By Shereen Lehman

(Reuters Health) – Drinking water violations may be more common in U.S. counties with greater numbers of minorities, low-income families, and uninsured households, a new report suggests.

More efforts are needed to ensure everyone in the U.S. has access to safe drinking water, the authors say.

“The Flint Water Crisis demonstrated that while the United States has one of the safest drinking water supplies in the world, there are problems. Flint is not an isolated incident,” coauthors Yolanda McDonald and Nicole Jones told Reuters Health by email.

McDonald is with the Peabody College at Vanderbilt University in Nashville and Jones is with the University of Missouri in Columbia.

McDonald and Jones say they wanted a better sense of how often water violations occur and whether “people of color and low socioeconomic status were more likely to be disproportionately burdened by poor water quality.”

The authors used information from the U.S. Environmental Protection Agency’s Safe Drinking Water Information System to identify water violations from 2011 to 2015. They also analyzed demographic data from the American Community Survey.

McDonald and Jones say they excluded Indian reservations and U.S. territories because in those communities, the historical injustices that have contributed to water quality, access, and administrative challenges are outside the scope of this study.

“We found that in counties that with a higher proportion of people of color, low-income households, and uninsured households, there was a greater risk of turning on the kitchen tap and water pouring out that did not meet drinking water standards,” McDonald and Jones said.

The violations were especially problematic in water systems that serve large populations (i.e., 50,000 people or more), McDonald and Jones reported in the American Journal of Public Health.

City, county, and state administrators need to work with the federal government, water utility companies, public health departments, and citizens to make safe drinking water a priority, the coauthors said.

“We can no longer ignore the aging infrastructure of community drinking water systems and wait for another Flint crisis,” they added. “We can no longer afford to not care about drinking water quality until it becomes a problem. We should be proactive versus reactive. We need to work with our local drinking water suppliers because they are a part of our community.”

They call for increased awareness of how the Safe Drinking Water Act operates, including the provision for citizens’ rights to enforce compliance with regulations.

On its website, the EPA explains, “The Safe Drinking Water Act (SDWA) is the federal law that protects public drinking water supplies throughout the nation. Under the SDWA, EPA sets standards for drinking water quality and with its partners implements various technical and financial programs to ensure drinking water safety. (

“We need to think globally, act locally about drinking water supplies,” McDonald and Jones said.

SOURCE: American Journal of Public Health, online August 23, 2018.