Using interviews conducted with 468 adults in nine different global locations, we tested for commonalities in how people culturally understand water-disease connections. On the basis of consensus analysis, we find evidence of shared cultural ideas about the causes and solutions to waterborne disease both within and across all locations. Causes of water-related illness with the highest salience in the different countries were comparable across sites, and mapped reasonably onto public health understandings. Comparison of specific items (statements) between public health and lay knowledge about the causes and solutions to waterborne disease showed a high level of agreement. We suggest that a straightforward, cohesive approach to water-health messaging in public health campaigns could often be the most effective point of departure, and that sophisticated cultural tailoring may be less important in regard to global waterborne disease prevention efforts than might be expected.