A Crisis We Would Rather Avoid: Water Quality and Public Health in the United States

Thomas Aldrich is a third year history and religious studies double major at Grinnell College. In his free time he enjoys singing, riding his bike around campus and out of town, and advocating for stronger government oversight.

For those of us who have lived our entire lives with a safe, secure water supply, the idea of anything else is nearly impossible to imagine. Unsafe water, especially drinking water, can seem like a problem thousands of miles away. Surely the richest country the world has ever seen, the United States of America, has clean drinking water for its citizens, the thinking goes. However, it is that exact notion that I wish to push back against.

The United States doesn’t have a water problem. It has many water problems . From pollution on a large scale from CAFO’s  in Iowa to lead pipes in Flint MI, to water affordability, in the coming years the U.S. will face a whole host of water and public health problems. This short essay seeks to answer why and what can be done to fix it through a presentation of the history of water problems in the U.S. and how they have been fixed. This essay will prove that it has been a failure of local, state, and federal governments to ensure that residents of the U.S. have safe drinking water.

To understand this problem in context, we need to address the historical precedent for water quality assurances. First seen in Ancient societies such as Egypt, India, Crete and Greece, disposal of wastewater and the assurance of safe drinking water has always been paramount for societies to flourish. In the United States, the first public water system was set up in Bethlehem, PA, in 1755 by Hans Christopher Christiansen. In 1842, New York City public officials brought an ample supply of water to the city from the Croton River. It was one of the earliest large municipal water supply projects in the United States [1].

Legislation supporting water quality has historical precedent in the United States. In 1892, Congress passed legislation to “develop regulations” to prevent the spread of disease from state to state [2]. It was not until 1912 that the first water regulations prohibited the use of common water cups on interstate common carriers. Finally, in 1914, the U.S. adopted U.S. Public Health Service Drinking Water Standards. They were not strict, however, as they only contained bacterial limits to protect a public that was traveling more than previous generations. The use of chlorine as a disinfectant became common for water in the United States by 1915. Combined, this meant that by the 1940’s, waterborne diseases were reduced in the largest U.S. cities by nearly 100-fold since 1910 [3].

Effective and impactful water quality legislation has only come about in the past 50 years or so. The 1960’s and 70’s specifically, were a time of legislative power over water health in the United States. Water quality standards became law in 1965 with the Water Quality Act, which required states to meet federal interstate water standards and if they did not develop plans for implementation and enforcement. By 1972, most states had met the new federal standards. In 1977, the most recent federal water quality standards were passed with the Clean Water Act (CWA), an amendment to the Federal Water Pollution Control Act of 1972 [4].

The CWA was the result of more than 100 years of State and Federal regulations and negotiations. It was developed as a way for Congress to regulate discharges and pollutants to waters inside the United States. Its three explicit goals were: eliminate discharges of pollutants into navigable waters, prohibit the discharge of toxic pollutants, and protect waters that allow for life such as fish, shellfish, and other wildlife to flourish. The history of the CWA itself is one of competing philosophies. One philosophy views water pollution in absolute moral terms, and the other counts it as the cost of economic activity that comes with a social benefit. These two philosophies informed the regulatory stance of the CWA. Effluent limitations propose to limit pollution at its source, while water quality standards accept that pollutants will be present in the water regardless, and defines how much of a pollutant a body of water may contain. Today, implementation of the CWA includes parts of both of these philosophies, but understanding the different approaches to water quality and safety is important to understand what we need to do better going forward [5].

So, in this brief history of water quality and the legislation concerning water quality, it has been well established that a strong precedent exists for stricter laws. This is specially seen in three well-documented areas where there are not currently enough laws to protect the citizens of the United States. Those three areas are water affordability, private drinking wells, and Iowa specific CAFO’s.

Water affordability has become a pressing issue within the United States. Presently, there are no laws that guarantee all citizens of the United States access to clean drinking water. There is little to no information on where households in the U.S. that don’t have clean drinking water are located. What we do know is that some major U.S. cities have increasingly alarming water shut-off rates. In Detroit, MI, 50,000 households had their water service terminated in 2014. Similarly, in Philadelphia, PA, around four of every ten water accounts were past due. The total number is somewhere around 227,000 citizens in Philadelphia [6]. Detroit and Philadelphia illuminate something that we would rather not believe- that water, something vital to everyone’s life, is not being distributed as though each life has value.

Of course, water affordability cannot fully be discussed without a discussion of intersectionality. The compounding economic factors such as high rates of unemployment, lack of healthcare, and those who rely on public assistance make water accessibility even harder. Those in low-income states face all of these problems, which correspond to the high risk states for water affordability problems. Mississippi, Louisiana, Alabama, Kentucky, and Arkansas are the top five states where water affordability is at a high risk [7]. Water affordability problems, to be blunt, are here and here to stay. They will start to affect more and more Americans each year, unless action is taken soon.

Private wells, similarly to water affordability, have little to no governmental oversight, despite the fact that roughly one in seven residents of the U.S. rely on a private well. Many of these private wells receive minimal oversight, as  tthe onus is on the individual to maintain the well, screen for pollutants, and eliminate them when discovered. This, however, is not as easy as it sounds. Often, residents assume that if their water tastes good and looks clear, there are no contaminants. Even if residents do suspect something, it can cost hundreds to thousands of dollars for effective in-home filters, and replacement can exceed $10,000. This, again, is an area affecting a broad range of households across the country. A 2013 study in rural Wisconsin found that of the 4,000 surveyed, 47% of privately owned wells had failed at least one health-based water standard. This is echoed in North Carolina, where between 2007 and 2013, nearly 99% of all acute gastrointestinal illnesses were caused by contaminated drinking water from private wells [8]. These figures are staggering. Yet neither the federal nor state governments have done much to anything to mitigate these clear continuous problems with private wells across the country.

Most states face local problems related to water quality and public health. In Iowa the problem is CAFO’s, or Confined Animal Feeding Operations. Iowa has nearly four times as many CAFO’s as it did in 2001, and now there are over 10,000 of various sizes around the state. While many know the smell consequences of living near a CAFO, few are aware of the water pollutant problems as well. Manure leaks and spills have been know to lead to fish kills, high levels of nitrate and ammonia pollution, hormones, antibiotics, to name a few [9]. This can and does lead to outbreaks of illness in both animals and humans. Adverse health effects can include liver damage, neurotoxicity, gastrointestinal problems, and a range of allergic reactions [10]. Currently, to the extent that laws exist covering CAFO’s pollution emissions into water, they are insufficient. It should be the duty of the elected officials of the state of Iowa to protect their citizens access to clean drinking water, regardless of agricultural runoff.

It is not easy to live in the United States today and never confront water accessibility issues in some capacity. Someone you know not having access to clean drinking water is going to become the norm. In all likelihood, it already is. However, I say this is not to end on a sour note. Rather, there are things that can and must be done. We must demand that clean drinking water is a right not a privilege, and that it should be for all and not just for the few that can afford it. Acceptance of this simple fact could vastly improve the lives of millions of Americans who struggle to know from where they will drink. The onus should be on us, the privileged, to fight for those who cannot fight for themselves. Providing water, a key to life, to everyone, would go a long way to evening that fight.


[1] Privatization of Water Services: An Assessment of Issues and Experience. Washington: National Academy Press, 2001. 30.

[2] Ibid, 32-33.

[3] Ibid, 34.

[4] Foster, Charles A., and Marty D. Matlock. “History of the Clean Water Act.” Water Resources IMPACT 3, no. 5 (2001): 26-30. http://www.jstor.org/stable/wateresoimpa.3.5.0026.

[5] Ibid

[6] Mack, Elizabeth A., and Sarah Wrase. “A Burgeoning Crisis? A Nationwide Assessment of the Geography of Water Affordability in the United States.” PLOS Medicine. January 11, 2017. Accessed April 2, 2018. 2. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169488.

[7] Ibid, 12-13.

[8] Merchant, James, and David Osterberg. “The Explosion of CAFOs in Iowa and Its Impact on Water Quality and Public Health.” The Iowa Public Policy Project. Iowa City, Iowa. January 2018. i.

[9] Ibid, i.

[10] Ibid, 15.

Further Reading:

Patrick, Ruth, Faith Douglass, Drew M. Palavage, and Paul M. Stewart. Surface Water Quality: Have the Laws Been Successful? Princeton University Press, 1992. http://www.jstor.org/stable/j.ctt7ztp8q.

Privatization of Water Services: An Assessment of Issues and Experience. Washington: National Academy Press, 2001. 30.

Rose, Joan B. “Americas Water Crisis Could Be Worse Than You Know.” Time. March 22, 2016. Accessed March 01, 2018. http://time.com/4266919/americas-water-crisis/.