What illnesses are linked to drinking water in Choctaw and Cherokee Nations?

Supporting the Waterborne Infection Risk Evaluation (WIRE) long-term study of the Choctaw and Cherokee Nations


The Centers for Disease Control and Prevention (CDC) notes that 7+ million Americans get sick every year from diseases spread through water. CDC also notes that waterborne diseases are responsible for many different types of illnesses, including respiratory, neurological, and gastrointestinal illnesses, just to name a few.

The purpose of this research study is to better understand which illnesses the Tribal members of the Cherokee and Choctaw Nations have been exposed to as a result of drinking water. This study encompasses Cherokee Tribal members as well as Choctaw Tribal members living in U.S. Environmental Protection Agency (EPA) Region 6: the states of New Mexico, Texas, Oklahoma, Arkansas, and Louisiana.

Westat is supporting the EPA in this research.


Westat set up all equipment, supplies, and promotional materials needed for in-person data collection. We then conducted in-person enrollment, baseline saliva sample collection, and administered participant questionnaires at Cherokee Nation and Choctaw Nation Labor Day Festivals. 

Westat produced saliva sampling kits and distributed kits to participants for follow-up samples, which were self-collected and mailed to the EPA laboratory.  

In 2020, due to COVID-19 concerns, participants were recruited remotely from counties of the Choctaw Nation. Westat mailed sample collection kits and questionnaires to participants, staffed a helpline to assist participants, and tracked return of samples to the EPA laboratory.


This research will provide knowledge about exposure to pathogens through drinking water sources. The goal is to ensure that the most effective and efficient methods are developed to identify, detect, and inactivate/remove pathogens that may be present in our drinking water supplies.

Focus Areas

Public Health


Data Collection


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