Public Health Concerns at the Intersection of Drinking Water Contamination and Low Healthcare Access in Maine

Abstract

Over half of Maine residents rely on unregulated private wells, many of which tap into bedrock aquifers containing toxic metals such as arsenic, uranium, and lead. Simultaneously, large portions of the state are designated Health Professional Shortage Areas (HPSAs), compounding potential health risks through delayed diagnosis and limited healthcare support. Using 1,887 drinking water samples collected by secondary school students through the All About Arsenic (AAA) citizen science initiative, we evaluated the distribution of metal contaminants relative to HPSA designations. Our findings reveal that 93.4% of sampled households were located in HPSAs, and while overall exceedance rates were similar between HPSA and non-HPSA regions, multi-metal exceedances and extreme outliers were disproportionately concentrated in HPSAs. Arsenic concentrations were positively correlated with all HPSA shortage scores, and other metal concentrations positively correlated with mental and dental health HPSA scores, suggesting that households in HPSAs with the greatest prioritization need also face the highest burdens of contaminant exposure. These results underscore the need for integrated environmental and healthcare policy approaches, particularly in rural areas. We recommend expanded well testing requirements, targeted remediation support, and enhanced public health education, especially for high-risk groups such as families with children, pregnant people, and older adults. Our findings position HPSAs in Maine as environmental justice zones and highlight the importance of coordinated efforts to ensure safe drinking water and equitable healthcare access.