Drinking water and behaviours
From the Northwest Territories participants’ answers, we learned that the consumption of water and water-based beverages averaged 0.9 L/day and mainly consisted of tea and coffee. Of the respondents, 19% did not report consuming any water and water-based beverages in the 24 hours prior to the survey (
Table 1). Of the people drinking water-based beverages, 33% drank more bottled water (average of 0.33 L/day) than tap water (average of 0.24 L/day), and 40% drank more coffee or tea than water (any sources of plain water, average of 0.58 L/day). About 2% of the respondents had consumed water from the land during the previous day, which was in wintertime (between November and March; average of 0.01 L/day).
There were differences in water consumption between men and women in the Northwest Territories. Women tended to drink more in terms of quantity of bottled water, while men were likely to drink water from the land as well as in coffee and tea. In the Yukon (
Table 2), a smaller portion of women reported drinking often untreated water from lakes, rivers, ice, and snowmelt. However, women reported higher rates of lake/river water as a main source of water than men. Interestingly, fewer women in the Yukon reported drinking bottled water as a main source of water. In the Northwest Territories, 2.4% of respondents had consumed untreated water the previous day, and 4.5% of respondents in the Yukon mentioned untreated water, in the form of lake or river water, as a main source of their drinking water overall through the year.
Tap water was the main source of drinking water for the Northwest Territories and Yukon respondents (67% and 87%, respectively), which demonstrates the importance of the infrastructure and water treatment facilities in place in the communities (see
Supplementary Material 1). Comparatively, the Regional Health Survey (RHS) 2015–2016 completed in the Northwest Territories found that only 34% of respondents used tap water as main source of drinking water, whereas 43% relied on bottled water and 16% took water from a river, lake, or stream (
Dene Nation 2019). While the importance of untreated water in the RHS seemed elevated compared with results of our study, our results were similar to other Indigenous populations, for instance between 1% and 7% of Inuit participants identified brook water as their primary source of drinking water (
Wright et al. 2018). In addition, the water intake reported by respondents was lower than the median amount of water consumed in Canadian Inuit communities (1 L per day) (
Wright et al. 2018).
Perception of water safety
During the consultation meetings, Sahtú people reported that the tap water had a strong chlorine taste, which made the tap water unpleasant to drink (“it tastes bad”). As a result, Sahtú people also consumed water from the land and bottled water. Through the Health Messages Survey, participants mentioned concerns related to contaminant issues in food and water. Unsurprisingly, as was heard during engagement activities, chlorine in drinking water was identified as a contaminant of interest by 62% of participants both in the Northwest Territories and in the Yukon (
Table 3). Metals or heavy metals were also a primary concern for 87% of the Northwest Territories respondents and 75% of the Yukon respondents. Fluoride was only identified as a concern by 2% of the Yukon participants and by none of the Northwest Territories participants. It is worth noting that fluoride was not included in the pre-identified options. When asked if there were any other sources or elements not included in the survey (i.e., country foods, store bought foods, cigarette smoke) that may impact the level of contaminants someone is exposed to, 6% of the Northwest Territories respondents typed down water. Finally, open-ended questions provided the opportunity for participants to provide feedback on their concerns regarding contaminants in general. The comments provided included: “Is it the water that is contaminating our country foods?”, “Test more lakes (for contaminants)”, “contaminants due to the thawing of permafrost and rising water levels”. Only one of the perception statements from Northwest Territories respondents found in
Table 3 were statistically associated with the consumption of water as categorized in
Table 1, participants who had concerns about chlorine in the water tended to drink more water from the land (untreated water).
Of the RHS respondents, 85% considered the main water supply in their home to be safe for drinking year-round (
Dene Nation 2019). In contrast, chemicals and chlorine in tap water were concerns reported by half of Inuit participants in 2013 (
Wright et al. 2018). The Government of Canada suggests that a private residential drinking water treatment device may be an option for reducing chlorine concentrations in drinking water if consumers find the taste objectionable (
NWT 2020d). The participants in our project also reported frequent concerns about tap water, which were collected through the Health Messages Survey (i.e., chlorine, fluoride, metals, contaminants). It has previously been found that individuals who were concerned about chlorine levels in tap water and those who negatively rated its quality had decreased odds of consuming tap water (
Wright et al. 2018). However, these associations were generally not observed in the current study, and a positive association was observed between concerns about chlorine and consuming more water from the land.
During engagement activities, we frequently heard negative comments related to the taste and odour of the tap water. Unsurprisingly, the potential link between perceived higher cancer rates and water quality was also raised. It is worth noting that there are historical considerations regarding the perception of contaminants and the distrust of the government in disclosing issues in the Northwest Territories (e.g., land contaminated by uranium/radium and gold mines, water downstream of resource development). However, there is limited knowledge available on the extent to which human activities in the region are affecting contaminants levels in the water.
Latchmore et al. (2018) acknowledged that historical contexts have shaped water perceptions, which impacts water security. The limited contaminants data that are available in the Dehcho and Sahtú regions in Northwest Territories, as well as around Old Crow, Yukon, do not currently indicate any concerns with water safety. Rather, existing water quality data in each of the participating communities indicate that the tap water is safe to drink.
Studies conducted in several Inuit communities reported the importance of untreated water sources due to municipal water shortages or a preference for untreated surface water. Untreated water was perceived as more familiar, higher quality, and more trustworthy than tap water (
Goldhar et al. 2013;
Daley et al. 2014,
2015).
Chlorine additives can react with natural organic matter present in the water resulting in unintentional disinfection by-products such as trihalomethanes, which are carcinogenic chemicals (
Sadeghi et al. 2019). In addition, they affect the aesthetic quality of drinking water (taste and odour) (
Hrudey 2009). These impacts might worsen the perception and consumption of drinking water and have an impact on diets and public health. There are mechanical means to decrease natural organic matter in the drinking water, preventing their formation.
Local knowledge and perceptions on water security
Owing to the potential of water perception and awareness to impact the practice of drinking water, the research team was interested in the different dimensions of water security. These include preferences, quality perception, availability, and access to drinking water. The team also wanted to identify some actions that might be taken to improve the perception people in the Sahtú region have of their drinking water. Three Elders (one man and two women) took part in the focus group with a middle-aged man joining us toward the end of the discussion. The first language of these participants was Sahtú Dene (North Slavey), but discussion was mainly carried out in English because of the researchers’ inability to speak the local language, with a few words of Dene language from time to time.
The opening question invited participants to share stories related to drinking water. Recently released research (which had appeared in the media) on plastic in the water was mentioned. Participants wondered if the snow was tested. When asked if they would change their behaviour regarding untreated water if they knew there might be plastic in the water, one participant replied:
“I don’t think so. We’ve always used snow for drinking, I don’t think I would. I will just keep melting snow for drinking.”—Camilla Rabisca
The question on where participants get their water from stimulated more interest and replies. They mentioned how snow water was used for tea as well as ice from the lake and river. This choice was based on the taste of the water as well as the traditional importance of it.
“I would rather drink snow water than tap water or bottled water. … It’s fresher. Tea is clear. When you make tea with tap water, it’s just really black and it has a film on top when you make tea. It has a film on top. I prefer to drink snow water. … We’ve always used snow. I prefer to use snow water for tea and for drinking. I can’t change that, I guess. It’s been all my life”—Camilla Rabisca
The focus group participants also discussed how people prefer the taste of the water from where they are from (place-based, wells/tap/lake), and the importance of knowing the water you are drinking, what is in it, and knowing the water system and any additives to it. Participants acknowledge that their natural water is probably one of the best and most pure sources of water on the planet. The participants mentioned how Indigenous knowledge informs people as to where to drink the water from lakes and rivers. For example, the Elders know which animals live in the area. As such, if beavers are numerous, they know not to drink water from the area. Participants also reported the challenges in communication related to water safety, mainly for the Health Authority:
“I have seen some water advisory; you scare the hell out of people. They get scared and they won’t drink water anymore from the lake or fish. You can’t do that to people.”—Participant who wishes to remain anonymous
Participants also talked about local concepts of dead water and living water. Good water, or living water, is water that flows, moves, and is indirectly oxygenated, whereas dead water, which is not safe to drink, is stagnant water where algae can develop more easily. The next topic discussed was whether participants thought that their water was safe to drink. Similar to the survey participants, the focus group participants expressed concerns about chlorine in tap water. The smell and the taste were indicators of elevated chlorine in the water.
“We hardly drink tap water because, as I said, sometimes you smell chlorine and sometimes you taste it.”—Participant who wishes to remain anonymous
While discussing concerns related to tap water, participants also discussed the water delivery system. Water is delivered a few times a week to each house in a tank that may be cleaned once a year by the owner. There are costs associated with this cleaning, and participants reported they do not know the best practices for cleaning the tank. Bleach was commonly mentioned as being used in the cleaning.
Bottled water was not mentioned much within the focus group, probably because it was extensively discussed previously during the camp. People reported occasionally drinking bottled water mainly for the convenience as well as for its plain taste compared with tap water.
Then, the group discussed if and why limiting the amount of drinking water. Participants reported not drinking much tap water because of the bad taste. In addition, there is a historical context to not drinking water. Traditionally, parents taught their children not to drink water, but instead broth and tea. The participants mentioned their confusion towards the current advice given by doctors who recommend drinking more water.
“When I was growing up, we hardly ever drank water, but we do drink broth. It could be fish broth. It could be meat broth.”—Participant who wishes to remain anonymous
“We were encouraged not to drink too much water. I am still trying to figure it out. There must have been a reason.… All doctors are saying drink a lot of water and it’s healthy. The Dene people our age—and I don’t know about the young people—we didn’t grow up like that. In the wintertime, it’s a broth. Yes, a lot of that stuff, but water directly, no.”—Walter Bezha
In terms of required actions, the importance of informing people about water for drinking was mentioned. It included when and how to clean water tanks, where water is safe to drink, and the environmental challenges of bottled water. However, it was also reported that government health authorities were taking actions related to drinking water in the communities without consulting community members.
Water was discussed from a holistic perspective, which might have an impact on people’s trust in water safety. It was mentioned that it is important to thank the water and “pay the lake”, which is a custom to honour the natural surrounding by providing a small gift (e.g., tobacco, tea). It ensures that water is good for people, good to drink, and safe to travel on. Participants expressed that everything is connected, and water is life.
“I seen everything connected, everything. Water, land, grass, animals, people, all connected.… We are put on Earth not to own anything. We are to take care of each other, take care of the animals, the fish, birds, everything. We cannot control anything. That’s not our work. Our work is just to take care. We need to take care of each other, take care of the water. … We take care of the water because water is our life.”—Participant who wishes to remain anonymous
The focus group discussed and explored sources of water, preferences, determinants, and the traditional perspective on drinking water. The discussion topics and information gained from the focus group is context dependent and obtained in a site surrounded by nature. The contextual evidence obtained by this group might be different in an urban environment and the findings of this discussion group may not represent the perceptions of the whole community.
The Indigenous perspective on water and the holistic knowledge that water is the source of life was mentioned. Living and dead water is a concept shared by other Indigenous groups (
Latchmore et al. 2018). Water plays a central role in keeping the traditional way of life alive in Indigenous communities.
There are scientific reasons to justify the differences in the taste, odour, and appearance of tea prepared with tap water versus snow/ice water. The thin, dark layer floating on the surface of the tea is a combination of oil from the tea leaves and insoluble compounds such as calcium and magnesium (
Franks et al. 2019). These dissolved compounds can be present naturally in unfiltered hard water, but precipitated by heating water (e.g., calcium carbonate). As snow does not pass through the ground and does not accumulate ground minerals, the water hardness of snow is usually low. Indigenous knowledge informs Western science, which can bring hypothesis of these situations.
Traditionally, water consumption in areas where there was no filtered water was limited, and instead drinking broth or tea was promoted. The use of boiled water ensured that risks from microorganisms were minimized. Drinking boiled water (i.e., broth) echoed what doctors now say about drinking filtered water. Now that people have easy access to filtered treated water, tap water seems to be a sensible solution, and the promotion of water can be an effective strategy to curb sweetened beverage consumption.
Through this project, we characterized the consumption of water and water-based beverages in subarctic Indigenous communities in Canada. Numerous residents mentioned prior to the project implementation and during the engagement activities, consultation processes, and public meetings that many have stopped drinking from local water sources and had concerns about the safety and contamination of tap water and natural sources. As such, this research component was to understand the extent of this situation and perception.
Climate change has and will continue to affect water in the Northwest Territories and Yukon, such as by the thawing permafrost disturbing the chemistry of waterbodies (
Kokelj et al. 2009). Warmer temperatures are also expected to increase waterborne diseases (
Dudley et al. 2015). Additionally, wildfires can release significant amounts of organic matter and heavy metals into water, which may have an impact on the water treatment infrastructure and operations in communities (
Bladon et al. 2014). Climate change might also affect the strong taste that communities reported in their tap water (
Health Canada 2021). Finally, climate change will also impact water storage and might decrease water availability in some parts of the Northwest Territories (
Dibike et al. 2017).
In 2012, the Northwest Territories Community-based Water Quality Monitoring program was implemented that aimed to increase the role of communities in water monitoring at specific untreated water sites across the territories (
MACA 2016). This included some sites along the Mackenzie River, which is the main source of water for the water plants in several participating communities (
Supplementary Material 1). Treated water is also tested frequently by water treatment plants and quality control is monitored. In the Northwest Territories, testing and reporting to officials is required under the Public Health Act. There are daily tests for chlorine and turbidity, monthly bacteria tests, quarterly tests for trihalomethanes, and annual chemical tests for metals completed by the local, trained officer and enforced by verification from the Municipal and Community Affairs (MACA) Environmental Health Officer.
Several stakeholders ensure that drinking water is safe in the Northwest Territories, including the community government, MACA, Public Works and Services, Health and Social Services, Environment and Natural Resources, and the Water Boards (
MACA 2020). Despite this collective effort, there are still instances of tap water being unsafe to drink; a boil water advisory is still in effect in one community of the Sahtú region (
NWT 2020a). Research in other Indigenous communities has shown that water in homes served by cisterns and water trucks more frequently have unacceptable levels of
Escherichia coli, even if the water was free of those bacteria when leaving the water treatment plant. Therefore, these residents have a higher risk of contracting waterborne illnesses (
Farenhorst et al. 2017).
A stronger collaboration with Indigenous partners is required to effectively promote treated tap water as people’s drink of choice. Regardless of access to safe tap water, Indigenous communities will continue to consume water from untreated sources for cultural and spiritual practices that date back to precolonial times (
Latchmore et al. 2018). An increased protection of source water can improve drinking water quality, while also supporting reconnection with the land for Indigenous people in Canada (
Patrick 2011). Health risk assessments should consider the importance of untreated water to northern Indigenous communities.