In Alaska over 66,000 residents (11%) lack access to safe drinking water. In the United States as a whole, 13 million people don't have access to safe drinking water. That's about the population of Tokyo, and almost 5 million more than the population of New York City.
The 2013 County Health Rankings (CHR) were released this week. While browsing the data, I noticed that Alaska has an alarmingly high percentage of residents with poor water quality. In Ketchikan Gateway, 99% of residents get water from public water systems with at least one health-based violation during the last year. The Northwest Arctic region isn't doing much better at 75%. Overall, 66,103 Alaskans drink from unsafe public water systems - that's 11% of the population, which is well above EPA's goal of 9%.
Drinking water in the United States is regulated by the Safe Water Drinking Act of 1974. The Environmental Protection Agency sets drinking water standards, and monitors compliance. A list of contaminants regulated by EPA can be found here. According to CHR, health-based violations can be categorized as: Maximum Contaminant Level, Maximum Residual Disinfectant Level and Treatment Technique.
The only notable demographic predictor of water quality that I found is median income, which also tracks closely with the percentage of the population that is Alaska Native. This fits with what we know about the intimate relationship between poverty, minority status, and health.
Why does access to safe drinking water matter? The CHR website explains:
"Recent studies estimate that contaminants in drinking water sicken 1.1 million people each year. Ensuring the safety of drinking water is important to prevent illness, birth defects, and death for those with compromised immune systems. A number of other health problems have been associated with contaminated water, including nausea, lung and skin irritation, cancer, kidney, liver, and nervous system damage."
Although my quick analysis didn't detect any associations between poor population health and poor drinking quality in the CHR data, many more sophisticated studies have.
Given that Alaska ranks poorly in many health measures compared to the lower 48, I thought/hoped the appalling drinking water quality was an isolated phenomenon. When I mapped the rest of the United States, I was sorely disappointed. A total of 13 million people get their water from public water systems with at least one health violation. There are 40 counties in which >90% of residents lack access to clean water. Of those 40, 15 are in Texas, and 5 are in Nebraska.
Percentage of population without access to safe water
Even though I'm a student of public health, I'm still surprised and disappointed at these numbers. Access to clean water and sanitation are a cornerstone of public health. A graphic I posted last month illustrates the huge downward trend in crude death rates attributed to infectious diseases in the 20th century. In that graphic, the continuous municipal use of chlorine in the water supply was identified as a major turning point in infectious disease mortality.
Part of the importance of clean municipal water is that it's a service people can't easily provide for themselves. Bottled water is expensive and impractical for drinking and cooking, so what are residents of these poor quality areas supposed to do?
The EPA does have goals to "strengthen public health protection from contaminants in drinking water." Unfortunately, public health agencies are facing more sequestration and budget cuts to an already-dwindling coffer. The future of safe drinking water initiatives seems woefully unclear.
If you want to learn more about safe drinking water in the United States, I like Mother Nature Network's post on the subject.
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