摘要：Potable drinking water is essential to public health; however, few studies have investigated income or racial disparities in water infrastructure or drinking water quality. There were many case reports documenting a lack of piped water or serious water quality problems in low income and minority communities, including tribal lands, Alaskan Native villages, colonias along the United States–Mexico border, and small communities in agricultural areas. Only 3 studies compared the demographic characteristics of communities by the quality of their drinking water, and the results were mixed in these studies. Further assessments were hampered by difficulties linking specific water systems to the sociodemographic characteristics of communities, as well as little information about how well water systems operated and the effectiveness of governmental oversight. Water supply infrastruc ture in the United States ranges from large systems serving millions of people to private wells serving a single family. In all, this infrastructure provides piped water to the homes of over 99% of the US population. Despite such high levels of access, there were reports from several parts of the country suggesting race and income driven disparities in access to piped and/or potable water. 1 – 6 The extent of disparities in the US drinking water infrastructure and drinking water quality, particularly as related to race and income, has not been well examined. An earlier review of the evidence linking income and race to health risk and drinking water quality identified only a few case studies, concluding “…inequities in exposure to contaminants in water may exist.” 7 Seventeen years after this review, only a handful of published studies addressed this issue. Racial and income disparities in drinking water infrastructure were reviewed with the goal of identifying disparity prone aspects of this infrastructure. As a first step, a framework was proposed that depicted key elements of the drinking water infrastructure in the United States. This framework took a systems approach, thus facilitating identification of aspects of the system that could trigger or enabled disparities, or even limited the mitigation of known disparities. Evidence of infrastructure and concomitant water quality disparities were reviewed using this framework, and the methodological issues that limited the assessment of disparities in water infrastructure were discussed.
