There is no publicity like word of mouth… Lessons for communicating drinking water risks in the urban setting

Effective communication to citizens is of prime importance during public health crises involving water. This paper takes a sequential mixed method approach to the problem of communicating drinking water risks prevention of exposure to health risks in cities. City water officials are interviewed to learn about the goals of their drinking water communications strategies, and household surveys are completed subsequently in three suburbs in Saskatoon, Saskatchewan Canada to assess the effectiveness of communications for drinking water risks and advisories, and household resident's knowledge of, and reported adherence to those advisories. Residents described how they heard about EBWA and PDWA's, and lead pipe replacement programs; whether suggested protocols were followed; and how residents were informed about the termination of the advisories. Official communication efforts advised 21.4% of respondents directly about drinking water risks, however, the residents’ use of multiple unofficial information sources demonstrates an opportunity for increased resilience through having many pathways for receiving water advisory information. Communicating through word of mouth, in person and through social networks, reached 71% of respondents. Suburb-based differences in EBWA and PDWA communication effectiveness were also revealed. Lessons for how small cities could more effectively communicate urgent drinking water security issues and longer-term drinking water risks due to aging infrastructure are discussed. Implications for public health officers are explored.