{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T23:27:22Z","timestamp":1775604442639,"version":"3.50.1"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Health-based drinking water violations impact millions of Americans each year. This study examines the relationship between 13 measures of drinking water quality, related to health-based violations of the Safe Drinking Water Act, and three self-reported health outcomes (general, physical, and mental health). Analyzing cross-sectional data from 3,100 counties in the United States using regression analysis, we found statistically significant relationships between health-based violations and all self-reported health outcomes. Specifically, counties with more health-based violations reported a higher percentage of people with fair or poor health, and more physically and mentally unhealthy days. Our findings indicate that a single health-based violation in an average county incurs yearly medical costs of approximately $3.48 million for physical health and $4.85 million for mental health. These results highlight the need for policymakers and health professionals to prioritize interventions that address these violations, particularly in vulnerable communities, to mitigate their long-term health impacts.<\/jats:p>","DOI":"10.3389\/fpubh.2025.1588338","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T05:24:13Z","timestamp":1754371453000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Health implications of safe drinking water act violations: a county-level 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