Beautiful Plants For Your Interior
Richard M. Mizelle, Jr., Ph.D.
More than 2 million people in the United States live without indoor plumbing or usable drinking water. Although having to worry about the origin, purity, and safety of water is often considered a premodern problem or one that affects only low-income countries, events that culminated in a state of emergency for Jackson, Mississippi, in 2022 highlight the ongoing burden created by poor water infrastructure in many historically racialized communities.
Before 1900 and the “bacteriologic revolution,” illness was perceived as emerging from dangerous, unknown, and suspicious environments. According to the miasma theory of disease, foul airs, gases, and putrid waters were thought to bring death and suffering. Indeed, cholera and typhoid outbreaks were common in New York City, Chicago, Boston, and the country’s other growing urban areas. As the search for viruses and bacteria slowly displaced theories of environmental causes of disease by the early 20th century, the “sanitary city” ideal ushered in modernized water infrastructure with which technical experts protected consumers from water’s potential dangers and unknowable contents. By 1910, municipalities were waging war against waterborne diseases by adding chlorine to local water supplies. Though engineers and chemists argued that chlorine effectively purified waste and sewage, chlorination was costly and prompted accusations of poisoning. The Public Health Service Act of 1912 expanded federal jurisdiction over water sanitation and infrastructure. As a result, water in the United States is now assumed to be safe and its contents knowable. Yet Black, Indigenous, and Latinx populations have reason not to trust the availability and safety of water in their communities.
Jackson’s water crisis has been a “slow-moving disaster,” a result of decades of anti-Blackness, environmental racism, and historical inaction. As historians Jacob Remes and Andy Horowitz have written, disasters aren’t individual events occurring in isolation, but rather are part of the connective tissue of a community and region.1 When President Joe Biden declared a state of emergency in Mississippi in August 2022, after several weeks of a boil-water advisory, Jackson had been facing an emergency for decades.
The current disaster dates to the 1940s, when technical experts with local knowledge of the water system were dismissed and repairs were frequently postponed. By the late 1940s and 1950s, leaders reported to state officials the need for infrastructure repairs to the water and sewer systems. Though Jackson was a majority-White city for most of the 20th century, its racial makeup shifted dramatically in the 1970s and 1980s, when Black migration to the city led to a precipitous White flight and infrastructure disinvestment. A 2021 Clarion Ledger article highlighted changes in the city’s racial geography,2 which included 35,000 White residents leaving Jackson for neighboring counties in the decade after 1990.
Today, more than 80% of the city’s population of 150,000 is Black, and more than one quarter lives below the federal poverty level. Its water crisis is a window into long-standing and interconnected issues of poverty, unemployment, poor housing, health disparities, lack of health insurance, and structural racism in Mississippi.3 The state has the lowest life expectancy in the United States and consistently ranks among the country’s worst in various disease categories, including for rates of diabetes, hypertension, stroke, infant deaths, and deaths from cancer, heart disease, and chronic kidney disease. Rates of dialysis are similarly high. Lack of access to clean water contributes to health disparities in the United States and throughout the world, affecting people undergoing cancer treatment and those with other chronic diseases, as well as infant mortality and maternal health.
As in Flint, Michigan, residents in Jackson have also most likely experienced harmful effects of environmental lead contamination. In 2016, the Mississippi State Department of Health warned of possible lead in Jackson’s water system. For decades, residents had been dealing with brown and rusty water and wondering whether they were being poisoned with lead. Lead exposure is particularly harmful for children, in whom it can cause speech and developmental delays, hyperactivity, rashes, and neurologic problems. In adults, lead exposure can lead to painful skin irritation, heart problems, infertility, seizures, and coma. Some parents in Jackson have linked long-term lead exposure to rare skin disorders and behavioral and neurologic conditions in their children.3
Exposure of Jackson residents to environmental contaminants can be directly traced to a breakdown of city services. In January 2020, Jackson had roughly 10 employees in charge of preventing corrosion, water-main leaks and breaks, contamination, and loss of water pressure for the entire water system. More than 750 boil-water notices were sent to residents between 2015 and 2020 in response to water-line breaks and concerns about Escherichia coli contamination. System failures in February 2021 left 100,000 residents without water for weeks during the same winter storm that crippled the Texas grid. Storms brought 4 inches of snow, 2 inches of sleet, and multiple days of subfreezing temperatures to Mississippi, causing power outages and equipment failure at Jackson’s water-treatment plant. Mechanisms that could have prevented system failures during a winter storm weren’t in place.
In addition to highlighting problems related to environmental exposure and public health, the Jackson crisis is a story of racial capitalism and the shifting financial burden for water infrastructure. Chokwe Antar Lumumba successfully ran for mayor of Jackson in 2017, promising to address the city’s long-standing issues related to water and sewer infrastructure. Such issues are increasingly the responsibility of states and local communities. Municipalities are spending a growing percentage of their annual budgets on water infrastructure, while at the federal level, spending has been relatively flat over the past few decades.4
An amendment to the Safe Drinking Water Act in 1996 created the Drinking Water State Revolving Fund program, a grant program in which states (with support from the federal government) provide loans for public water systems that must be repaid by local communities, with interest. With a tax base that is often lower than that of other communities, majority-Black cities can have more difficulty repaying these loans.4 As geographer Sage Ponder has written, predominantly Black cities such as Flint, Detroit, and Jackson also have higher interest rates and lower credit ratings from major credit agencies than many majority-White cities, which makes the rebuilding or managing of city services difficult.5 Meanwhile, Mississippi Governor Tate Reeves hasn’t provided financial support for Jackson, and the state has required Lumumba to get approval from a conservative legislature to receive local funds for civic improvements. The disaster therefore illustrates the importance of financial systems, water infrastructure, and local politics when it comes to the effects of racism on public health.
The Jackson crisis continues to demonstrate the dangers associated with water insecurity and the ways in which daily life in many historically racialized communities is governed by a lack of usable water. Using bottled water to cook, clean, and bathe is psychologically stressful. Adding to this burden are rising utility bills for low-income people. Residents of poor and majority-Black cities are routinely disconnected from water systems because of their inability to pay. United Nations representatives have said that such shutoffs violate human rights.
Protections should be implemented to safeguard water consumption for all people. The ongoing disaster in Jackson represents a failure of local, state, and federal planning and investment related to water infrastructure. Historically racialized communities are especially likely to have unreliable water-infrastructure systems, which makes it imperative that the federal government provide resources for communities to make timely repairs. Some cost estimates for repairing Jackson’s water infrastructure are higher than $1 billion, a burden far too heavy for city officials and residents to carry alone. Cross-jurisdictional policies could be implemented to build a resilient water system that can prevent contamination with lead and other dangerous materials, is protected against inclement weather, and requires minimal monitoring to ensure constant operability, as well as to mitigate the costs of maintenance. Funding is essential, and Congress can protect communities like Jackson by providing funds to modernize the water infrastructure in ways that would prevent leaks and the accumulation of harmful bacteria and lead. Boil-water notices and low water pressure shouldn’t be a way of life. One T-shirt circulating in Jackson reads, “Welcome to Boil Water Alert Mississippi” — words that for many residents capture this ongoing, slow-moving disaster.
Disclosure forms provided by the author are available at NEJM.org.
This article was published on June 10, 2023, at NEJM.org.
Author Affiliations
From the Department of History, University of Houston, Houston.
Supplementary Material
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