Water and Health Equity

The water systems we use to deliver drinking water and remove wastewater from the homes and businesses of 327 million Americans are broken. Far too many Americans lack consistent access to affordable and safe water supplies to meet their needs. Far too many Americans distrust their tap water, even when it is safe. Far too many Americans experience sewage overflows, polluted riverfronts, and flooded streets. The failures of our water systems prevent all Americans, especially lower income and people of color, from having the healthy and prosperous lives they deserve. These disparities affecting some groups can be reduced and eliminated in much of the country and our water systems can simultaneously do a better job of providing even higher quality water services to all people.

While there is a general public interest in water issues across the country at a profoundly higher level than in past decades, this moment may not last. We must prove that we can solve problems of water quality, like the cities of Lansing, Madison, and Washington DC have done or are doing. That faith is critical to keeping all populations involved in efforts to keep making progress with America’s water needs.

The Report

This report provides a strategic overview of water services in the country, their connection to health equity issues, and opportunities to address those issues. The report captures our best insights into how to make the most dramatic impacts that will have health, cultural, behavioral, and economic impacts that extend well beyond the strategies themselves and help the water sector get at the root causes of and key obstacles to health equity in water infrastructure. See the report here and an Executive Brief here.

Additionally, the report discusses a number of case studies and federal policy issues that highlight the themes presented in the report, as well as interviews with community water advocates. They are discussed and presented below.

Case Studies

These case studies highlight and embody some of the key themes covered in the report. In most instances, they are a snapshot about one particular place at perhaps one point in time, but there is much to learn from the struggles and successes of individual communities.

Policy Issues

In this section, we highlight three policy issues currently being debated at the national level that will widely impact the water sector and by extension residents in every community. These policy issues have enormous direct relevance to public health and health equity outcomes and there are immediate opportunities to influence their shape and extent.

Interviews with Water Advocates

During the course of developing this report, we spoke to more than 100 water experts throughout the country, and their insights are reflected in this report. We present below just two of those interviews in greater detail as they cover a variety of interconnected issues one encounters when understanding and addressing community water challenges.

Feedback from Peers

"This is the most, concise yet comprehensive and actionable synthesis of policy recommendations to ensure water for health in the U.S. that I have seen to date."

"Thoughtful & bold, comprehensive but engaging, the report articulates a vision to advance the U.S. water sector. It's [a] remarkable work."

"This [report] is a tour de force. I actually found it hard to put down."

"This is one of the best laid out, specific, policy analyses and memos I've seen in a long while. The combination with great story, specific recommendations, and solid reasoning is impressive."