Public Health a Low Priority for Water and Sewer Extensions, Study Finds - North Carolina Health News
Much of the improvement in health and longevity over the past century can be attributed to better sanitation. But more recently, this important public health function has become an afterthought in municipal budgets.
By Gabe Rivin
Cost, rather than a concern for public health, can take priority when local officials decide whether to expand water and sewer lines into unserved areas, a new study by UNC-Chapel Hill researchers found.
The researchers found that even in densely populated communities, officials focused on the large costs of water and sewer services rather than on the health benefits that off-the-grid citizens stand to gain.
The finding is significant because in North Carolina about 30 percent of residents rely on private wells for their drinking water, according to the N.C. Department of Health and Human Services. Some 48 percent of residents use septic systems to treat their sewage, the department estimates, though those figures are based on U.S. Census data from 1990, the last year the information was collected.
Nationally, an estimated 15 percent of Americans use private water wells and 25 percent use septic systems, both about half the rate for North Carolina.
If improperly monitored, these water and sewage systems can threaten the public’s health, the researchers warn in their study published Aug. 13 in the American Journal of Public Health. Well water is not covered by federal drinking-water standards. This means its safety is largely a question for homeowners who use drinking-water wells.
“The existing literature has put health concerns as a major factor for why we should extend water and sewer services to as many people as possible,” said Julia Naman, the lead author of the study.
The researchers also raised concerns about the prevalence of septic systems in North Carolina. When used properly, these systems can treat harmful pathogens in human waste, allowing residents to safely dispose of their sewage, according to Mike Hoover, a retired professor of soil science at N.C. State University and an expert in septic systems.
But septic systems can fail – and often do, Hoover said. DHHS estimates that 6 to 10 percent of septic systems fail annually in North Carolina. But Hoover said that, on average, 10 to 20 percent of septic systems fail each year.
This can be a problem.
Untreated septic wastes from a failed system can seep into groundwater, which residents draw from their wells as drinking water. Sewage can also overflow into the streets and into nearby bodies of water, spreading potentially harmful pathogens to humans who come in contact with it.
An expensive option
In urban areas throughout North Carolina, residents rely on public sewers and public drinking water.
When these residents use their toilets, waste travels through their home’s sewage pipes and then into a system of municipal sewers. Sewers ultimately lead to public wastewater treatment plants.
Drinking water can take a similarly circuitous route. Municipal plants draw water from lakes and rivers, among other sources. They then filter and sanitize the raw water, removing pathogens and solid matter. The clean water is then pumped through a network of water pipes and storage tanks, which deliver water to residents’ kitchen sinks.
Federal legislation – the Clean Water Act and the Safe Drinking Water Act – set standards for these services in order to protect the public’s health.
But water and sewer systems are expensive to build and maintain. And extending services into sparsely populated rural areas can be prohibitively expensive.
“We cannot afford financially to sewer up the United States,” Hoover said. “If we were to do that, there would literally be no money left for schools, for senior citizen centers, for libraries.”
Short on money, short on data
The UNC researchers acknowledge that these services are impractical for some rural residents. But some areas in North Carolina, they say, are close to cities with municipal services, and are densely populated. And yet these areas are still without municipal water and sewer services.
“You would not be able to tell the difference if you went from a city neighborhood to one of these communities,” Naman said.
The researchers sought to understand this phenomenon. So they interviewed influential community members in three counties: Hoke, Transylvania and New Hanover. These counties have unincorporated neighborhoods that lack water or sewer services, or both, and are near cities with these services.
The researchers interviewed a wide range of people, all of whom are involved in the decision to extend services. These included staff at public utilities, health officials, legislators, zoning officials, city and county managers and community members.
After conducting interviews, a consistent theme emerged. The high costs of water and sewer services, above all, weighed on communities’ decisions whether to extend services. The public’s health was generally a low priority in these discussions.
“Health is very central to this issue,” Naman said. And yet, she added, “Very few people, one, recognized the health risks that are associated with wells and septic tanks, and, two, were basing their decision-making off of these health risks.”
At the same time, the researchers said, septic system failures may go underreported. Health departments mainly place the responsibility on residents and neighbors to report a failure. But with potentially high repair costs to bring a system into compliance with state rules, residents may hesitate to request repair permits.
And that can cause a data gap for counties and cities, Naman said.
“They don’t have systematic data to prove that these communities are facing considerable health risks,” she said. “Without this systematic data, the county officials and city officials will assume that everything is fine, and the community members won’t have their problems addressed.”
Naman said that in New Hanover County, anonymous surveys helped fill this gap.
Going it alone
State officials acknowledge that off-the-grid residents have a greater responsibility to protect their own health.
“Having one’s own system puts one in control,” said Larry Michael, who heads the Environmental Health Section at DHHS. “Routine maintenance is essential to having your own decentralized wastewater system and/or well.”
Beyond maintaining wells, residents must also “take initiative to regularly sample for contaminants,” Michael said.
But he said municipal systems can also be sources of concern. Municipal systems can leak or get blocked up, causing a potential health hazard on a much larger scale, he said. That’s particularly true for aging infrastructures, he added.
N.C. State’s Hoover echoed this claim. He also questioned the assumption that sewers are always preferable to septic tanks.
“What I spent my career trying to tell people is, septic systems can be a permanent, dependable form of wastewater treatment,” he said. “But not so if they’re ignored and not maintained and not utilized correctly.”