Strong Heart Water Study

Inclusion Criteria: * Arsenic levels in household drinking water must be ≥10 µg/L * Households must have ≥1 adult ≥18 years of age eligible and willing to participate. * Household must have an active well on the property that is used for drinking water. * Household must have indoor plumbing and a permanent heat source. * Participant must plan to reside in the household for the next year, must reside in the residence for ≥4 days/week, and year round (i.e. all seasons). * ≥1 household members must identify as American Indian. * Household must be willing to grant study members access to the interior of their household for screening and data collection. Exclusion Criteria: * Arsenic levels in household drinking water \<10 µg/L * Households with no adult ≥18 years of age eligible and willing to participate. * Households without an active well on the property that is used for drinking water (i.e. connected to municipal water supply). * Households without indoor plumbing and/or a permanent heat source. * Participant planning to reside in the household \<1 year, residing in the residence for \<4 days/week, or not year round (i.e. not during all seasons). * No household member identifies as American Indian. * Household unwilling to grant study members access to the interior of their household for screening and data collection.