Water may be a basic necessity of life, but not all American communities can trust that the water coming out of their faucets is safe to drink.

“There is no safe level of lead exposure for children,” said Lubna Ahmed, who opened a Tuesday morning APHA Annual Meeting session on “Water and Health Equity.” “Any standard that falls short of that jeopardizes the health of millions of children across the country and is especially offensive in environmental justice communities.”

Ahmed spoke about how her organization, WE ACT for Environmental Justice, is partnering with 20 other groups to end lead poisoning in New York City. The organization focuses on “environmental justice communities,” or those most affected by environmental harms or risks. These are typically low-income communities home to people of color living in both urban and rural areas and who bear the brunt of harmful exposures to toxics such as lead.

“But there is power in numbers,” said Ahmed, who called on attendees to support health-promoting policy change. “We can make a difference.”

Lindsay McCormick, program manager for the Environmental Defense Fund’s Health Program, noted that equity also factors into efforts to replace lead service lines, which represent a major source of drinking water contamination. Across the U.S., more than 6 million homes and businesses still get their drinking water from lead service lines.

The Environmental Defense Fund, along with APHA, is one of over two-dozen national organizations that formed the Lead Service Line Replacement Collaborative in 2016 to accelerate the process.

“Replacing (lead service lines) is the best long-term solution to protect public health, but it’s not easy and it’s expensive,” said McCormick. She offered examples of funding assistance that low-income homeowners can access to upgrade their water lines and ways to identify locations and prioritize lead service line replacements.

“Everyone deserves clean water, not just affluent white communities,” she told session attendees.

The city of Philadelphia, host to APHA 2019, is addressing another equity issue — water affordability. It’s created a first-of-its-kind, income-based rate structure known as the Tiered Assistance Program, or TAP.

“It’s an income-based water bill,” explained Susan Crosby, divisional deputy city solicitor with the City of Philadelphia.

Crosby also spoke about “tapwater distress,” which refers to the impact on well-being of not being able to trust the safety of available drinking water.

“It’s linked to increased consumption of bottled water and sugary beverages, which can have negative financial and health impacts,” she said. “We are very proud of our drinking water in Philadelphia. Yet, 40% of people here don’t drink tap water due to safety concerns like they’ve seen in Flint, Detroit or D.C.”

In response, Philadelphia launched a campaign to encourage people to drink tap water using community taste tests, trained water ambassadors, public art projects and more.

“We want to show them that it’s safe, affordable and delicious,” said Crosby.

Rounding out the panel was Surili Patel, deputy director of APHA’s Center for Public Health Policy. She celebrated the one-year anniversary of APHA’s Center for Climate, Health and Equity and spoke about the work it’s doing on safe water access.

“Water is a necessity of human life, and access to clean water is a fundamental human right,” she said. “Unfortunately, climate change jeopardizes the quality and safety of our water.”

Patel noted that climate-sensitive populations, such as children, the elderly, pregnant women and others, bear the largest burden of disease from waters that can be contaminated by extreme weather like floods and droughts.

“The aging infrastructure of our water system leaves low-income communities at higher risk of exposure as those communities may not have resources available to fix the problem,” she said. “They encounter structural racism, lack social capital and face language and other barriers. That’s the baseline, but as we know, climate change is a threat multiplier.”

Photo by Ridofranz, courtesy iStockphoto