Water and public health have long been tied together. The actual origin of public health as a field — tracing cholera outbreaks to contaminated drinking water in 18th-century London — shows just how fundamental water truly is. Today, stress on our freshwater systems, from salmon-bearing watersheds to small rural water providers serving families and farms, magnifies both climate and health challenges, especially for low-income and vulnerable communities.
Clean water is one of the most fundamental building blocks of public health, yet in the United States — one of the wealthiest nations in the world — safe and reliable water access is far from guaranteed. The connection between clean water and public health is obvious: Water is essential for drinking, cooking, bathing, sanitation, and the functioning of nearly every public health system we rely on. When water is contaminated or inaccessible, the ripple effects are felt across entire communities, contributing to both acute illnesses and long-term health disparities. Aging infrastructure, industrial pollution, agricultural runoff, and failing septic systems compromise water quality. Contaminants such as lead, PFAS “forever chemicals,” nitrates, and pathogens increase the risk of serious health issues, including gastrointestinal disease, developmental delays in children, reproductive challenges, and chronic illnesses like cancer. These risks fall disproportionately on low-income communities, rural areas, and communities of color — in neighborhoods that historically have been underinvested in and overexposed to environmental hazards. Clean water is not just an environmental need; it’s a matter of racial, economic, environmental, and health justice.
Water systems remain a common denominator in outbreaks of infectious disease, just as they were in London centuries ago. Waterborne pathogens like cryptosporidium, norovirus, and the bacteria that cause Legionnaires’ disease often signal deeper problems in water infrastructure. Chemical contaminants are also widespread; even more than 10 years after lead was found in Flint’s water supply, the nation continues to grapple with lead and other heavy metals in aging pipes.
Clean water sustains broader conditions for health. Hospitals, schools, childcare centers, parks, rivers, public fountains, and wastewater systems all rely on safe water, making it part of the essential fabric of our everyday lives. Yet millions of Americans experience water shutoffs due to affordability challenges, and others live with inadequate plumbing, making even basic hygiene difficult.
Maximizing the positive impact of clean water on public health requires coordinated, long-term action: modernizing infrastructure, enforcing protections, restoring ecosystems, and empowering communities to monitor and shape the water infrastructure systems they depend on. This work is at the heart of the Water Foundation’s partnership with Los Angeles County’s Safe Clean Water Program, which has granted over $8 million to more than 50 community organizations to help residents better understand and address these connections. One SCWP grantee, Pacoima Beautiful, has championed inclusive planning processes and long-term investments such as stormwater capture projects that double as green public spaces, showing how public health, water infrastructure, and community beautification seamlessly blend into one another.
Ultimately, clean, reliable, and affordable water is not only the foundation of public health — it is a positive force for thriving communities. Our broader partnership approach values both the integrity of freshwater systems and the well-being of the people who rely on them. Through collaborative action and community-centered grantmaking, we work to strengthen water systems and, in turn, the health of those they serve.