The causes of absenteeism are multi-dimensional and exist within individual, family and school domains42. We add to the existing literature by focusing specifically on environmental factors such as localized and city-wide BWAs, which can have impacts across all three domains. Using publicly available data at the level of census block, we were able to control for a variety of neighbourhood-level factors that could confound the relationship between BWAs and unexcused absence rates39. These include people living in poverty, social isolation, single-parent households, households with limited-to-no-computer access, those who speak English less than well, the disabled and the elderly (as they are also more likely to be heads of households in Mississippi)43,44,45,46. Our findings show that, after adjusting for these confounding factors and the unique impact COVID-19 had on instructional delivery, we observe statistically significant increases in unexcused absence rates in JPSD during and proceeding a BWA. We found that a BWA contributes to an approximately 1–10% boost in unexcused absence rates in JPSD, impacting between 210 and 2,100 students with each issue. During the 454 alerts issued in 2020, there were between 95,000 and 9.5 million individual days of school lost by students in JPSD. These impacts were most prevalent in elementary and high schools and these students came from communities where there is a high prevalence of single-family, individuals who identify as Black, Asian, Native American, Hispanic, or 2 or more races and household living in poverty. These effects were prevalent for up to 2 days after an alert was released.
A breakdown of our findings suggests that the burdens of BWAs are borne by students at a handful of schools. In all the individual schools that experienced a statistically significant boost in unexcused absences during a BWA, their student body was 96–99.5% non-white. Contrastingly, a couple of schools experienced an boost in student attendance during BWAs, suggesting a protective effect. For example, one school where this trend was observed was Clausell Elementary School, located in South Jackson, where the entire student body receives free and reduced lunch assistance47.
Our findings are consistent with previous studies examining how environmental factors such as temperature48 and air pollution38 can negatively impact absenteeism. Like our findings, in these studies, exposure to environmental hazards increased absenteeism both during and well after an event. As previous studies have also shown, both short-term and chronic school absences can lead to an increased probability of high school dropout, social disengagement, substance employ, suicide ideation, criminal arrests, reduced adult economic wellbeing and decreased life expectancy37,49,50,51,52,53. In the JPSD where nearly one-quarter of its current population is school-aged youths whose current dropout rates are higher than state goals, and graduation rates are well below state goals, our findings are particularly concerning, especially given that these impacts on students can start as early as kindergarten36.
Historical factors for a current situation
The water infrastructure issues in Jackson are long standing, with rumblings of concern dating back to over a century ago when city officials warned that water treatment facility upgrades were needed to accommodate Jackson’s rapidly growing population54. Former mayors as early as 1953 and as slow as 2014 all explicitly expressed concerns about the failing water systems and ran on platforms making these issues a mayoral legislative priority. However, it was a series of educational rulings—Brown versus Board of Education in 1954 and Singleton versus Jackson Municipal Separate School District rulings in 1970—that greatly impacted Jackson’s current water system failures55,56. Up until the Supreme Court ruled that the segregation of public schools was unconstitutional, many of the neighbourhoods in North, West and South Jackson were all-white, affluent areas, and the JPSD was predominantly white and was separated by race into all Black and predominantly white schools57. After these two rulings, these affluent white Jackson residents migrated to nearby suburbs. What was left behind after the migration to the suburbs was a city without a substantial tax base to assist in paying for the urgently needed water system repairs and upgrades and staff. As of 2017, 96% of JPSD students are Black, and in the city of Jackson, 82.5% are Black.
As a result, Jackson is currently operating under two separate federal enforcement orders for non-compliance with federal and state laws related to water quality including sewage overflows from the wastewater system and increased levels of lead and turbidity (sediment) in drinking water58. Compliance costs for both orders are estimated at over US$1 billion (ref. 30). These issues are exacerbated by the impacts of increasingly habitual severe weather events that cause water main breaks and equipment damage. In the future, as climate change continues to influence extreme weather events, if these infrastructure problems are not quickly and equitably resolved, we anticipate compounded community impacts. Further, the EPA is currently investigating the Mississippi Department of Environmental Quality and the MSDH for allegations that the agencies discriminated against the majority Black population of the city in their funding of water infrastructure and treatment programmes, in violation of Title VI of the Civil Rights Act of 196459.
The need for better data infrastructure
Beyond Jackson’s water infrastructure issues, there is a non-existent data infrastructure for residents, public health officials and local leaders on the community health impacts of impoverished water. In this study, we treated BWA as a real-time approximation for community water quality. However, these alerts can also be viewed as a real-time assessment of Jackson’s lacking community information systems and local government impoverished responsiveness to environmental issues. Existing studies that have surveyed residents affected by BWAs showed that when issued, they reach 76–97% of affected persons60. It is recommened that water systems experiencing a BWA share a press release to local media outlets (television, radio and local newspapers) detailing the reason for the BWA and sheltered practices the public should follow61. For smaller, more localized emergencies, local water systems are encouraged to ‘notify them (those affected) by personal contact, door-hangers, or notes taped to their doors’. Despite these recommendations, BWAs can only be consistently found on MSDH and the City of Jackson’s website. Access to these alerts requires internet connectivity, which is still out of reach for 44% of Mississippi’s residents, especially Black residents, who make up most of Jackson’s population62,63.
If/when a BWA reaches an affected household in Jackson, they rarely describe the cause of the issue or provide residents with information about what contaminants are expected to be in the water. While directions to boil water may reduce harmful levels of bacteria such as Escherichia coli, boiling can boost the concentrations of hefty metals, such as lead. The City of Jackson exceeded the EPA’s action level for lead in 2017, and the MSDH currently continues to urge households with youthful children and pregnant women to take precautions64. We are not aware of any protocols for alerting residents of lead contamination. Further, on the boil water advisories we collected, there were no additional instructions noting necessary precautions to take in households with lead-contaminated water. Strict adherence to boil water advisories in households with lead-contaminated water can compound health impacts, especially in women and children. The City of Jackson has taken action to reduce the risk of lead contamination by implementing up-to-date corrosion control methods; however, the effectiveness of those measures is negatively impacted by the ongoing system-wide infrastructure challenges.
Conclusions
While our study only focuses on Jackson, we believe our findings will be beneficial in other cities currently struggling with impoverished water infrastructure and will shed delicate on the multitude of issues incessant BWAs can bring about66,67,68. Our study also shows that, even in the face of confined data, we can unearth meaningful associations between BWAs and unexcused absences.
