Jessica Lilly Published

Nonprofit Says Lack Of Water Access Is Costing U.S. Billions 


While the Infrastructure Investment and Jobs Act is expected to help with water lines and systems across the country, the new law wasn’t designed to help bring running water to every American. And yes, in America, in 2022 there are some families and communities that have never had running water or frequently lose water in their homes.

California based non-profit Dig Deep says there are 2.2 million people in the US who live without running water or a flush toilet in a report called “Closing the Water Access Gap in the United States.”

What is this costing the country?

A recent study found that the financial cost goes further than the individual families and their communities.

A study released this week by the same organization called, “Draining: The Economic Impact Of America’s Hidden Water Crisis,” found that the disparities cost families, communities and the US economy $8.58 billion each year.

George McGraw, the CEO at Dig Deep says while the cost starts at an individual and household level, it ripples out, eventually reaching the national economy as a portion of the Gross Domestic Product or GDP.

How did Dig Deep get to this number? 

“When you don’t have access to water and sanitation, it impacts every part of your life,” McGraw said.

The report accounts for things like time spent collecting water instead of going to school or work. McGraw said that’s money they don’t spend in their local economy, which in turn, contributes to the larger economy.


A family in Wyoming County was the central collection point for bottled water.

“And by our estimates, they’re causing almost a billion dollars in what economists call knock-on impacts to GDP,” McGraw said. “So our gross domestic product as a country is $1 billion lower than it could be if we closed the ‘water gap.’”

The report also accounted for the money a family spends on bottled water, additional health care because of a higher incidence of waterborne illness or diabetes. Lack of access to water is the reason more than 36,000 people have diabetes.

“Families that don’t have running water at home are more likely to buy sugary beverages,” McGraw said. “[Sugary drinks] are more aggressively marketed, they may seem more valuable than water, which may be the same price. In a lot of places we work, they’re just more available, it’s easier to buy a two liter of coke, than it is to buy a two liter of water. So this results in more cases of diabetes, hypertension, heart disease and death.”

McGraw points out that complications from diabetes increase because you can’t keep yourself healthy and clean at home without water.

What’s not in the report? 

As West Virginia Public Broadcasting found in 2017, the data about some water systems is limited or non-existent.

“We know from other surveys that about 2.2 million people or more in the U.S. don’t have running water or a flush toilet. We also know that that estimate is low because the census has a hard time penetrating rural areas where most of these people live, like rural West Virginia.”

Dig Deep found other limitations in the data and considers the staggering estimated cost “conservative.” The study focused on the 1.57 million people in the US who the census identified as living in households without running water or flush toilets. The report does not include people experiencing homelessness or people who can’t afford it or have had their water shut off.

“We couldn’t quantify, for instance, the health care burden for people who drink dirty water, because they don’t have access to clean water and are facing things like arsenic or lead poisoning,” McGraw said. “We couldn’t quantify the cultural impacts that this has on local communities, or the impacts of tourism or the water industry.”

How does this happen? 

It’s not a new problem. While some communities in West Virginia are familiar with losing consistent or clean water, there are still communities in America that have never had running water or flush toilets.

The report points to the New Deal after the Great Depression when President Franklin Roosevelt created several programs to help jump start the economy. The programs built water and sanitation systems through federal investment across the country. But the investments didn’t reach every community. The majority of the communities left out were poor, rural or communities of color.


Daniel Walker
Water tank in McDowell County before start of Elkhorn Water project.

“Since then, more communities have fallen offline because of economic shifts, or disinvestment and infrastructure,” McGraw said.

According to the Annals of the American Association of Geographers you are more likely to live without access to water if you are a person of color in the U.S. While that’s not the case in the mostly white state of West Virginia, the community on the longest boil water advisory in the state of recent has a population that’s mostly black.

In southern West Virginia, many communities were built as “coal camps” by companies. This included the infrastructure in the communities. When coal operators, people and jobs left the area, they left behind remnants like some beautiful buildings, coal tipples and water systems. The crumbling infrastructure is not reliable, which means living without consistent, clean tap water.

There are many coalfield communities that live with this challenge. Some households have gone months without tap water. That’s if they were able to get water at all.

But projects spearheaded by the McDowell County Public Service District are improving the quality of life for residents in the region. The Elkhorn Water Project started back in 2015.

It took a combination of a USDA loan and grants from USDA Rural Development in addition to the Economic Development Administration (EDA), the McDowell County Commission and McDowell County Economic Development Authority.

But all of this still wasn’t enough. Phase One and Two of the Elkhorn Water project connected a new water source and paid for new main lines and the installation but getting the lines from the public lines to the homes, came to a screeching halt in low income communities. Residents simply couldn’t afford to pay for the connection. Dig Deep helped bring the project across the finish line by hiring a local team and paying for the hookups in what’s called the Appalachian Water Project.

The town of Keystone first went on a boil water advisory in 2010. It was lifted earlier this year. The town of Northfork’s boil water advisory was also lifted after almost ten years. But there’s still more work to do in McDowell and other counties in Appalachia and across the country.

Credit Jessica Lilly

Jessica Lilly
Water pipe where people collect water for their homes in Wyoming County.

“The reason that hasn’t been solved, I think, is because a lot of these communities are invisible to other Americans and to lawmakers,” McGraw said.

The economic impact study suggests that America should invest a lot more federal dollars to close what they call the “water gap.”

“Federal investments, since the 1970s, have fallen off a cliff,” McGraw said. “It’s just 4 percent of what it used to be in water and sanitation, which leaves these communities kind of to fend for themselves.”

A lot of the money allotted from the Infrastructure Investment and Jobs Act is intended for things like lead line replacement.

“A lot of the families that we serve at Dig Deep still won’t benefit from those funds,” McGraw said.

There are Americans in all 50 states who don’t have water taps or toilets. Other than the Appalachian Project, Dig Deep is managing three other projects to help pay for water connections in these communities. Dig Deep says the government should help more, pointing to the “wrong pockets dimension.”

“Meaning that [Dig Deep] could create a tremendous amount of economic value by closing the water and sanitation gap by something like $200 billion over the next 50 years,” McGraw said. “But not one single investor recoups all of that, some will benefit families directly, some will benefit their communities, some will benefit the national economy. And when multiple people benefit from an investment, sometimes there’s not one party who’s incentivized enough to invest all that money. And in those circumstances, the federal government has to lead just like they did in the 30s in the 50s. In the 70s, when we built this infrastructure for the first time, they had to come in and make this commitment, and that is going to mean increased federal funding. But as this report shows, it’s well worth every dollar.”

Spending billions of dollars in low income communities? Really? 

Inflation in America hasn’t been this high for 40 years, so it might seem like a tough political pill to swallow on Capitol Hill, but McGraw says the inflation and potential recession challenges in the U.S. are the reasons why the federal government should invest in more water and wastewater.


Jessica Lilly
Coal mine in Keystone, W.Va.

“This economic impact study didn’t just show how much money the economy’s losing every year,” McGraw said. “It also showed how much money we stand to gain by investing in this. You know, when you have the looming specter of a recession, federal investments are important to get people working and to sort of juice the engine of the economy. And there’s really few better investments you can make on this one.”

The study calculated that for every dollar the country invests in new access to running water and flush toilets it can expect a $5 return back into the national economy.

“These investments that not only make people’s lives markedly better, and save lives — an estimated 600 lives a year are lost because of the water gap — but that actually generates an economic return that generates wealth to create prosperity in some of the most marginalized, economically marginalized parts of the country,” he said.