Worldwide, an estimated 785 million people lack access to clean drinking water. According to the results of new studies published in the Proceedings of the National Academy of Sciences of the United States of America and the American Journal of Public Health, some of these people reside in the richest country on earth—the United States.

Access to potable water and sanitation services and facilities is considered a fundamental human right under international law. In 2010, the General Assembly of the United Nations declared that lack of these resources “has a devastating effect on the health, dignity, and prosperity of billions of people and has significant consequences for the realization of other human rights,” reports Medical News Today.

Consumption of water contaminated with human waste is a major risk factor for several bacterial and parasitic diseases, including cholera, diarrhea and schistosomiasis (snail fever). Combined, the first two conditions cause hundreds of thousands of deaths annually. The U.S. Centers for Disease Control and Prevention estimates that 446,000 children under age 5 die of diarrhea every year alone.

The first of the new studies found that between 2013 and 2017, 1,121,100 Americans had “insecure water access,” including 65,000 New Yorkers. However, study authors cautioned that the actual number is likely significantly higher because the U.S. Census Bureau frequently undercounts renters, people experiencing homelessness and people of color. In 2019, the water safety advocacy organizations DigDeep and the U.S. Water Alliance produced an exposé citing evidence that Black and Latino households are nearly twice as likely to have inadequate plumbing as white households. Additionally, Native American households are 19 times as likely to live with inadequate plumbing as white households.

The second study estimated that between 2017 and 2019, 610,000 city-dwelling Americans did not have “at least basic water access” and 930,000 city-dwelling Americans did not have “at least basic sanitation” access.

In response to calls to action by DigDeep and the U.S. Water Alliance, President Joe Biden pledged $111 billion to efforts to build and improve water infrastructure as part of his American Jobs Plan on March 31, 2021. That includes $56 billion specifically earmarked for “states, tribes, territories and disadvantaged communities.” It’s a step in the right direction, George McGraw, the chief executive officer of DigDeep, told Medical News Today. But “it is impossible that the problem will be solved overnight,” he added.

In addition, climate change coupled with population growth makes it likely that the problem will only increase in scope in the coming years.