Environmental Health Indicators in New Zealand: Drinking Water—A Case Study

This study examines and quantifies the linkages between population health, environmental risks, and its determinants for drinking water in New Zealand using routinely collected data. It was conducted as part of the national environmental health indicators project in New Zealand. The project is based on the World Health Organization’s (WHO) “Environmental and Health Information System” program. Drinking water quality indicators based on the Driving force–Pressure–State–Exposure–Effect–Action (DPSEEA) framework as part of this program were analyzed to validate the model by quantifying the linkages between the indicators. The results of the model suggested over the study period, the state (drinking water quality) and exposure (water access) indicators are significant independent predictors of the effect indicator (waterborne disease rate). This study suggests that routinely collected data can be structured using the DPSEEA framework and tested quantitatively using standard Poisson regression models, thus, illustrating that the model can be used routinely to provide a basis for consideration of the costs and benefits of any interventions to reduce the burden of waterborne disease. Data quality issues need to be considered if such routinely collected data linkages are to be performed for policy purposes.