Elizabeth B. Pearce and Alexis Castaneda-Perez

Safe Water and Sanitation

Photograph of a water bottle fountain that you can refill your own water bottle.
Fig. 9.10. Water bottle filling stations cut down on costs related to disposable bottles.

For about 100 years, water in the United States has been supported by a federally funded infrastructure that ensures families safe drinking water and sanitation. Water-borne diseases, such as cholera, were virtually eliminated by the provision of this system. Although the effort to create safe water and sanitation was well funded up until the end of the 20th century, there are some geographic areas and groups that are underserved; systems were not funded equitably before funding dried up.

Safe water and sanitation can be defined by these three things:

  • Access to safe and reliable drinking water;
  • A shower, toilet, and tap in the home;
  • A reliable system for treating and disposing of wastewater

Socioeconomic status is a barrier to safe water access. Challenges in poor communities include contaminated water supplies, housing with lead-infested water, other substandard plumbing issues, and unequal distribution of public drinking water such as water fountains in schools and other public places.

As individuals more regularly carry their water with them, access to a bottle filling station can mean the difference between a one-time purchase or the ongoing expense of hundreds of plastic water bottles. Look around your own daily environments; where can you find these stations? Could there be more bottle fillers added and more equitably distributed?

Almost one third of adults in America are inadequately hydrated. Race is the biggest predictor to lack of water access; African American and Latinx people are more likely to experience lack of adequate hydration as are lower income people.[1] This graphic from the University of North Carolina describes six access challenges.


Fig. 9.11. It is eye-opening to realize the number of water access challenges families face in the United States.

There is no centralized government or research entity that collects national data about water and sanitation in the United States, which creates challenges to assessing and meeting needs. In November, 2019, the US Water Alliance and Dig Deep, two organizations dedicated to improving water access for families in the United States, released a comprehensive report analyzing all available data from local, regional and national sources. More than two million Americans lack access to safe water. Closing the Water Access Gap in the United States: A National Action Plan has five key findings:

  1. Federal data doesn’t accurately measure the water access gap
  2. Race is the strongest predictor of water and sanitation access
  3. Poverty is a key obstacle to water access
  4. Water access challenges affect entire communities
  5. Progress is uneven, and some communities are backsliding.

Along with race and poverty as indicators, the report identifies residents of Puerto Rico, houseless people, and members of American Indian communities as having a greater likelihood of lack of access to water and sanitation.[2]

Case Study: Flint, Michigan

Let’s look more closely at a community that has experienced a safe water crisis between 2014 and 2020. For some context, Flint was a booming city with an economy centered around the automotive industry through the late 20th century. In fact, this is where vehicle manufacturer General Motors was founded. Although its industrial prime is past, Flint is still home to roughly 100,000 Americans. According to the United States census population estimates, 53.7% of Flint residents are African American and 40.4% of its population lives in poverty.[3] The median household income in Flint is about $24,000-$27,000 a year.


Fig. 9.12. Flint, Michigan has many families who are poor.

Saving Money

City officials in Flint decided to change its water source in 2014. The city used to get its water from the Detroit Water and Sewage Department. This water was treated and sourced from Lake Huron and the Detroit River. While this worked fine, the city was strapped for cash and in 2011, Flint had a $25,000,000 deficit.[4] The city declared a state of emergency and was looking for ways to save money. City leaders decided to source water from the Flint River as a cheap and temporary alternative while a pipeline from the Huron River was built. Unfortunately, shortcuts were taken and the water was not treated properly for human consumption, which caused spikes of lead in the water. Immediately after the water source was switched, people noticed that the tap water in Flint was different. The color ranged from yellow to brown, it smelled weird, and it tasted terrible.

Effects on Families

Dangerous amounts of lead were found in Flint’s drinking water. In one home, Virginia Tech researchers found that the lead levels in the water were between 200 parts per billion (ppb) to 13,200 ppb.[5] Lead amounts above 5,000 pbb are classified by the EPA to be hazardous waste. Children are the most susceptible to the effects of lead. It can lead to many health issues such as anemia, slowed growth, and learning problems. Lead can put pregnant women at risk for miscarriage, as well as causing organ issues in adults. High levels of lead can cause death.[6] An outbreak of Legionnaires’ disease is also thought to be caused by the water crisis.[7] According to the CDC, “Legionnaires’ (LEE-juh-nares) disease is a very serious type of pneumonia (lung infection) caused by bacteria called Legionella.” At least twelve people have died as a result, and numerous criminal and civil lawsuits have been filed against officials. After 18 months of negotiations, a $600 million settlement to be paid by the state of Michigan was agreed to in August, 2020. More than 80% of that money would go to people who were minors and most affected by the toxins in the water. As of the publication of this text, plaintiffs still had time to decide whether or not to agree to the settlement.

To read more about how to find lead in your home environment and the effects of lead on children, click here for the CDC’s infographic.

Environmental Justice

According to the EPA, “Environmental justice is the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.”[8] People of color and low income families are disproportionately being affected by the water crisis in Flint, a classic case of environmental injustice. These families can’t easily move or fund a new source of water.

The EPA also emphasizes “the same degree of protection from environmental and health hazards” along with its definition of environmental justice. It is clear that the people of Flint are not receiving the same degree of protection.

Watch this 3 ½ minute video to further understand the definition and history of environmental justice.

Institutional Forces

While on the surface it may seem like the crisis in Flint was caused by a singular error (switching the water source), the underlying responsibility is with multiple government policies that are institutionalized. These are the results of over a hundred years of policy that eventually culminated into a health crisis.


Magazine ad from 1968 advertising cars.
Fig. 9.13. General Motors was a highly profitable automaker in the late 20th century.

Earlier we described Flint as a city of industry, home to a rich automotive economy. The Deindustrialization (The decline of the manufacturing industry) of the United States was hard for everyone who relied on these companies to provide for their families. The decline was reinforced in the 1980s as the manufacturing industry hit a recession. Flint’s population shrunk from around 200,000 to just 100,000 residents.[9] Many people who had the means relocated to a different area in search of better opportunities. But then there are those who are more or less forced to stay, as relocating can be a risk, as well as being cost-prohibitive. As the overall population of Flint declined, the African American population percentage of Michigan has steadily increased. According to Census data, in 1960 the total percentage of African Americans in Michigan was roughly 9%. As deindustrialization occurs, and people relocate, it jumps to 14% in 2000.[10] Those who remained in Flint were White Americans and African Americans of low income. These two groups are by far the most impacted by the effects of deindustrialization, although this isn’t isolated to Flint.


Photograph of people on the streets watching an artist making art.
Fig. 9.14. Flint is a community filled with diverse and hard-working families.

Could this Happen in Oregon?

Photograph of a library with shelves of books.
Fig. 9.15. When cities and counties are underfunded, they must choose between programs that serve all families such as water, parks, schools, and libraries.

The decline of deindustrialization can be felt in Oregon as well. Oregon’s timber industry faced a massive decline after the 1980s recession.[11] Environmental regulations have affected job availability. We can see many parallels between this situation and other communities who have faced job and company losses. Many towns that were dependent on the income from the timber industry are now left struggling.

Douglas county recently voted to shut down their entire library system.[12] Jackson County and Josephine County have also had to shut down their libraries, although eventually they managed to bring back partial services.[13] Many timber towns depended on a federal program that gave $100,000,000 every year to Oregon counties. Since the program has been discontinued, many counties are having to make sacrifices to keep from going under.[14] Another parallel we can see between the deindustrialization of Michigan and Oregon is people leaving small towns for urban centers, with those remaining mostly being of low income.

Lawmakers in these communities face similar choices as the leaders in Flint, Michigan. When there are fewer taxpayers to fund local services and less federal funding for services that all families can use, programs such as libraries, schools, parks, and even water must be examined as places to save money.

Looking Ahead

One purpose of analyzing Flint, Michigan as a case study is to give a voice to those impacted by this and similar hardships. To see additional perspective and proposed solutions to these social problems, watch the TED Talk below. LaToya Ruby Frazier was hired to document the unfolding crisis in Flint and relates her history growing up with environmental racism in Philadelphia to the crisis. She details the experiences of the low-income residents as well as a creative solution that helps.

The US Water Alliance described at the start of this section has provided the most comprehensive view of water access in the United States and is dedicated to valuing and managing this resource. Via listening sessions and collaborations with businesses, governments, non-profit organizations and individuals all over the country, they have developed a platform of seven big ideas to sustain water resources:

  1. Advance regional collaboration on water management
  2. Accelerate agriculture-utility partnerships to improve water quality
  3. Sustain adequate funding for water infrastructure
  4. Blend public and private expertise and investment to address water infrastructure needs
  5. Redefine affordability for the 21st century
  6. Reduce lead risks, and embrace the mission of protecting public health
  7. Accelerate technology adoption to build efficiency and improve water service.

Ideas and organizations such as this one provide leadership so that all families in the United States will have access to safe water and sanitation.


Licenses and Attributions

Open Content, Shared Previously

A Brief History of Environmental Justice” by ProPublica. License Terms:  CC BY 4.0.

Figure 9.10. “Water Bottle Fountain, Brokeoff Mountain 2015” by ray_explores. License: CC BY 2.0.

Figure 9.12. “Distribution of household income in Flint, Michigan in 2015” by Delphi234. CC0. Data from US Census in 2015 inflation adjusted dollars.

Figure 9.13. “1968 General Motors Buick Electra Pontiac Calalina Caprice Olds 98 Fleetwood Advertisement Readers Digest November 1967” by SenseiAlan. License: CC BY 2.0.

Figure 9.14. “ArtWalk in Flint Michigan Photo by Michigan Municipal League” by Michigan Municipal League (MML) License: CC BY-ND 2.0.

Figure 9.15. “Library” by Albuquerque South Broadway Cultural Center. License: CC BY 2.0.

Figure 9.16. “Longview Farm Water Tower” by Vincent Parsons. License: CC BY-NC 2.0.

Figure 9.17. “water fountains” by drpavloff. License: CC BY-NC 2.0.

Figure 9.18. “Indoor Shower” by KevinStandlee is licensed under CC BY-NC-SA 2.0.

All Rights Reserved Content

A creative solution for the water crisis in Flint, Michigan | LaToya Ruby Frazier ” (c) TED. License: Standard Youtube license.

Figure 9.11. “An Overview of Clean Water Access Challenges in the United States” (c) University of North Carolina Environmental Finance Center. Used under fair use.



  1. Brooks, C. J., Gortmaker, S. L., Long, M. W., Cradock, A. L., & Kenney, E. L. (2017). Racial/ethnic and socioeconomic disparities in hydration status among us adults and the role of tap water and other beverage intake. American Journal of Public Health, 107(9), 1387–1394. https://doi.org/10.2105/AJPH.2017.303923
  2. US Water Alliance. Dig Deep. (2019, November). Closing the water access gap in the United States. http://uswateralliance.org/sites/uswateralliance.org/files/Closing%20the%20Water%20Access%20Gap%20in%20the%20United%20States_DIGITAL.pdf
  3. U.S. Census Bureau. (2020). QuickFacts: Flint City, Michigan [table]. Retrieved February 17, 2020 from https://www.census.gov/quickfacts/flintcitymichigan
  4. City of Flint. (2012, April 15). Quarterly report to the state Treasurer regarding the financial condition of the City of Flint. https://www.cityofflint.com/wp-content/uploads/Reports/Quarterly%20Report%20to%20State%20Treasurer%20April%2015,%202012.pdf
  5. Mantha, A. & Roy, S. (2015, August 24). Hazardous waste-levels of lead found in a Flint household's water. http://flintwaterstudy.org/2015/08/hazardous-waste-levels-of-lead-found-in-a-flint-households-water/
  6. Environmental Protection Agency. (2019, August 12). Learn about lead. https://www.epa.gov/lead/learn-about-lead
  7. AlHajal, K. (2016, January 13). 7 cases, 10 fatal, of Legionella bacteria found in Flint area; connection to water crisis unclear. MLive. https://www.mlive.com/news/detroit/2016/01/legionaires_disease_spike_disc.html
  8. Environmental Protection Agency. (2020, February 17). Environmental justice. https://www.epa.gov/environmentaljustice
  9. State of Michigan Department of Technology, Management, and Budget. (2016, April). Demographic and labor market profile: City of Flint. http://milmi.org/Portals/198/publications/Flint_City_Demographic_and_Labor_Mkt_Profile.pdf
  10. Metzger, K. & Booza, J. (2002, February). African Americans in the United States, Michigan and Metropolitan Detroit. Wayne State University. Center for Urban Studies. http://www.cus.wayne.edu/media/1356/aawork8.pdf
  11. Mapes, J. (2019, January 10). Charting the decline of Oregon's timber industry. Oregon Live. https://www.oregonlive.com/mapes/2012/01/charting_the_decline_of_oregon.html
  12. Friedman, G. R. (2019, January 9). Douglas County libraries to close after voters reject funding. https://www.oregonlive.com/politics/2017/03/douglas_county_libraries_to_cl.html.
  13. Swinder, S. (2017, April 5). When libraries close, timber counties face tough reality.https://www.oregonlive.com/pacific-northwest-news/2017/04/when_libraries_close_timber_co.html
  14. Mapes, J. (2014, December 10). Federal payments to timber counties die in last-minute congressional maneuvering. Oregon Live. https://www.oregonlive.com/mapes/2014/12/federal_payments_to_timber_cou.html


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Contemporary Families: An Equity Lens 1e Copyright © 2020 by Elizabeth B. Pearce and Alexis Castaneda-Perez is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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