Int. J. Environ. Res. Public Health 2011, 8 574 These results show similar patterns as with primary bottled water users found in Table 2. Groundwater quality perception, safe drinking water perception, age, gender, and region of residence were found to be significant predictors. Community size, however, unlike in the first regression model, was not significant. The likelihood of private water supply users being regular bottled water users was about 25% less than that of small water supply system users. There were no significant differences in bottled water use between municipal water supply users and small water supply system users. The pseudo r-squared statistics are relatively small compared with our first model, which suggests that the same independent variables do not have particularly strong correlations with or explaining power for regular bottled water usage, although the chi-square test statistic is still non-significant. 3.4. Discussion With findings of both logistic models, we confirmed the hypothesized negative association between perception of ground water quality and bottled water use. Given that an estimate of 49% of the U.S. population depends on groundwater for its drinking water supply from either a public source or private well [24], the groundwater quality perception seems to explain the consumers’ behavior regarding bottled water. Perception of drinking water safety is found to be highly associated with bottled water use. The findings about water quality perceptions generally confirmed that when public doubts about the safety of their tap water, they look for alternatives like bottled water [6,14]. No significant relationship, however, was found between surface water quality perception and bottled water use. Our data do not include actual water quality or safety conditions so it is not known whether consumer’s perceptions of the condition of their local drinking water are accurate reflections of the real water quality or not. If perceptions are accurate, then community leadership along with regulatory agencies needs to act to correct the problems for public health to be maintained. However, one might ask why consumers have turned to bottled water purchases rather than voice their concern and pressure public water departments and elected officials for solutions. This is particularly relevant since it is public municipal and rural water system supply users rather than private water supply users that are likely to purchase bottled water. Public water systems are tax supported, regulated and maintained under much more rigorous monitoring and testing conditions than bottled water manufacturers. This suggests that if a large number of consumers purchase drinking water as a substitute for public tap water, they can undermine the water infrastructure investments needed to assure safe public water supplies. This has implications for community capacities to provide low cost, accessible, and safe drinking water for their entire population. Without safe public water supplies, limited income households’ health and well-being are at risk. Our findings show that although municipal water supply users and small water supply users were equally likely to be regular bottled water users when every other condition is held the same, private water supply users (private well or surface water sources) were less likely to use bottled water than small water supply users. Consumers on private wells are often targets of public health campaigns reminding them to have their water tested regularly. To the extent this happens, private water supply users may believe they have more knowledge of and control over the quality of their water supply and thus trust it. Also, media coverage and increased headlines concerning problems with public water systems around the world can lead to high distrust (appropriately) of local water supplies [14]. The