Drinking Water in the United States: Implications of Water Safety, Access, and Consumption

Annu Rev Nutr. 2020 Sep 23:40:345-373. doi: 10.1146/annurev-nutr-122319-035707.


Recent water quality crises in the United States, and recognition of the health importance of drinking water in lieu of sugar-sweetened beverages, have raised interest in water safety, access, and consumption. This review uses a socioecological lens to examine these topics across the life course. We review water intakes in the United States relative to requirements, including variation by age and race/ethnicity. We describe US regulations that seek to ensure that drinking water is safe to consume for most Americans and discuss strategies to reduce drinking water exposure to lead, a high-profile regulated drinking water contaminant. We discuss programs, policies, and environmental interventions that foster effective drinking water access, a concept that encompasses key elements needed to improve water intake. We conclude with recommendations for research, policies, regulations, and practices needed to ensure optimal water intake by all in the United States and elsewhere.

Keywords: access; consumption; drinking water; life course; policy; water quality.

Publication types

  • Review

MeSH terms

  • Drinking Water*
  • Drinking*
  • Humans
  • United States
  • Water Quality / standards*
  • Water Supply*


  • Drinking Water