The Impact of Sustainable Nitrogen Management on the Health Risks of Unsafe Drinking Water and the Mediating Role of Food Production

This study adopts a policy-centric perspective to explore the complex relationship between sustainable nitrogen management (SNM) and the health risks associated with unsafe drinking water. The critical policy challenge lies in balancing the essential role of nitrogen fertilizers in achieving high agricultural productivity with their detrimental environmental impacts. Using the Sustainable Nitrogen Management Index (SNMI) as a measure of nitrogen use efficiency, this research analyzes data from 143 countries spanning 1990 to 2015. The findings reveal that SNM significantly reduces health risks by decreasing water contamination. However, food production plays a critical mediating role. Although SNM improves environmental sustainability, increased agricultural output can counteract its benefits by contributing to further water pollution. These results highlight the complex interplay between SNM, food production, and public health. The study underscores the need for integrated strategies that address both the environmental and health impacts of nitrogen use while supporting global food security. These insights provide a foundation for developing evidence-based policies to balance agricultural productivity with safeguarding water quality and public health. They also set the stage for deeper institutional analysis.