The importance of water and sanitation for public health is once again visible and may change the trajectory of the water sector moving forward. Given that water is essential for public health, what must be done to ensure that these life-sustaining services are affordable and accessible to all and the utilities providing services are financially resilient? How do we reconcile the different values as individuals and society negotiate who decides, who gets what, and who pays. In a just society this process is inclusive, meaning all have a seat at the table.
To unpack these questions, this paper explores the evolution of water services in the United States. The construction of water and wastewater systems during the 19th and early 20th century were significant feats. Now, most people have access to water, most tap water is drinkable, most dams are secure, most farms can grow more with less water, and most rivers are cleaner than they were 50 years ago. Most does not mean all. There is growing evidence that an increasing number of Americans are losing access to safe drinking water and sanitation—and others never had it at all.