Despite evidence that tap water is often safer and cheaper than alternative sources, tap water is avoided when perceived to be unsafe. Therefore, we conducted the first nationally representative U.S. trends analysis of in‐home tap water avoidance between 2007 and 2016. We tested whether changes occurred during/after the Flint water crisis, and whether not drinking tap from one's main water source differed by age, race/ethnicity, and socioeconomic status across time. Finally, we tested whether tap water avoidance was associated with higher prevalence of bottled water consumption among children. We used data on 12,915 children and 23,139 adults from the National Health and Nutrition Examination Survey. Significant covariate‐adjusted quadratic time trends were found in the prevalence of avoiding tap water with an inflection at 2013–2014 for children, but not adults. Piecewise log‐binomial regressions estimated that between 2007 and 2014 each survey cycle was associated with 14% lower prevalence of not drinking tap water (prevalence ratio [PR] 0.86, 95% CI: 0.80–0.93), but in 2014–2016 a 53% (95% CI: 1.12–2.09) higher prevalence was found for children corresponding to the water crisis. Younger children, Hispanic, non‐Hispanic black, and those from low socioeconomic status backgrounds had consistently higher probability of avoiding tap water over time. Children who avoided tap water had 92% higher prevalence of drinking bottled water. In 2015–2016, 78% of non‐Hispanic black children who avoided tap water drank bottled water on a given day. Avoiding tap water may indicate underlying water insecurity in the United States. Efforts to address tap water distrust have critical health and economic implications.

中文翻译：

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2007年至2016年间，美国儿童而非成人的家庭自来水消费趋势发生了变化

尽管有证据表明自来水通常比其他来源更安全，更便宜，但如果认为自来水不安全，则应避免使用自来水。因此，我们在2007年至2016年间进行了首次全国范围内具有代表性的美国家庭自来水避免使用趋势分析。我们测试了在弗林特水危机发生期间/之后是否发生了变化，以及主要年龄段的自来水饮用量是否随年龄而变化，种族/族裔，以及不同时期的社会经济地位。最后，我们测试了避免自来水是否与儿童瓶装水消费较高的患病率相关。我们使用了来自美国国家健康和营养调查的12915名儿童和23139名成年人的数据。在2013-2014年，儿童（而非成人）避免使用自来水的趋势普遍存在着显着的经协变量调整的二次时间趋势。分段对数二项式回归估计，在2007年至2014年之间，每个调查周期与未饮自来水的患病率降低14％相关（患病率[PR] 0.86，95％CI：0.80-0.93），但在2014-2016年为53与水危机相对应的儿童中，较高的患病率（95％CI：1.12-2.09）。年龄较小的儿童，西班牙裔，非西班牙裔黑人以及社会经济地位较低的人，随着时间的推移，避免自来水的可能性一直较高。避免使用自来水的儿童患瓶装水的患病率高92％。在2015-2016年间，避免自来水的非西班牙裔黑人儿童中有78％在特定的一天喝瓶装水。避免使用自来水可能表示美国潜在的水不安全状况。解决自来水不信任问题的努力具有至关重要的健康和经济意义。