but May be Unhealthy.” The New York Times. Web. 16 December 2009.

7. Earthworks. “Hydraulic Fracturing 101.”

8. Energy Tomorrow. “Hydraulic Fracturing.” Copyright 2009.

9. Evans WD, Hastings G. “Public Health Branding: Recognition, Promise, and Delivery of Healthy Lifestyles.” Public Health Branding: Applying Marketing for Social Change. 3-24. Oxford University Press, Oxford. 2008.

10. “Frank Panico Opposes The Adoption Of A Tough New National Standard For Drunk Driving.” Business News New Jersey. Vol. 11. 16 March 1998. Pg. 13.

11. “H.R. 2766: Fracturing Responsibility and Awareness of Chemicals Act of 2009.”

12. Heare, S. F. “Hydraulic Fracturing: Regulatory and Policy Considerations.” National Association of Regulatory Utility Commissioners. 15 February 2010.

13. Hornik, R., Jacobsohn, L., Orwin, R., Piesse, A., and Kalton, G. “Effects of the National Youth Anti-Drug Media Campaign on Youths.” American Journal of Public Health Vol. 98 No. 12 (Dec 2008): 2229-2236.

14. Industrial Minerals Association North America. “Hydraulic Fracturing Exclusion from the Safe Drinking Water Act.” Copyright 2009.

15. King, D., Mainous III, A.G., Caremilla, M., and Everett, C. J. “Adherence to Healthy Lifestyle Habits in US Adults, 1988-2006.” The American Journal of Medicine Vol. 122 No. 6 (Jun 2009): 528-534.

16. Mothers Against Drunk Driving.

17. Pam Laffin-Difference. Massachusetts Department of Public Health.

18. Pam Laffin-Kids. Massachusetts Department of Public Health.

19. Policy Facts: U.S. Department of Energy National Energy Technology Laboratory. “More Restrictive Regulation (Hydraulic Fracturing) Could Impact Natural Gas Supply.” June 2001.

20. ProPublica. “What is Hydraulic Fracturing?”

21. Siegel, M. and Lotenberg, L. D. “The Importance of Formative Research in Public Health Campaigns: An Example from The Area of HIV Prevention Among Gay Men.” Marketing Public Health. 73-78. Jones and Bartlett Publishers, Boston. 2007.

22. Siegel, M. and Lotenberg, L. D. “Marketing Public Health-An Opportunity for the Public Health Practitioner.” Marketing Public Health. 127-152. Jones and Bartlett Publishers, Boston. 2007.

23. The United States Environmental Protection Agency. Protect Your Drinking Water for Life.

24. The United States Environmental Protection Agency. Understanding the Safe Drinking Water Act fact sheet.

25. The United States Environmental Protection Agency. Safe Drinking Water Act Amendments of 1996: General Guide to Provisions.

26. The United States Environmental Protection Agency. Regulation & Guidance: Current Drinking Water Rules.

27. The United States Environmental Protection Agency. Public Access to Information & Public Involvement fact sheet.

28. The United States Environmental Protection Agency. It’s Your Drinking Water.

29. The United States Environmental Protection Agency. Drinking Water Monitoring, Compliance, and Enforcement fact sheet.

30. Yul Brynner-Anti Smoking Commercial. American Cancer Society.

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