Public water works: How international and local initiatives to support public water systems are essential for public health

In public health history, public water systems are often hailed as one of our greatest victories. For over a century, implementation of strong public water systems and the safeguarding of access to clean, reliable drinking water have had a profound impact on the health of populations. In 1900, waterborne diseases, such as typhoid and dysentery accounted for 44 percent of all mortality in U.S. cities. The introduction of filtration and chlorination systems led to major reductions in mortality, explaining nearly half the overall reduction in mortality from 1900-1936. Even more striking, in the same time-frame, research suggests that clean water was responsible for three quarters of the decline in infant mortality and nearly two thirds of the decline in child mortality. Public water has served as a key vehicle for prevention that reaches across populations, ensuring that our built environment and infrastructure supports prevention of waterborne illness and that people have access to this basic human right. Yet currently, this fundamental public service is under threat because of under-funding and the impact of transnational water corporations in international and local policies that undermine confidence in public water systems. Public reinvestment and political commitment to public water is critical to public health, and this presentation will explore the critical role of international institutions, such as the World Bank, and mayors, city officials, and national leaders in supporting public water for public health. This presentation will also examine: the history of public water systems and their impact on public health; the threat of the bottled water and water privatization industries, which jeopardize prevention efforts; and finally, the role of health professionals, government officials, and residents in ensuring that our global and local communities reinvest in public water, bolstering and safeguarding this fundamental public service and public health tool for generations.