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Ignoring America’s Water and Sanitation Crisis Is No Longer an Option

On Feb. 3, 2022, a train loaded with toxic chemicals derailed in East Palestine, Ohio, igniting a fire and forcing the controlled release and burn of vinyl chloride, a known cancer-causing compound, to avert a disastrous explosion. The environmental catastrophe killed thousands of fish in nearby streams and has triggered growing concerns over the impact on residents’ health and on the village’s surface, ground, and well water.

East Palestine joins a long list of other places in the United States facing major threats to clean water. In October 2022, a campaign called “Imagine a Day Without Water” asked Americans to stand with those who lack adequate drinking water, sanitation, or both. In one of the richest countries on Earth, the tally of those who live even without basic indoor plumbing might surprise you: more than 2 million.
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The acronym WASH, which stands for “water, sanitation, and hygiene,” is often associated with nonprofits like the World Toilet Organization, working in developing parts of the globe. But the lack of access to clean drinking water, sanitary bathrooms, and treated wastewater is an ongoing emergency for many parts of the U.S. as well. In rural and urban communities throughout the country, water tainted by pollutants, woefully inadequate sewage treatment, and a lack of restrooms (or plumbing at all) have laid bare the legacy of neglect.

Ohio National Guard/APThis photo provided by the Ohio National Guard, ONG 52nd Civil Support Team members prepare to enter an incident area to assess remaining hazards with a lightweight inflatable decontamination system (LIDS) in East Palestine, Ohio, on Feb. 7, 2023.

In her book Waste: One Woman’s Fight Against America’s Dirty Secret, author Catherine Coleman Flowers describes how rural residents in Lowndes County, Ala., often have no means of wastewater treatment. They lack what most of us take for granted, “because septic systems cost more than most people earn in a year and tend to fail anyway in the impervious clay soil,” Flowers writes. “Families cope the best they can, mainly by jerry-rigging PVC pipe to drain sewage from houses and into cesspools outside.” With her assistance, researchers found that more than one-third of 55 stool samples collected from county residents tested positive for hookworms—intestinal parasites often associated with poor sanitation in developing countries.

To the west, historic flooding incapacitated an aging water treatment plant in Mississippi’s capital of Jackson in September 2022, leaving residents of the predominantly Black city without safe drinking water for weeks. When students returned from their holiday break in January 2023, more than half of the city’s public schools lacked water and had to hold virtual classes after cold weather again damaged the system. The majority-Black Michigan cities of Flint and Benton Harbor faced severe lead contamination in their own drinking water, a consequence of aging lead pipes leaching the toxic contaminant into the water supply. And in West Baltimore, E. coli bacteria contaminated the water, a crisis again blamed on aging water treatment infrastructure.

A 2021 analysis, “The widespread and unjust drinking water and clean water crisis in the United States,” found that nearly half a million U.S. households lacked complete plumbing, while many more were living in communities with unclean water. Surveys suggest that the former problem is a disproportionately rural issue while the latter is disproportionately urban. “As it currently stands, counties with elevated levels of incomplete plumbing and poor water quality in America—which are variously likely to be more indigenous, less educated, older, and poorer—are continuing to slip through the cracks,” the authors of the study concluded.

Without urgent action, those cracks will only continue to widen. The 2021 Report Card for America’s Infrastructure, released by the American Society of Civil Engineering, gave a dismal D+ grade to the country’s more than 16,000 wastewater treatment plants, a significant fraction of which have reached or exceeded their design capacities. The U.S. drinking water infrastructure earned only a marginally better rating, with a C-grade.

Read more: We’re in a Water Crisis. We Need to Act Like It

As local and state investment in vital infrastructure has faltered, so too has federal action. Amid decades of chronic underfunding, the U.S. government’s share of capital costs on water infrastructure fell from more than 60% in 1977 to less than 10% 40 years later. A 2020 report by the American Society of Civil Engineering spelled out the growing investment gap in stark terms. But the costs of failing to update the country’s aging and deteriorating drinking water and wastewater infrastructure could be far greater, with trillions lost in preventable diseases, higher medical costs, lost productivity, and environmental pollution.

That inattention couldn’t come at a worse time. A 2021 study by Just Security, based at the NYU School of Law, explained how extreme weather events—exacerbated by global warming—are leading to even more failures of inadequate and poorly maintained infrastructure. Undoing the harm will require sustained attention, especially in what environmental justice pioneer Robert Bullard at Texas Southern University describes as the “invisible” communities of color that have disproportionately shouldered the burden of environmental racism.

Effecting change will require a major investment in urban and rural systems. Nearly $800 million in federal funds have been earmarked for water projects in Jackson. And in 2022, the U.S. Environmental Protection Agency and Department of Agriculture launched the Closing America’s Wastewater Access Gap Community Initiative, to be piloted in Lowndes County and ten other underserved communities where residents lack basic wastewater management. The federal Inflation Reduction Act provided another $550 million for water systems in disadvantaged communities—not nearly enough but a start in reversing the decades of damage.

Well-considered projects could make a big impact by not only improving public and environmental health, but also redistributing wealth back to those same communities. More wastewater treatment plants are becoming resource recovery facilities, preventing pollution from the treated liquid waste and extracting valuable resources. Biogas and electricity, pure water, charcoal-like biochar, nutrients like nitrogen and phosphorus, and soil amendments can all be recovered, creating new sources of local wealth.

At the grass-roots level, organizations like PHLUSH (Public Hygiene Lets Us Stay Human) are pushing for equitable access to toilets and sanitation systems. PHLUSH has positioned public restrooms as critical elements of the U.S. infrastructure, rightfully arguing that they are “as essential to community well-being as sidewalks, traffic signals and street lighting.” For people experiencing homelessness, a lack of access to sanitary toilets can be dehumanizing, dangerous, and disease-causing. The public health crisis for that segment of the population is growing throughout America, with a recent report calling for more stigma-free access to WASH facilities in rural areas.

In rural communities from Puerto Rico to Hawaii, advocates are introducing advanced biofilters and composting or incineration toilets as more affordable, sustainable, and sanitary alternatives to leaking, broken, or altogether lacking septic systems. Installing these systems in large enough numbers to make a difference will require revisions to outdated or punitive local codes and a rethinking of what might be recouped through long-term investments in our communities.

The Center for Rural Enterprise and Environmental Justice, founded by Flowers, is working to “eliminate the health, economic and environmental disparities suffocating rural and marginalized communities.” Doing so will be easier with renewed local, state, and federal backing, bolstered by public awareness and the recognition that reinvesting in neglected communities helps us and our environment. Most of all, it will require a reaffirmation that access to water and sanitation are fundamental human rights—no matter where you live.

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